The pathogenesis of renal infection has no uniform pattern, but infection is the result of one or usually several different factors. Clinical and experimental observations show that an anatomically and functionally normal kidney is quite resistant to infection, and, on the other hand, all kidneys are very vulnerable to infection under certain circumstances. We have found that up to 10% of persons examined by consecutive autopsies had pyelonephritis,1 and in clinical studies 15% of patients with hypertension,2 58% of those who had a nephrectomy because of unilateral kidney disease,3 and 70% of patients with chronic urinary tract infections were found to have pyelonephritis in a biopsy specimen.4 Among these patients the clinical illness and mechanisms of pathogenesis varied greatly.
Concepts of Pathogenesis of Renal Infection
Much time and discussion have concerned the route by which bacteria lodge in the kidney. Recently Beeson has reviewed the evidence in