ICD-10: N11.1

Chronic obstructive pyelonephritis

Clinical Information

Inclusion Terms

  • Pyelonephritis (chronic) associated with stricture of ureter
  • Pyelonephritis (chronic) associated with kinking of ureter
  • Pyelonephritis (chronic) associated with anomaly of pelviureteric junction
  • Pyelonephritis (chronic) associated with obstruction of ureter
  • Pyelonephritis (chronic) associated with anomaly of pyeloureteric junction
  • Pyelonephritis (chronic) associated with crossing of vessel
  • Pyelonephritis (chronic) associated with stricture of pelviureteric junction

Additional Information

Description

Chronic obstructive pyelonephritis, classified under ICD-10 code N11.1, is a significant renal condition characterized by long-term inflammation and scarring of the kidney tissue, primarily affecting the renal pelvis and calyces. This condition often results from recurrent urinary tract infections (UTIs) or obstructive uropathy, leading to progressive kidney damage.

Clinical Description

Definition

Chronic obstructive pyelonephritis is defined as a chronic inflammatory condition of the kidney that is associated with obstruction of the urinary tract. This obstruction can be due to various factors, including anatomical abnormalities, kidney stones, or tumors, which impede normal urine flow and create an environment conducive to infection and inflammation[1][2].

Pathophysiology

The pathophysiology of chronic obstructive pyelonephritis involves a cycle of infection and obstruction. The obstruction leads to urine stasis, which increases the risk of bacterial growth. The persistent infection causes inflammation, resulting in scarring and fibrosis of the renal parenchyma. Over time, this can lead to a decline in kidney function and, in severe cases, renal failure[3][4].

Symptoms

Patients with chronic obstructive pyelonephritis may present with a variety of symptoms, including:
- Flank pain: Often unilateral, depending on which kidney is affected.
- Fever and chills: Indicative of infection.
- Dysuria: Painful urination.
- Increased urinary frequency and urgency: Common in urinary tract infections.
- Nausea and vomiting: May occur due to systemic infection or renal impairment[5].

Diagnosis

Diagnosis typically involves a combination of clinical evaluation, imaging studies, and laboratory tests:
- Imaging: Ultrasound or CT scans can reveal structural abnormalities, hydronephrosis (swelling of the kidney due to urine buildup), and signs of chronic changes in the kidney.
- Urinalysis: This may show signs of infection, such as the presence of white blood cells, bacteria, and nitrites.
- Blood tests: These can assess kidney function (e.g., serum creatinine levels) and detect signs of infection (e.g., elevated white blood cell count) [6][7].

Treatment

Management of chronic obstructive pyelonephritis focuses on addressing the underlying cause of the obstruction and controlling the infection:
- Antibiotics: To treat any active infection.
- Surgical intervention: May be necessary to relieve obstruction, such as the removal of kidney stones or correction of anatomical abnormalities.
- Supportive care: Including hydration and monitoring of kidney function, especially in cases of significant renal impairment[8][9].

Prognosis

The prognosis for patients with chronic obstructive pyelonephritis largely depends on the extent of kidney damage at the time of diagnosis and the effectiveness of treatment. Early intervention can lead to improved outcomes, while delayed treatment may result in irreversible kidney damage and potential progression to chronic kidney disease[10].

In summary, chronic obstructive pyelonephritis is a complex condition that requires a multidisciplinary approach for effective management. Understanding its clinical features, diagnostic criteria, and treatment options is crucial for healthcare providers to optimize patient outcomes.


References

  1. ICD-10 code: N11.1 Chronic obstructive pyelonephritis.
  2. ICD-10-CM Diagnosis Code N11.1 - Chronic obstructive pyelonephritis.
  3. Pyelonephritis ICD-10-CM Codes | 2023.
  4. ICD-10 Code for Chronic obstructive pyelonephritis- N11.1.
  5. Interstitial Nephritis | 5-Minute Clinical Consult.
  6. Validating Use of Electronic Health Data to Identify Patients.
  7. 2025 ICD-10-CM Diagnosis Code N11.1.
  8. ICD-10-CM Code for Chronic obstructive pyelonephritis N11.1 - AAPC.
  9. N11.1 ICD 10 Code - Chronic obstructive pyelonephritis - Billable.
  10. ICD-10 (2024) Code: N111 (Diagnosis) - HIPAASpace.

Clinical Information

Chronic obstructive pyelonephritis, classified under ICD-10 code N11.1, is a significant renal condition characterized by chronic inflammation of the kidney due to recurrent urinary tract infections (UTIs) and obstruction. Understanding its clinical presentation, signs, symptoms, and patient characteristics is crucial for effective diagnosis and management.

Clinical Presentation

Chronic obstructive pyelonephritis typically presents with a combination of symptoms related to both the urinary tract and the underlying renal pathology. The condition often develops insidiously, making early diagnosis challenging.

Signs and Symptoms

  1. Flank Pain: Patients may experience persistent or intermittent pain in the flank region, which can be dull or sharp, often exacerbated by movement or palpation.

  2. Fever and Chills: Recurrent episodes of fever, sometimes accompanied by chills, may occur, indicating ongoing infection or inflammation.

  3. Dysuria: Patients often report painful urination, which can be a result of associated urinary tract infections.

  4. Increased Urinary Frequency and Urgency: There may be a notable increase in the frequency of urination, often accompanied by a sense of urgency.

  5. Nausea and Vomiting: Some patients may experience gastrointestinal symptoms, including nausea and vomiting, particularly during acute exacerbations.

  6. Hematuria: Blood in the urine can occur, which may be visible (gross hematuria) or detectable only through urinalysis.

  7. Weight Loss and Fatigue: Chronic conditions often lead to systemic symptoms such as weight loss and fatigue due to the body's ongoing inflammatory response.

Patient Characteristics

Certain patient characteristics can predispose individuals to chronic obstructive pyelonephritis:

  • Age: This condition can occur in individuals of any age but is more common in middle-aged adults due to the cumulative effects of recurrent infections and potential anatomical abnormalities.

  • Gender: Women are generally at a higher risk for urinary tract infections, which can lead to chronic pyelonephritis, although men with urinary obstruction (e.g., due to prostatic hypertrophy) are also at risk.

  • Underlying Conditions: Patients with diabetes mellitus, immunocompromised states, or anatomical abnormalities of the urinary tract (such as vesicoureteral reflux) are more susceptible to developing chronic obstructive pyelonephritis.

  • History of UTIs: A significant history of recurrent urinary tract infections is often noted in patients, which can lead to chronic kidney damage over time.

  • Obstructive Uropathy: Conditions that cause urinary obstruction, such as kidney stones or tumors, can contribute to the development of this condition by preventing normal urine flow and leading to infection.

Conclusion

Chronic obstructive pyelonephritis is a complex condition that requires careful clinical evaluation and management. Recognizing the signs and symptoms, along with understanding patient characteristics, is essential for timely diagnosis and treatment. Early intervention can help prevent further renal damage and improve patient outcomes. Regular follow-up and monitoring are also critical for managing this chronic condition effectively.

Approximate Synonyms

Chronic obstructive pyelonephritis, classified under ICD-10 code N11.1, is a specific renal condition characterized by chronic inflammation of the kidney due to recurrent urinary tract infections, leading to obstruction. Understanding alternative names and related terms for this condition can enhance clarity in medical documentation and communication. Below are some of the alternative names and related terms associated with N11.1.

Alternative Names for Chronic Obstructive Pyelonephritis

  1. Chronic Pyelonephritis: This term is often used interchangeably with chronic obstructive pyelonephritis, although it may not specifically denote the obstructive component.

  2. Obstructive Pyelonephritis: This name emphasizes the obstruction aspect of the condition, which is a critical feature of N11.1.

  3. Chronic Tubulo-Interstitial Nephritis: While this term broadly refers to chronic inflammation of the renal tubules and interstitium, it can be related to chronic obstructive pyelonephritis when obstruction is a significant factor.

  4. Chronic Renal Infection: This term may be used in a more general context to describe ongoing infections affecting the kidneys, which can lead to chronic obstructive pyelonephritis.

  5. Recurrent Pyelonephritis: This term highlights the recurrent nature of the infections that can lead to chronic obstructive pyelonephritis.

  1. Urinary Tract Infection (UTI): Chronic obstructive pyelonephritis often results from recurrent UTIs, making this term relevant in discussions about the condition.

  2. Hydronephrosis: This term refers to the swelling of a kidney due to a build-up of urine, which can occur as a result of obstruction in chronic obstructive pyelonephritis.

  3. Renal Obstruction: This term describes any blockage in the urinary tract that can lead to conditions like chronic obstructive pyelonephritis.

  4. Chronic Kidney Disease (CKD): While not synonymous, chronic obstructive pyelonephritis can contribute to the progression of CKD if left untreated.

  5. Interstitial Nephritis: This term refers to inflammation of the kidney's interstitial tissue, which can be a component of chronic obstructive pyelonephritis.

Conclusion

Understanding the alternative names and related terms for ICD-10 code N11.1 is essential for accurate diagnosis, treatment, and documentation in medical practice. These terms not only facilitate better communication among healthcare professionals but also enhance patient understanding of their condition. If you have further questions or need more specific information regarding chronic obstructive pyelonephritis, feel free to ask!

Diagnostic Criteria

Chronic obstructive pyelonephritis, classified under ICD-10 code N11.1, is a specific type of kidney inflammation that is characterized by the obstruction of urinary flow, leading to recurrent infections and potential kidney damage. The diagnosis of this condition involves several criteria, which can be categorized into clinical, laboratory, and imaging findings.

Clinical Criteria

  1. Symptoms: Patients may present with symptoms such as:
    - Flank pain or discomfort
    - Fever and chills
    - Nausea and vomiting
    - Dysuria (painful urination)
    - Increased frequency and urgency of urination

  2. History of Urinary Tract Infections (UTIs): A history of recurrent UTIs, particularly those that are complicated or resistant to standard treatment, can indicate chronic obstructive pyelonephritis.

  3. Obstructive Symptoms: Symptoms related to urinary obstruction, such as difficulty urinating or a weak urine stream, may also be present.

Laboratory Criteria

  1. Urinalysis: The presence of:
    - White blood cells (WBCs) indicating infection
    - Bacteria in the urine
    - Possible hematuria (blood in urine)

  2. Urine Culture: Positive cultures for uropathogens, particularly if they are resistant to common antibiotics, can support the diagnosis.

  3. Blood Tests: Elevated serum creatinine levels may indicate impaired kidney function, which can be a consequence of chronic obstruction and infection.

Imaging Criteria

  1. Ultrasound: Renal ultrasound may reveal:
    - Hydronephrosis (swelling of the kidney due to urine buildup)
    - Structural abnormalities in the urinary tract, such as stones or strictures

  2. CT Scan: A computed tomography (CT) scan can provide detailed images of the kidneys and urinary tract, helping to identify:
    - Obstructions
    - Abscesses
    - Other anatomical abnormalities contributing to the condition

  3. MRI: In some cases, magnetic resonance imaging (MRI) may be used to assess kidney structure and function, particularly if there are concerns about other underlying conditions.

Conclusion

The diagnosis of chronic obstructive pyelonephritis (ICD-10 code N11.1) is multifaceted, relying on a combination of clinical symptoms, laboratory findings, and imaging studies. A thorough evaluation is essential to confirm the diagnosis and to rule out other potential causes of the patient's symptoms. Early diagnosis and management are crucial to prevent further kidney damage and complications associated with this condition.

Treatment Guidelines

Chronic obstructive pyelonephritis, classified under ICD-10 code N11.1, is a condition characterized by chronic inflammation of the kidney due to recurrent urinary tract infections (UTIs) and obstruction. This condition can lead to significant renal damage if not managed appropriately. Here, we will explore the standard treatment approaches for this condition, including medical management, surgical interventions, and supportive care.

Understanding Chronic Obstructive Pyelonephritis

Chronic obstructive pyelonephritis typically arises from long-standing urinary obstruction, which can be caused by anatomical abnormalities, kidney stones, or tumors. The obstruction leads to urine stasis, creating an environment conducive to bacterial growth and recurrent infections. Over time, this can result in renal scarring and loss of kidney function.

Standard Treatment Approaches

1. Medical Management

Antibiotic Therapy

  • Initial Treatment: The cornerstone of treatment for chronic obstructive pyelonephritis is the use of antibiotics to manage infections. Empirical antibiotic therapy is often initiated based on local resistance patterns and the patient's history of infections[1].
  • Culture and Sensitivity: Once urine cultures are obtained, antibiotic therapy may be adjusted according to the sensitivity results to ensure effective treatment of the specific pathogens involved[2].

Management of Underlying Conditions

  • Addressing Obstruction: Identifying and treating the underlying cause of urinary obstruction is crucial. This may involve the use of medications to manage conditions like benign prostatic hyperplasia (BPH) or urethral strictures[3].
  • Pain Management: Analgesics may be prescribed to manage pain associated with kidney infections or obstruction[4].

2. Surgical Interventions

Surgical Decompression

  • Indications: If the obstruction is severe or persistent, surgical intervention may be necessary. This can include procedures to remove obstructions, such as ureteral stenting or nephrostomy, which helps to drain urine from the kidney[5].
  • Corrective Surgery: In cases where anatomical abnormalities are present, corrective surgery may be performed to restore normal urinary flow and prevent future infections[6].

Kidney Removal

  • Nephrectomy: In cases of significant renal damage or recurrent infections that do not respond to other treatments, nephrectomy (removal of the affected kidney) may be considered to prevent further complications[7].

3. Supportive Care

Hydration

  • Fluid Intake: Maintaining adequate hydration is essential to help flush out bacteria and prevent further complications. Patients are often advised to increase their fluid intake unless contraindicated[8].

Monitoring and Follow-Up

  • Regular Check-Ups: Continuous monitoring of kidney function and regular follow-up appointments are important to assess the effectiveness of treatment and make necessary adjustments[9].
  • Imaging Studies: Periodic imaging studies, such as ultrasounds or CT scans, may be performed to evaluate the status of the kidneys and any obstructions[10].

Conclusion

The management of chronic obstructive pyelonephritis (ICD-10 code N11.1) requires a comprehensive approach that includes antibiotic therapy, addressing underlying causes of obstruction, and potentially surgical interventions. Supportive care, including hydration and regular monitoring, plays a vital role in the overall management of the condition. Early diagnosis and treatment are crucial to prevent complications and preserve kidney function. For patients experiencing symptoms or recurrent infections, timely medical evaluation is essential to determine the most appropriate treatment strategy.

Related Information

Description

  • Chronic inflammation and scarring of kidney tissue
  • Long-term obstruction of urinary tract
  • Recurring urinary tract infections (UTIs)
  • Kidney damage from obstructive uropathy
  • Inflammation of renal pelvis and calyces
  • Obstruction due to anatomical abnormalities, stones or tumors
  • Urine stasis leading to bacterial growth

Clinical Information

  • Flank pain due to kidney inflammation
  • Fever and chills indicating ongoing infection
  • Dysuria caused by associated urinary tract infections
  • Increased urinary frequency and urgency
  • Nausea and vomiting during acute exacerbations
  • Hematuria visible in urine or detectable through urinalysis
  • Weight loss and fatigue due to chronic inflammation
  • Higher risk for women with recurrent UTIs
  • Men at risk with urinary obstruction
  • Underlying conditions like diabetes increase susceptibility
  • History of UTIs contributes to kidney damage
  • Obstructive uropathy causes urine flow obstruction

Approximate Synonyms

  • Chronic Pyelonephritis
  • Obstructive Pyelonephritis
  • Chronic Tubulo-Interstitial Nephritis
  • Chronic Renal Infection
  • Recurrent Pyelonephritis

Diagnostic Criteria

  • Flank pain or discomfort
  • Fever and chills
  • Nausea and vomiting
  • Dysuria (painful urination)
  • Increased frequency and urgency of urination
  • Recurrent urinary tract infections
  • Difficulty urinating or weak urine stream
  • White blood cells in urine
  • Bacteria in urine
  • Hematuria (blood in urine)
  • Elevated serum creatinine levels
  • Hydronephrosis (kidney swelling)
  • Structural abnormalities in urinary tract
  • Obstructions
  • Abscesses

Treatment Guidelines

  • Initial antibiotic therapy for urinary tract infection
  • Identify and treat underlying causes of obstruction
  • Addressing pain with analgesics
  • Surgical decompression for severe obstruction
  • Corrective surgery for anatomical abnormalities
  • Nephrectomy for significant renal damage or recurrent infections
  • Maintain adequate hydration to flush out bacteria

Coding Guidelines

Excludes 1

  • obstructive uropathy (N13.-)
  • calculous pyelonephritis (N20.9)

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