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Chronic pyelonephritis is a long-term kidney disorder characterized by inflammation and scarring of the renal tissue due to recurrent or persistent kidney infections, often linked to anatomical abnormalities such as vesicoureteral reflux (urine flowing backward from the bladder to the kidneys) or obstruction. This condition causes progressive damage to the kidney parenchyma, resulting in loss of kidney function and potentially leading to chronic kidney disease or end-stage renal failure. Symptoms may be subtle or include fever, malaise, flank pain, nausea, weight loss, and hypertension. Diagnosis involves urinalysis, culture, and imaging studies to detect scarring and structural abnormalities, although kidney biopsy is rarely performed.

Treatment focuses on managing infections with antibiotics and correcting any urinary tract obstructions, but kidney damage is often irreversible. Severe cases may require surgical intervention or even kidney transplantation. Chronic pyelonephritis notably includes variants like xanthogranulomatous pyelonephritis, characterized by an abnormal inflammatory response and severe kidney tissue destruction. Early detection and treatment of urinary infections and underlying causes are essential to slow progression and preserve kidney function.?