Pyelonephritis

Summary

Pyelonephritis (MONDO:0006939) is a disease with 5 GWAS associations across 8 studies and 45 clinical trials. Top therapeutic interventions include levofloxacin anhydrous, cephalexin anhydrous, and clavulanic acid. A subtype of uterine inflammatory disease — broader associated-gene and molecular evidence is on the parent page (see Disease family below).

At a glance

• GWAS associations: 5
• Clinical trials: 45

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

Field	Value
Canonical name	pyelonephritis
Mondo ID	MONDO:0006939
EFO	EFO:1001141
MeSH	D011704
DOID	DOID:11400
NCIT	C34965
SNOMED CT	45816000
UMLS	C0034186
MedGen	19590
MedDRA	10037596
Is cancer (heuristic)	no

Also known as: kidney infection · pyometrium

Data availability: 5 GWAS associations (8 studies).

Disease family

This is a subtype of uterine inflammatory disease. Genetic, therapeutic, and trial evidence is largely curated at the broader-term level — see the parent page for the associated-gene cohort and molecular evidence.

Classification path: disease › human disease › disease by body system or component › reproductive system disorder › female reproductive system disorder › uterine disorder › uterine inflammatory disease › pyelonephritis

Subtypes (2): chronic pyelonephritis, acute pyelonephritis

Genetics & variants

GWAS landscape

5 GWAS associations across 8 studies. Top hits map to 1 distinct genes (as reported by GWAS).

Top associations by p-value

rsID	p-value	Gene	Risk allele	Odds ratio
rs184512262	3e-13	TRIM8	T	3.75
rs751707728	2e-11	MSR1 - RN7SL474P	A	2.73
rs371933975	4e-11	LINC01901 - LINC01477	G	2.82
rs17703846	2e-08	LINC02277 - RRAGAP1-AS1	T	0.83
rs10461286	8e-07	RNU6-1325P - LINC02496	?

Top studies (by case count)

Study	Lead author	Year	Cases	Controls	Title
GCST90018909	Sakaue S	2021	7,992	454,495	A cross-population atlas of genetic associations for 220 human phenotypes.
GCST90652210	Liu TY	2025	3,696	192,000	Diversity and longitudinal records: Genetic architecture of disease associations and polygenic risk in the Taiwanese Han population.
GCST90478546	Verma A	2024	3,149	443,721	Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program.
GCST90018689	Sakaue S	2021	1,811	175,288	A cross-population atlas of genetic associations for 220 human phenotypes.
GCST90436428	Zhou W	2018	1,324	379,936	Efficiently controlling for case-control imbalance and sample relatedness in large-scale genetic association studies.
GCST90478545	Verma A	2024	900	119,648	Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program.
GCST90480389	Verma A	2024	900	119,648	Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program.
GCST90482214	Verma A	2024	483	58,765	Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program.

Variant details and genetic-evidence tiers

Tier distribution (top 50 variants)

Tier	Variants
Tier 1: coding	0
Tier 2: splice/UTR	0
Tier 3: regulatory	0
Tier 4: intronic/intergenic	5

MAF distribution

Bucket	Variants
common (>=0.05)	1
low_freq (0.01-0.05)	1
rare (<0.01)	3
unknown	0

Functional consequences

Consequence	Count
intergenic_variant	3
intron_variant	2

Top variants

rsID	Chr	Pos	Alleles	MAF	Consequence	Gene	p-value	Tier
rs184512262	10	102652959	T>C	0	intron_variant	TRIM8	3e-13	Tier 4: intronic/intergenic
rs751707728	8	16669780	A>C,G	0	intergenic_variant	MSR1 - RN7SL474P	2e-11	Tier 4: intronic/intergenic
rs371933975	18	39978608	G>A	0	intron_variant	LINC01901 - LINC01477	4e-11	Tier 4: intronic/intergenic
rs17703846	14	44736740	C>G,T	0.016	intergenic_variant	LINC02277 - RRAGAP1-AS1	2e-08	Tier 4: intronic/intergenic
rs10461286	4	59987895	A>C,T	0.05	intergenic_variant	RNU6-1325P - LINC02496	8e-07	Tier 4: intronic/intergenic

Genes & proteins

No associated-gene cohort resolved for this disease. Atlas builds the molecular and therapeutic sections — associated genes, protein families, druggability, pathways, interactions, and drug associations — by aggregating over a disease’s associated genes (resolved via GWAS / GenCC / ClinVar / CIViC), and none resolved here. This is expected for antibody-mediated, autoimmune, or otherwise non-gene-defined conditions; the curated evidence for this disease is its clinical features, GWAS susceptibility, and clinical trials (above).

Function

No pathway enrichment — requires an associated-gene cohort.

Therapeutics

Drugs indicated for this disease

4 approved, 12 in late-stage (phase 3) trials. Disease-direct ChEMBL indications, not inferred from the associated-gene cohort below.

Drug	Development status
Aztreonam	Approved (phase 4)
Ceftazidime	Approved (phase 4)
Ciprofloxacin	Approved (phase 4)
Doripenem	Approved (phase 4)
Amoxicillin	Phase 3 (in late-stage trials)
Avibactam	Phase 3 (in late-stage trials)
Cefepime	Phase 3 (in late-stage trials)
Ceftibuten	Phase 3 (in late-stage trials)
Ceftolozane	Phase 3 (in late-stage trials)
Cilastatin	Phase 3 (in late-stage trials)
Levocarnitine	Phase 3 (in late-stage trials)
Meropenem	Phase 3 (in late-stage trials)
OMEGA-3-ACID ETHYL ESTERS	Phase 3 (in late-stage trials)
Sulfamethoxazole	Phase 3 (in late-stage trials)
Tazobactam	Phase 3 (in late-stage trials)
Trimethoprim	Phase 3 (in late-stage trials)

Earlier-phase candidates (phase 2, investigational — efficacy not yet established): Acetylcysteine, Cycloserine, Ertapenem.

Clinical trials & evidence

Clinical trials

Clinical trials: 45.

Phase distribution (across all retrieved trials)

Phase	Trials
Not specified	20
PHASE3	10
PHASE4	9
PHASE2	5
PHASE1	1

Top trials by phase / activity

NCT	Phase	Status	Title
NCT05544565	PHASE4	RECRUITING	3-day IV Antibiotic Treatment Versus 3-day IV Followed by 7-day Oral Antibiotic Treatment for AP in Children
NCT00136656	PHASE4	COMPLETED	Treatment of Acute Pyelonephritis With Gram Negative Strains in Infants and Children Less Than 3 Years Old
NCT00382343	PHASE4	COMPLETED	A Randomized Controlled Trial on Antibiotic Prophylaxis in Children With Vesico-Ureteral Reflux
NCT02246361	PHASE4	COMPLETED	Impact of Six Patient Information Leaflets (PIL) on Doctor Patient Communication
NCT02598362	PHASE4	COMPLETED	Pharmacokinetics of Ciprofloxacin in Pediatric Patients
NCT03179384	PHASE4	COMPLETED	Impact on the Intestinal Microbiota of Treatment With Ceftriaxone in Women’s Acute Community Pyelonephritis
NCT03275623	PHASE4	COMPLETED	Management of Sub-Clinical Bacteriuria in Pregnancy
NCT03282006	PHASE4	COMPLETED	Treating Pyelonephritis an Urosepsis With Pivmecillinam
NCT06127160	PHASE4	COMPLETED	Patient-Directed Antimicrobial Duration in Acute Uncomplicated Pyelonephritis
NCT05597540	PHASE3	RECRUITING	Efficacy of 7 Days Versus 14 Days of Antibiotic Therapy for Acute Pyelonephritis in Kidney Transplant Recipients, a Multicentre Randomized Non-inferiority Trial.
NCT00210886	PHASE3	COMPLETED	A Comparison of the Effectiveness and Safety of Levofloxacin to That of Ciprofloxacin in Treating Complicated Urinary Tract Infection and Acute Pyelonephritis.
NCT00210990	PHASE3	COMPLETED	Doripenem in the Treatment of Complicated Lower Urinary Tract Infection or Pyelonephritis
NCT00229021	PHASE3	COMPLETED	Doripenem in the Treatment of Complicated Lower Urinary Tract Infection or Pyelonephritis
NCT00258089	PHASE3	COMPLETED	A Study of the Safety and Effectiveness of Oral Levofloxacin Compared With Oral Ciprofloxacin in the Treatment of Complicated Urinary Tract Infections
NCT00724256	PHASE3	TERMINATED	Short-term Antibiotic Therapy for Pyelonephritis in Childhood
NCT00752375	PHASE3	WITHDRAWN	Antibiotic Prophylaxis in Children With Pyelonephritis
NCT01110408	PHASE3	TERMINATED	A Safety and Tolerability Study of Doripenem Compared With Cefepime in Children Hospitalized With Complicated Urinary Tract Infections
NCT01345929	PHASE3	COMPLETED	Study Comparing the Safety and Efficacy of Intravenous CXA-201 and Intravenous Levofloxacin in Complicated Urinary Tract Infection, Including Pyelonephritis
NCT02728089	PHASE3	COMPLETED	Study of Ceftolozane/Tazobactam (MK-7625A) in Japanese Participants With Uncomplicated Pyelonephritis and Complicated Urinary Tract Infection (MK-7625A-014)
NCT01505634	PHASE2	COMPLETED	Safety, Tolerability, and Efficacy of MK-7655 (Relebactam) + Imipenem/Cilastatin Versus Imipenem/Cilastatin Alone for Treating Complicated Urinary Tract Infection (cUTI) (MK-7655-003)
NCT01628900	PHASE2	TERMINATED	Prospective Study in the Emergency
NCT02080182	PHASE2	COMPLETED	Effect of Acetylcysteine in Pediatric Acute Pyelonephritis.
NCT03230838	PHASE2	COMPLETED	MK-7625A Versus Meropenem in Pediatric Participants With Complicated Urinary Tract Infection (cUTI) (MK-7625A-034)
NCT06128213	PHASE2	UNKNOWN	NRX-101 for Complicated Urinary Tract Infection (UTI) Including Pyelonephritis
NCT04700787	PHASE1	WITHDRAWN	Safety, Tolerability, and Pharmacokinetics of Sulopenem in Adolescents
NCT03959163	Not specified	RECRUITING	The Validity of the Quick Renal MRI in Pediatric Kidney Disease
NCT06848816	Not specified	ACTIVE_NOT_RECRUITING	Duration of Antibiotic Therapy in Acute Kidney Graft Pyelonephritis (AGPN): Effect on the Risk of Recurrence
NCT07070102	Not specified	NOT_YET_RECRUITING	Population Pharmacokinetics of Temocillin in Acute Enterobacterial Pyelonephritis in Children
NCT07579312	Not specified	RECRUITING	Diagnosis of Abdominal Pain Using RNA Levels: The NATURAL Study
NCT00190281	Not specified	UNKNOWN	Contrast-Enhanced US of Spleen, Liver and Kidney
NCT00528476	Not specified	COMPLETED	Risk Factors for Recurrent Urinary Tract Infection in Children
NCT00805181	Not specified	COMPLETED	Kinetics of Biomarkers in Acute Pyelonephritis
NCT00948779	Not specified	COMPLETED	Antibiotic Education for Children in an Emergency Care Unit
NCT01476995	Not specified	COMPLETED	Prognostic Indicators as Provided by the EPIC ClearView
NCT01641029	Not specified	COMPLETED	Community-Associated Uropathogen Antimicrobial Resistance Among Emergency Department Patients With Acute Pyelonephritis
NCT01771432	Not specified	UNKNOWN	Antibiotic Treatment Versus no Therapy in Kidney Transplant Recipients With Asymptomatic Bacteriuria
NCT01861353	Not specified	COMPLETED	Cranberry-lingonberry Juice Started During Acute Infection in Prevention of Urinary Tract Infections in Children
NCT03873701	Not specified	COMPLETED	Bedside Ultrasonography in Acute Patients With Suspected Kidney Involvement
NCT04594161	Not specified	COMPLETED	Effectiveness of Drainage by PCN vs. JJ in Patients With Symptoms of Obstructive Kidney Disease Caused by Urolithiasis
NCT04651244	Not specified	COMPLETED	Diagnostic Imaging of Acute Pyelonephritis

Drugs tested across these trials (top 30)

Molecule	Max phase	Trials referencing
LEVOFLOXACIN ANHYDROUS	4	6
CEPHALEXIN ANHYDROUS	4	3
CLAVULANIC ACID	4	3
CIPROFLOXACIN	4	2
DORIPENEM	4	2
IMIPENEM ANHYDROUS	4	2
OFLOXACIN	4	2
SULFAMETHOXAZOLE	4	2
TAZOBACTAM	4	2
TRIMETHOPRIM	4	2
AMDINOCILLIN PIVOXIL	4	1
CEFEPIME	4	1
CEFTIBUTEN	4	1
CEFTOLOZANE	4	1
CEFTRIAXONE	4	1
CILASTATIN	4	1
LURASIDONE	4	1
MEROPENEM	4	1
RELEBACTAM	4	1
SULOPENEM	3	1
17	0	3
CHEMBL388266	0	1
CHEMBL5219924	0	1
CHEMBL5425738	0	1