Purulent pyelonephritis diet. Pyelonephritis - what is it, symptoms, first signs, treatment and consequences

Pyelonephritis is an inflammation of the kidneys that occurs in acute or chronic form. The disease is quite widespread and very dangerous to health. Symptoms of pyelonephritis include pain in lumbar region, increased body temperature, severe general state and chills. Occurs most often after hypothermia.

It can be primary, that is, it develops in healthy kidneys, or secondary, when the disease occurs against the background of already existing kidney diseases (glomerulonephritis, etc.). There are also acute and chronic pyelonephritis. Symptoms and treatment will directly depend on the form of the disease.

This is the most frequent illness kidneys in all age groups. More often they suffer from young and middle-aged women - 6 times more often than men. In children, after diseases of the respiratory system (,) takes second place.

Causes of pyelonephritis

Why does pyelonephritis develop, and what is it? main reason pyelonephritis is an infection. Infection refers to bacteria such as coli, Proteus, Klebsiella, Staphylococcus and others. However, when these microbes enter the urinary system, the disease does not always develop.

In order for pyelonephritis to appear, contributing factors are also needed. These include:

Violation of the normal flow of urine (urine reflux from Bladder in the kidney, "neurogenic bladder", adenoma prostate);
Violation of the blood supply to the kidney (deposition of plaques in the vessels, vasospasm with, diabetic angiopathy, local cooling);
Immune suppression (treatment steroid hormones(prednisolone), cytostatics, immunodeficiency as a result);
Pollution of the urethra (non-compliance with personal hygiene, with incontinence of feces, urine, during sexual intercourse);
Other factors (decrease in secretion of mucus in the urinary system, weakening local immunity, impaired blood supply to the mucous membranes, urolithiasis, oncology, other diseases of this system and in general any chronic diseases, reduced fluid intake, abnormal anatomical structure kidneys).

Once in the kidney, microbes colonize pelvicalyceal system, then the tubules, and from them - the interstitial tissue, causing inflammation in all these structures. Therefore, you should not put off the question of how to treat pyelonephritis, otherwise severe complications are possible.

Symptoms of pyelonephritis

In acute pyelonephritis, the symptoms are pronounced - it starts with chills, when measuring body temperature, the thermometer shows over 38 degrees. After a while, aching pain in the lower back appears, the lower back "pulls", and the pain is quite intense.

The patient is disturbed by the frequent urge to urinate, very painful and indicating accession and. Symptoms of pyelonephritis may have general or local manifestations. General signs are:

High intermittent fever;
Severe chills;
Sweating, dehydration and thirst;
Intoxication of the body occurs, as a result of which the head hurts, fatigue increases;
Dyspeptic symptoms (nausea, no appetite, stomach ache, diarrhea appears).

Local signs of pyelonephritis:

Pain in the lumbar region, on the affected side. The nature of the pain is dull, but constant, aggravated by palpation or movement;
The muscles of the abdominal wall may be tense, especially on the affected side.

Sometimes the disease begins with acute cystitis- rapid and, pain in the bladder area, terminal hematuria (appearance of blood at the end of urination). In addition, general weakness, weakness, muscle and headache, lack of appetite, nausea, vomiting.

If these symptoms of pyelonephritis appear, you should consult a doctor as soon as possible. In the absence of competent therapy, the disease can turn into a chronic form, which is much more difficult to cure.

Complications

acute or chronic renal failure;
various suppurative diseases of the kidneys (kidney carbuncle, kidney abscess, etc.);

Treatment of pyelonephritis

In primary acute pyelonephritis, in most cases, the treatment is conservative, the patient must be hospitalized in a hospital.

Basic therapeutic measure is the impact on the causative agent of the disease with antibiotics and chemical antibacterial drugs in accordance with the data of the antibiogram, detoxification and immunity-enhancing therapy in the presence of immunodeficiency.

In acute pyelonephritis, treatment should begin with the most effective antibiotics and chemical antibacterial drugs, to which the microflora of urine is sensitive, in order to eliminate the inflammatory process in the kidney as quickly as possible, preventing its transition to a purulent-destructive form. In secondary acute pyelonephritis, treatment should begin with the restoration of urine massage from the kidney, which is fundamental.

Treatment of the chronic form is fundamentally the same as the acute form, but longer and more laborious. In chronic pyelonephritis, treatment should include the following main measures:

Elimination of the causes that caused the violation of the passage of urine or renal circulation, especially venous;
The appointment of antibacterial agents or chemotherapy drugs, taking into account the data of the antibiogram;
Increasing the immune reactivity of the body.

Restoration of urine outflow is achieved primarily by the use of one or another type of surgical intervention (removal of prostate adenoma, stones from the kidneys and urinary tract, nephropexy with, plastic surgery of the urethra or ureteropelvic segment, etc.). Often after these surgical interventions it is relatively easy to obtain a stable remission of the disease without long-term antibacterial treatment. Without sufficiently restored urine massage application antibacterial drugs usually does not give long-term remission of the disease.

Antibiotics and chemical antibacterial drugs should be prescribed taking into account the sensitivity of the patient's urine microflora to antibacterial drugs. To obtain antibiogram data, antibacterial drugs with a wide spectrum of action are prescribed. Treatment for chronic pyelonephritis is systematic and long-term (at least 1 year). The initial continuous course of antibiotic treatment is 6–8 weeks, since during this time it is necessary to suppress the infectious agent in the kidney and resolve the purulent inflammatory process in it without complications in order to prevent the formation of cicatricial connective tissue. In the presence of chronic renal failure, the appointment of nephrotoxic antibacterial drugs should be carried out under constant monitoring of their pharmacokinetics (concentration in the blood of urine). With a decrease in the indicators of humoral and cellular immunity, apply various drugs to boost immunity.

After the patient reaches the stage of remission of the disease, antibiotic treatment should be continued in intermittent courses. The timing of interruptions in antibacterial treatment is set depending on the degree of kidney damage and the time of onset of the first signs of an exacerbation of the disease, i.e., the appearance of symptoms of the latent phase of the inflammatory process.

Antibiotics

Medicines are selected individually, taking into account the sensitivity of the microflora to them. Most often assigned the following antibiotics with pyelonephritis:

penicillins with clavulanic acid;
2nd and 3rd generation cephalosporins;
fluoroquinolones.

Aminoglycosides are undesirable because of their nephrotoxic effects.

How to treat pyelonephritis with folk remedies

Home treatment of pyelonephritis with folk remedies must be accompanied by bed rest and a wellness diet, consisting mainly of plant food raw, boiled or steamed.

During the period of exacerbation, such a collection helps. Mix equally taken white birch leaves, St. John's wort and knotweed grass, calendula flowers, fennel fruits (dill). Pour in a thermos 300 ml of boiling water 1 tbsp. l. collection, insist 1-1.5 hours, strain. Drink warm infusion in 3-4 doses 20 minutes before meals. The course is 3-5 weeks.
Outside of an exacerbation of the disease, use a different collection: knotweed herb - 3 parts; herb yasnotki (deaf nettle) and grass (straw) oats, leaves of sage officinalis and round-leaved wintergreen, rose hips and licorice roots - 2 parts each. Take 2 tbsp. l. collection, pour 0.5 l of boiling water in a thermos, leave for 2 hours and strain. Drink a third cup 4 times a day 15-20 minutes before meals. The course is 4-5 weeks, then a break for 7-10 days and repeat. In total - up to 5 courses (until stable results are obtained).

Diet

With inflammation of the kidneys, it is important to observe bed rest and strict diet. Consume enough fluids to stop dehydration, which is especially important for pregnant women and people over 65.

In case of inflammatory processes in the kidneys, it is allowed: lean meat and fish, stale bread, vegetarian soups, vegetables, cereals, soft-boiled eggs, dairy products, sunflower oil. In small quantities, you can use onions, garlic, dill and parsley (dried), horseradish, fruits and berries, fruit and vegetable juices. Forbidden: meat and fish broths, smoked meats. You also need to reduce the consumption of spices and sweets.

is a non-specific infectious disease of the kidneys caused by various bacteria. The acute form of the disease is manifested by fever, symptoms of intoxication and pain in the lumbar region. Chronic pyelonephritis may be asymptomatic or accompanied by weakness, loss of appetite, increased urination, and mild back pain. The diagnosis is based on the results laboratory tests(general and biochemical urinalysis, bakposev), urography and ultrasound of the kidneys. Treatment - antibiotic therapy, immunostimulants.

General information

is a widespread pathology. Patients suffering from acute and chronic pyelonephritis account for about 2/3 of all urological patients. The disease can occur in acute or chronic form, affecting one or both kidneys. Diagnosis and treatment is carried out by a specialist in the field of clinical urology and nephrology. In the absence of timely therapy, pyelonephritis can lead to such severe complications as kidney failure, carbuncle or kidney abscess, sepsis and bacterial shock.

Causes of pyelonephritis

The disease can occur at any age. More often pyelonephritis develops:

In children under the age of 7 years (the likelihood of pyelonephritis increases due to the peculiarities of the anatomical development.
In young women aged 18-30 years (the occurrence of pyelonephritis is associated with the onset of sexual activity, pregnancy and childbirth).
In older men (with obstruction of the urinary tract due to the development of prostate adenoma).

Any organic or functional reasons that prevent the normal outflow of urine, increase the likelihood of developing pathology. Often pyelonephritis appears in patients with urolithiasis. Unfavorable factors contributing to the occurrence of pyelonephritis include diabetes mellitus, immune disorders, chronic inflammatory diseases and frequent hypothermia. In some cases (usually in women), pyelonephritis develops after acute cystitis.

Asymptomatic course is often the cause of delayed diagnosis of chronic pyelonephritis. Patients begin treatment when kidney function is already impaired. Since pathology very often occurs in patients suffering from urolithiasis, such patients need special therapy even in the absence of symptoms of pyelonephritis.

Symptoms of pyelonephritis

An acute process is characterized by a sudden onset with sharp rise temperatures up to 39-40°C. Hyperthermia is accompanied profuse sweating, loss of appetite, severe weakness, headache, sometimes nausea and vomiting. dull pains in the lumbar region different intensity, more often unilateral, appear simultaneously with an increase in temperature. Physical examination reveals tenderness with tapping in the lumbar region (positive Pasternatsky's symptom).

The uncomplicated form of acute pyelonephritis does not cause urination disorders. Urine becomes cloudy or takes on a reddish tint. At laboratory research urine revealed bacteriuria, slight proteinuria and microhematuria. The general blood test is characterized by leukocytosis and increase in ESR. In about 30% of cases, an increase in nitrogenous slags is noted in a biochemical blood test.

Chronic pyelonephritis often becomes the outcome of an untreated acute form. Perhaps the development of a primary chronic process. Sometimes the pathology is discovered by chance during the study of urine. Patients complain of weakness, loss of appetite, headaches and frequent urination. Some patients are bothered by dull aching pain in the lumbar region, worse in cold damp weather. Symptoms indicating an exacerbation coincide with the clinical picture of an acute process.

Complications

Bilateral acute pyelonephritis can cause acute kidney failure. Among the most formidable complications include sepsis and bacterial shock. In some cases acute form the disease is complicated by paranephritis. Perhaps the development of apostenomatous pyelonephritis (the formation of multiple small pustules on the surface of the kidney and in its cortical substance), carbuncle of the kidney (often occurs due to the fusion of pustules, is characterized by the presence of purulent-inflammatory, necrotic and ischemic processes) kidney abscess (melting of the renal parenchyma) and necrosis of the renal papillae .

If treatment is not carried out, the terminal stage of a purulent-destructive acute process sets in. Pyonephrosis develops, in which the kidney is completely subjected to purulent fusion and is a focus consisting of cavities filled with urine, pus and tissue decay products. With the progression of chronic bilateral pyelonephritis, kidney function is gradually impaired, which leads to a decrease in specific gravity urine, arterial hypertension and the development of chronic renal failure.

Diagnostics

Diagnosis is usually not difficult for a nephrologist due to the presence of pronounced clinical symptoms. The anamnesis often indicates the presence of chronic diseases or recent acute purulent processes. The clinical picture is formed by a characteristic combination of severe hyperthermia with lower back pain (usually unilateral), painful urination and urine changes. Urine is cloudy or reddish in color and has a pronounced fetid odor.

Laboratory confirmation of the diagnosis is the detection of bacteria and small amounts of protein in the urine. To determine the pathogen, a urine culture is performed. About availability acute inflammation indicates leukocytosis and an increase in ESR in general analysis blood. With the help of special test kits, the microflora that caused inflammation is identified. Diagnostics structural changes with pyelonephritis, it is carried out with the help of ultrasound of the kidneys. The concentration ability of the kidneys is assessed using the Zimntsky test. For exclusion urolithiasis and anatomical abnormalities, CT of the kidneys is performed.

During survey urography an increase in the volume of one kidney is detected. Excretory urography indicates a sharp limitation of kidney mobility during orthoprobe. With apostematous pyelonephritis, there is a decrease excretory function on the side of the lesion (the shadow of the urinary tract appears late or is absent). With a carbuncle or abscess on the excretory urogram, the bulging of the contour of the kidney, compression and deformation of the calyces and pelvis are determined.

Treatment of pyelonephritis

An uncomplicated acute process is treated conservatively in a hospital setting. Antibacterial therapy is carried out. Medicines are selected taking into account the sensitivity of the bacteria found in the urine. In order to eliminate inflammation as quickly as possible, preventing the transition of pyelonephritis to a purulent-destructive form, treatment begins with the most effective drug.

Conducted detoxification therapy, correction of immunity. When fever is prescribed diet with reduced content proteins, after normalization of the patient's temperature, they are transferred to good nutrition with high liquid content. At the first stage of therapy for secondary acute pyelonephritis, obstacles that impede the normal outflow of urine should be eliminated. The appointment of antibacterial drugs in case of impaired passage of urine does not give the desired effect and can lead to the development of serious complications.

Treatment of chronic pyelonephritis is carried out according to the same principles as the treatment of an acute process, but is more time consuming and labor intensive. The therapeutic program provides for the elimination of the causes that led to difficulty in the outflow of urine or caused renal circulation disorders, antibiotic therapy and the normalization of general immunity.

In the presence of obstructions, it is necessary to restore the normal passage of urine. Restoration of urine outflow is performed promptly (nephropexy for nephroptosis, removal of stones from the kidneys and urinary tract, removal of prostate adenoma, etc.). The elimination of obstacles that interfere with the passage of urine, in many cases, allows to achieve stable long-term remission. Antibacterial drugs are prescribed taking into account the data of the antibiogram. Before determining the sensitivity of microorganisms, therapy with broad-spectrum antibacterial drugs is carried out.

Patients with chronic pyelonephritis require long-term systematic therapy for a period of at least a year. Treatment begins with a continuous course antibiotic therapy lasting 6-8 weeks. This technique makes it possible to eliminate purulent process in the kidney without the development of complications and the formation of scar tissue. If renal function is impaired, constant monitoring of the pharmacokinetics of nephrotoxic antibacterial drugs is required. To correct immunity, if necessary, use immunostimulants and immunomodulators. After achieving remission, intermittent courses of antibiotic therapy are prescribed.

During remission, patients are shown Spa treatment(Jermuk, Zheleznovodsk, Truskavets, etc.). It should be remembered about the mandatory continuity of therapy. Antibacterial treatment started in the hospital should be continued on an outpatient basis. The treatment regimen prescribed by the doctor of the sanatorium should include taking antibacterial drugs recommended by the doctor who constantly monitors the patient. As additional method treatment is phytotherapy.

The kidneys are the main filtering organ in the body. Its main task is to remove from the blood unnecessary and dangerous elements for the body, which are excreted along with urine. The kidneys have increased regenerative abilities, due to which they can withstand the influence for a long time. negative factors. One of the common renal pathologies is pyelonephritis. Complications of pyelonephritis resulting from failure to provide proper treatment can have irreparable consequences. The destruction of the kidney tissue provoked by them can not only aggravate the work of the organ, but also make it absolutely impossible.

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Common Complications

Pyelonephritis is infectious. The causative agents of pathology are different kinds bacteria. One or both kidneys may be affected at once. A serious risk of developing pyelonephritis is present in women who have recovered from cystitis, as well as in those suffering from urological diseases men.

For characteristic the following symptoms:

spontaneous fast growth temperatures up to 38 degrees Celsius;
noticeable tremor of the limbs;
deterioration of well-being;
swelling of the face;
vomit.

Predisposing factors for the development of complications:

transfer of endoscopic examinations of organs genitourinary system;
transferred cystitis in women;
diagnostic work during the examination of the upper genital tract;
insufficiency of functioning various bodies simultaneously;
the presence of nitrogen in the blood;
diseases that depress the immune system;
microorganisms insensitive to many types of antibiotics.

The main factor in the development of complications, no doubt, is the indifferent attitude of the patient to his health. Many believe that recovery is a matter of time. However, this is only true for a very small number of people who have superior immunity. Pyelonephritis is either complicated by other diseases, or becomes chronic.

If you do not prescribe adequate treatment, the disease quickly flows into purulent form, which often leads to various complications. The most common of them are:

secondary paranephritis;
necrotic papillitis;
arterial hypertension;
bacteriotoxic shock;
acute and chronic.

They need to be considered more carefully.

Secondary paranephritis

According to the etiology, paranephritis is primary, arising as a primary disease, and secondary - appears as a complication of another disease, in this case -. According to statistics, secondary paranephritis, compared with primary, manifests itself in four out of five cases. It is quite difficult to diagnose, as it has a similar clinical picture with pyelonephritis. His specific symptoms are:

instant rise in temperature;
general malaise;
pain in the lower back;
the skin in the lumbar region is noticeably warmer than on the rest of the body;
anemia.

Put correct diagnosis, based only on the symptoms of the disease, is not possible. However, in the general blood test, the presence of leukocytosis and accelerated erythrocyte sedimentation are recorded. The main problem with this disease is the transformation into pus of tissues located near the site of inflammation.

For effective treatment paranephritis, you must first eliminate the underlying disease. The most important procedure in the treatment of secondary paranephritis is the drainage of pus from the cavity taken.

Chronic pyelonephritis in the acute stage may be complicated by necrotic papillitis. Accompanying the development of tissue necrosis renal colic. Gross hematuria develops due to the closure of the lumen of the urinary tract by the products of tissue decay. The formation of necrotic processes is characteristic of purulent lesions organ or during the usual inflammatory process, during which blood vessels are destroyed.

Whether it will be possible to restore the normal functioning of the kidneys depends entirely on the rate of detection of the disease and the degree of effectiveness of its treatment. The latter implies a set of measures aimed at strengthening the ability of tissues to resist destruction.

This disease occurs in three percent of cases. Its trigger is the presence of diseases in the patient, in which blood vessels break up.

Stages of passage of necrosis:

Accumulation of leukocytes in the area of origin of the papilla.
Due to the insufficient supply of blood to it, and, accordingly, glucose and oxygen, it begins to scar.
Destruction and decay of the papilla.

Treatment of the disease directly depends on the degree of spread of the necrotic process. In most cases, drug therapy is preferred. In the presence of large areas filled with necrotic masses, surgical intervention is required.

Arterial hypertension

This disease is more late complication, as it appears a few weeks after the onset of inflammation. If only one kidney is affected by pyelonephritis, arterial hypertension manifests itself in a third of cases, with bilateral damage - in every second case of the disease. The disease manifests itself under the influence of two unrelated processes:

Atrophy of the renal tissue.
Pathological violation of circulation in the organ of blood or lymph, caused by the presence of an inflammatory process.

Clinical picture:

BP 140/90 mm Hg. Art.;
diastolic pressure indicators are always at a high level;
suddenness of symptoms.

The appearance of renal hypertension is possible in both adults and children. Further prognosis for the treatment of the disease in nine out of ten cases is unfavorable. This is due to the low effectiveness of drug therapy.

The disease is characterized by the sudden onset of symptoms, which may be exacerbated by a significant deterioration general well-being, progressive tissue swelling, cardiac disorders, visual impairment and many others.

Renal arterial hypertension develops due to stenosis of the main renal artery, and in rare cases and its smaller tributaries. In chronic pyelonephritis with alternating remissions and exacerbations, sclerosis of the connective tissue membranes and blood vessels is observed.

It is very difficult to treat this pathology due to the ineffectiveness of drug therapy. Nephrectomy is usually used, which gives an almost absolute result.

Bacteriotoxic shock

Bacteriotoxic shock is the most common and dangerous complication pyelonephritis. The danger lies in the extremely high rates of development of this process. With a high degree of pathogenicity of the causative agent of the underlying disease, toxic damage to the organ becomes the cause of shock. A feature of the disease at this stage is the absence of symptoms of sepsis due to the rapid breakdown of toxins.

In most cases, this condition affects pensioners and the elderly: their share among total number patients is about eighty-five percent. This is due to the possible presence of factors that exacerbate the excretion of urine from the kidney:

the presence of stones in the organs urinary system;
multiple benign neoplasms in the kidneys;
organ injury;
BPH.

Bacteriotoxic shock in young people is caused by compression of the ureter. The reason for this are:

inflammation;
inflection;
pregnancy and childbearing.

The danger of this complication is associated with a high number of deaths. According to statistics, sixty-five percent of patients die from bacteriotoxic shock. It has to do with secrecy and high speed the course of the pathological process, which makes it difficult to prevent the occurrence of critical situations. To prevent death, drainage of the renal contents and specialized drug therapy. The effectiveness of treatment directly depends on the speed of detection of symptoms of the disease and the appointment of adequate therapy.

Acute and chronic renal failure

Often complicated. The development of the disease takes from several days to two weeks. During this period, the immediate danger to the patient is the pus accumulated in the organ. His chemical composition very diverse: bacterial toxins, substances formed during the destruction of kidney tissue, shaped elements blood. The pus collected in the abscess mechanically affects the surrounding renal tissues, provoking their destruction. It is the degree of destruction of the tissues of the organ that determines the time of development of renal failure, the acute form of which is reversible, due to the high regenerative properties of the kidneys.

The disease passes against the background of pyelonephritis defeat of both one and two kidneys at the same time. To resume normal operation body needs to relieve inflammation and simplify its work with the help of instrumental methods treatment. To do this, periodically perform renal dialysis and hemosorption. These actions will help the kidneys to repair the affected areas and tissues.

Severe swelling

Symptoms of acute renal failure:

pain syndrome in the lower back;
vomit;
bad feeling;
decrease in urine output.

The clinical picture is indicative. The diagnosis is made on the basis of the listed symptoms.

Despite the possibility of complete recovery, the patient is obliged to comply with preventive measures until the end of his life, among which an important place is occupied by proper nutrition and use of funds traditional medicine. Violation of medical instructions can lead to the transition of the disease to chronic stage(CHP).

Chronic renal failure

This disease often occurs in parallel with other diseases of the urinary system. predisposition to development of CKD due to the following diseases:

urolithiasis disease;
analgesic nephropathy;
prostate enlargement;
the presence of benign neoplasms in the kidneys.

hydronephrosis

The danger of pyelonephritis lies in the fact that during the course it is one hundred percent likely to provoke a disease that will eventually lead to the development of chronic renal failure.

The disease proceeds with an alternation of remissions and exacerbations, during which the destruction of the renal tissue slowly but surely occurs, which does not perform any specific functions. This process often remains invisible to the patient. Critical damage accumulates over several years. The disease is incurable. To alleviate the patient's condition, blood dialysis is performed. Due to the accumulation of damage, the performance of the kidneys decreases, dialysis is required to be performed more often than before: in case of critical damage to the organ, twice a week.

Complications of pyelonephritis can even lead to death. Therefore, you need to be attentive to your health and, if it appears, immediately seek medical help.

Defeating severe kidney disease is possible!

If the following symptoms are familiar to you firsthand:

persistent back pain;
difficulty urinating;
violation of blood pressure.

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Pyelonephritis is a disease in which the parenchyma, or otherwise the kidney, becomes inflamed. In most cases, this condition is triggered by bacteria invading the kidneys, which can reach them through the urethra, bladder, or blood vessels.

Important for successful treatment pyelonephritis is early diagnosis and adequate treatment. If the problem is neglected, a kidney infection may be necessary condition for permanent damage or uncontrolled spread of bacteria in the blood and dangerous sepsis, even life threatening.

According to the method of flow, pyelonephritis is divided into:

acute pyelonephritis - the period of the disease up to 3 months;
chronic pyelonephritis - in patients with pyelonephritis, the infection is active for more than 3 months. There are signs of exacerbation and lull symptoms. What is typical in this case is that it is always the same cause;
recurrent pyelonephritis - in this form there are acute infections, the basis of which is another pathogen.

Chronic pyelonephritis

The frequency of chronic pyelonephritis is higher than in other forms. The disease itself is an inflammation of the kidney tissue that results from urinary tract obstruction or urinary reflux.

In many patients, it first appeared in childhood. Lack of adequate treatment is a prerequisite for the disease to become chronic. On the late stage disease, an infected kidney significantly reduces its size, changes the color and surface of the organ, and the kidneys are severely deformed.

When recognizing chronic pyelonephritis, attention should be paid to a number of individual symptoms. Their diversity is due to various factors, predisposing factors and characteristics of the organism itself.

In order to determine with certainty what chronic form disease, it is noted that periods of acute manifestation of the condition alternate with moments of calm symptoms. In matters of crisis, the patient complains of general fatigue, problems with urination, and pain in the waist area.

If no attention is paid to the condition, it is difficult for the infected kidney to function in the end stage of chronic pyelonephritis, which leads to kidney failure.

Causes of pyelonephritis

Most infections that affect the kidneys begin first in the lower urinary tract, in the urethra or bladder. Gradually, with reproduction, the bacteria rise up the urethra and reach the kidney. Among the most common causes of the disease is the bacterium Escherichia coli. Rarely - pathogens such as Proteus, Pseudomonas, Enterococcus, Stafilococ, Chlamydia and others.

Another possible scenario is the presence of an infection in the body, which reaches the kidney through the bloodstream and becomes a necessary condition for pyelonephritis. This happens relatively rarely, but the danger increases if the body has foreign body. heart valve, an artificial joint or another infected person is taken as such.

In rare cases, pyelonephritis develops after kidney surgery.

Risk factors for pyelonephritis

Considering the most common causes of kidney infection, the following groups of risk factors can also be identified:

gender - women are believed to be exposed greater risk kidney infections than men. The reason lies in the anatomy excretory system at a woman. A woman's own urethra is much shorter than a man's, making it much easier for bacteria to move out of the external environment into the bladder. One more thing - the anatomical proximity of the urethra, vagina and anus also creates conditions for more mild infection bladder and, therefore, for bacteria to enter the kidneys;
urinary problems - obstruction of the urinary tract and all other problems that interfere with normal urination and prevent complete emptying bladder, can lead to inflammation of the kidney tissue. This group of factors includes abnormalities in the structure of the urinary tract, kidney stones, prostate enlargement in men, and others;
weakened immune system - some diseases are considered a prerequisite for the development of pyelonephritis. Diabetes, HIV infection and others are similar. The target factor is also the deliberate weakening immune system for example, by taking medication after organ transplantation;
damaged nerves are irregularly functioning nerves around the bladder or spinal cord blocking the symptoms that accompany a bladder infection. Thus, the body does not respond to inflammation, which is easily transferred to the kidneys;
catheter - extended catheter use is a prerequisite for infections urinary system;
vesicourethral reflux - not in last turn, a risk factor is the so-called vesicourethral reflux, in which a small amount of urine returns from the bladder towards the urethra and kidneys.

Symptoms of pyelonephritis

Pain is often present in pyelonephritis!

If you have a bladder infection and have not been adequately treated, expect some of the tell-tale signs of parenchymal inflammation in the kidneys soon. Among the most common symptoms of the disease are the following:

increased body temperature;
tingling pain in the back, waist, on one side of the body, or in the groin;
severe pain in the abdomen;
frequent, strong and uncontrollable urination urgency;
pain, burning and other complaints during urination;
blood or pus in the urine.

The symptoms listed above should be treated with due care. If adequate measures are not taken and timely treatment does not exist, there may be a number of complications, including:

renal failure - pyelonephritis may be at the root of chronic renal failure;
blood poisoning - due to the rich blood supply to the kidneys, the spread of bacteria multiplying in them quickly becomes colorless and can lead to complete blood poisoning;
in pregnancy - the main risk during pregnancy of untreated kidney disease is premature birth of an underweight newborn.

Pyelonephritis in a child

Infants and children at an early age have pyelonephritis with mild fever, vomiting. There is complete fatigue and lack of weight. The child indicates pain in the abdomen through anxiety.

If it's very Small child, kidney infection can also occur with weight loss, unreasonable excitement, seizures, darkening of the complexion or skin coloration in a white or yellow tint, swelling of the abdomen. You must immediately consult a doctor.

In older children, the main symptoms of inflammation of the kidney tissue are pain in the abdomen and waist, frequent urination, burning or pinching during urination. Complaints are supplemented by high fever, alternating constipation with diarrheal stools, lack of appetite, and headaches.

How to determine pyelonephritis

If you've had pain in your waist or groin, if you've got a fever, or if you've had a burning sensation while urinating, you're probably already convinced that you should go to the doctor's office. As soon as the specialist analyzes the symptoms that you have indicated, he will most likely diagnose pyelonephritis. As an accompanying diagnostic method physical examination, urinalysis and others are indicated. Urine itself is examined both microbiologically and under a microscope. The first test detects the presence of bacteria and it is important to combine this with pathogen susceptibility testing. this antibiotic. Under a microscope, a urine sample is monitored for white and red blood cell counts, and for the presence of epithelial cells and protein.

Frequent imaging is an abdominal ultrasound procedure. It controls the changes that occur in acute pyelonephritis. It should be borne in mind that the absence of changes in the kidneys does not exclude the presence of a kidney infection in all cases.

As possible methods detection of pyelonephritis is also shown more CT scan, magnetic resonance imaging and venous urography.

Treatment of pyelonephritis

First of all - when it comes to the treatment of pyelonephritis, antibiotics are recommended. This is not accidental - it is the antibiotic that can neutralize harmful bacteria causing kidney infection.

As a rule, just a few days after the start of antibiotic therapy, the general condition of the patient improves. In rare cases, a course of treatment lasting a week or more is required. It is extremely important not to stop taking medications after the symptoms disappear, as this can lead to resistance to other pathogens present in the body.

If the diagnosis is late and the patient's condition is already severe, it may be necessary to treat with intravenous antibiotics.

Surgical intervention for pyelonephritis is also not excluded. This is the case with defects in the structure of the organs of the urinary system, which provoke frequently recurring infections of the kidneys. Surgery is also necessary in case of large kidney abscesses leading to purulent outbreaks.

The main objectives of the treatment of pyelonephritis may be the following:

timely accurate diagnosis and appropriate initiation of treatment;
elimination of predisposing factors, as far as possible;
prescribing antibiotics according to antibiotic results;
simultaneous treatment and relapses in the presence of rabbits;
general strengthening of the body and strengthening of immune defenses.

Antibiotics for pyelonephritis

The most commonly assigned groups are:

aminoglycosides - this group includes amikacin, tobramycin, gentamicin and others;
beta-lactams - amoxicillin, zinaz and others;
quinolones - ciprofloxacin, ofloxacin and others;
macrolides;
polymyxins and others.
ciprofloxacin

Ciprofloxacin

One of the most commonly prescribed antibiotics for urinary tract infections is ciprofloxacin. It belongs to the group of fluoroquinolones, and its action is aimed directly at eliminating the cause of the infection. The data show that a course of treatment with ciprofloxacin for 7 days would be as effective in pyelonephritis as therapy with the same product for 14 days. It is usually taken from 5 to 21 days, and it is up to the doctor to determine the duration of treatment.

Gentamicin

Further, as a commonly prescribed antibiotic for pyelonephritis, gentamicin is mentioned. It should be borne in mind that patients with concomitant disease kidney and hearing impairment should be very careful while taking this medicine.

In severe cases of infection, treatment with gentamicin begins as intravenous therapy, then progresses to muscle injection. The dose is obtained by dissolving in saline.

Amoxicillin

Group penicillin preparations includes amoxicillin, which is also used to treat inflammation of the parenchyma in the kidneys. Recommended daily dose the drug is up to 3000 mg, divided into several receivers. The dose is determined based on the individual condition.

Osmamox and Amoxicl are similar products containing amoxicillin.

Levofloxacin

For the treatment of pyelonephritis, the antibiotic Levofloxacin or a similar product Tavanic is also often prescribed. They belong to the quinol drugs and act against bacteria that cause infection in the human body.

Tobramycin

An antibiotic of the aminoglycoside group, Tobramycin is also prescribed for kidney infections depending on the results of the antibiotic. It is given as an injection, which destroys pathogenic microorganisms from which disease arises.

Other drugs for the treatment of pyelonephritis

We have already mentioned that the main attention in the treatment of pyelonephritis is given to antibiotic therapy.

However, another group of drugs that many consider antibiotics also work for kidney problems. It's about about chemotherapy drugs. The difference between the two classes of drugs is that while antibiotics are made from living microorganisms, chemotherapeutics are completely synthetic.

The most popular product of this group, which is applicable to pyelonephritis, is Biseptol. It is most often prescribed for acute illness and may be extended. The choice falls on this drug when single-component therapy is ineffective or there is no oral treatment.

Nitrox also belongs to the group of chemotherapeutic agents. It is used to treat kidney disorders, including pyelonephritis, caused by viral or fungal infections. It is also often prescribed to prevent relapse.

Nolicin contains norfloxacin and acts directly on the bacteria that cause kidney inflammation. It can also be used prophylactically.

uro-waxom is a drug commonly used for pyelonephritis. Its action, however, is aimed at increasing the immune capacity of the body and limiting infections of the urinary tract and urinary tract in general. It is used in frequent re-infections and also in antibiotic therapy for higher efficacy.

Homeopathy for pyelonephritis

We will also briefly mention some of the homeopathic products that are used for diseases of the urinary system, especially for kidney infection. As with other homeopathic treatments, it is also important to take the appropriate prescriptions regularly.

Apis- homeopathic product mainly used for urinary retention, but also for pain and discomfort during urination. The effect of therapy is the urgency of urination.

Arnica- its action is aimed at reducing pain during urination.

Berberis- Most often for the treatment of pyelonephritis, it is prescribed together with Calcarea Sulfurica. The combination of drugs is suitable in cases where the intensity of pain increases.

The most common disease of the genitourinary system in women is pyelonephritis. It accounts for about 65% of all cases. urological pathology, several times ahead of the incidence of cystitis and urethritis. Therefore, it is desirable for any representative of the weaker sex to have an idea of \u200b\u200bwhat kidney pyelonephritis is.

Pyelonephritis - what is it?

The diagnosis of "pyelonephritis" implies the presence of an infectious and inflammatory process in the interstitial tissue, which forms the fibrous basis of the kidney, as well as in the pelvis and tubules, but without damage to the renal vessels and glomeruli.

In this regard, on early stages diseases main function kidneys (urine filtration) does not suffer, however, with long course or improper treatment, inflammation can also cover the vessels with the glomerular apparatus.

Pyelonephritis occurs in acute or chronic form. One kidney is most often affected, but there are also bilateral inflammatory processes.

The high incidence of the disease in the fair sex is associated with the peculiarity of the structure of the urinary system in women:

The urethra is shorter than the male;
The urethra in women is located next to additional sources of infection - anus and the vagina, so germs quickly and easily enter the urethra.

Causes of pyelonephritis

In women, due to the above anatomical features, the ascending (urinogenic) route of infection in the pelvis and kidney tissue- due to cystitis, urethritis, colpitis, colitis, urolithiasis and anomalies in the structure of the urinary system, a long stay of a catheter to remove urine.

It is also possible hematogenous (with blood flow) spread of infection, when any focus can become a potential source - transferred purulent mastitis, sore throat, panaritium, inflammation of the ear and even inflammation of the dental canal (pulpitis).

The main microbe causing pyelonephritis, is E. coli (up to 75% of all cases).

The remaining 25% of cases are associated with getting into urinary tract klebsiella, protea, Staphylococcus aureus, enterococcus, Pseudomonas aeruginosa, fungal infection, chlamydia, salmonella, etc.

Risk factors in the occurrence of pyelonephritis in women are all protracted pathological processes any localization occurring with a decrease in the general immunity of the body: diabetes, diseases bone marrow, neurological problems (multiple sclerosis), HIV infection, condition after chemotherapy or organ transplantation.

In addition, pregnancy can exacerbate the chronic form of the disease and trigger an acute inflammatory process due to compression of the bladder and ureters by the growing uterus.

Signs and symptoms of pyelonephritis in women

Chronic inflammation often proceeds smoothly and the symptoms of pyelonephritis in women are practically absent or manifested by blurred non-specific complaints of aching pain in the lower back after hypothermia, fatigue and minor general malaise.

Signs of acute pyelonephritis in women are usually more pronounced:

Severe pain in the back or side is more often from inflammation, but there may also be diffuse pain under the ribs, in the lower abdomen or without a clear localization;
High temperature (38-40°C);
Nausea and vomiting;
Urine changes (darkening, blood or pus appearing, bad smell);
Pain when urinating;
The appearance of swelling of the face and fingers;
Marked weakness.

Diagnosis of pyelonephritis

To establish a diagnosis, a number of standard examinations are needed:

Examination by a urologist or nephrologist with palpation of the abdomen and determination of Pasternatsky's symptom (striking on the back in the projection of the kidneys).
Gynecological examination to exclude problems in the female genital area.
Urinalysis: general, according to Nechiporenko, urine culture with the establishment of flora and sensitivity to antibiotics.
Blood tests: general, biochemical (determination of creatinine, urea, protein).
Ultrasound of the kidneys.
In complex and severe cases, resort to CT, MRI, excretory urography, radioisotope scanning and other methods.

Treatment should be aimed at restoring the normal outflow of urine (removing stones, eliminating vesicoureteral reflux) and eliminating the source of infection - with pyelonephritis in women, antibiotics, chemical antibacterial agents and uroseptics are prescribed.

The acute form of the disease requires hospitalization and bed rest, in the chronic form it is possible ambulatory treatment. The diet is prescribed high content light carbs, fermented milk products, drinking plenty of water.

The terms of treatment of acute pyelonephritis are 10-14 days, chronic - from 6-8 weeks to 1 year. To consolidate the effect at the stage of recovery, it is recommended to increase the body's immune reactivity (immunomodulators, hardening).

Medical preparations for the treatment of pyelonephritis:

Antibiotics - ciprofloxacin, cefuroxime, gentamicin, cefepime, meronem.
Chemical antibacterial agents - furagin, nitroxoline, gramurin, nevigramon, palin, bactrim.

Medicines should be prescribed by a doctor, taking into account the form of the disease and the individual sensitivity of the flora sown from the urine. To prevent the development of infection resistance to antibacterial agents They need to be changed every 5-7 days.

Together with medications treatment for pyelonephritis folk remedies: make infusions, decoctions and teas from medicinal plants with anti-inflammatory and diuretic properties (chamomile, bearberry, St. John's wort, nettle, horsetail, elderberry, lingonberry, cranberry).

Complications of pyelonephritis

In case of incorrect or untimely treatment acute pyelonephritis may occur chronic form of the disease, kidney abscess, blood poisoning, sometimes even hypotension and shock.

The chronic process is also more than dangerous - the pathology gradually leads to the development of chronic renal failure. Pregnant women and women with concomitant diseases are most susceptible to the development of complications.

Prevention of pyelonephritis

To prevent the development of the disease, it is necessary not to overcool, treat all inflammatory processes in a timely manner (from SARS or caries to panaritium or vulvovaginitis), ensure normal emptying of the bladder, and maintain hygiene intimate zone, to practice safe sex, eat right and monitor the quality and quantity of fluids consumed (purified water, teas, juices - up to 1.5-2 l / day; carbonated sweet drinks should be excluded).

But crucial in the prevention of any disease of the genitourinary system has correct diagnosis and the course of treatment started in a timely manner, therefore, if the suspicious symptoms of pyelonephritis described above appear, you should consult a doctor.