What causes kidney pyelonephritis. Pyelonephritis - causes and treatment of the disease in adults
– insidious disease, which is characterized by the development of the inflammatory process of the renal pelvis and kidneys. This disease often develops in humans both as an independent disease and as a consequence of other diseases. genitourinary system, due to which the outflow of urine is disturbed in a person. So, very often the development happening in the background prostate , often the disease can develop against the background of ailments of an infectious nature.
Pyelonephritis in children often develops as a complication after the disease. , pneumonia . In pregnant women, this disease is the result of a noticeable hormonal imbalance in the body, and also develops due to impaired urine outflow due to squeezing internal organs uterus. Moreover, during pregnancy exacerbation of chronic pyelonephritis often occurs.
pathogenesis (what happens)
The development of pyelonephritis occurs when pathogenic microbes enter the kidney tissue. In patients, either they pass from the bladder through the ureters. Also, microbes can spread through the blood vessels from different foci of inflammation throughout the body.
- a disease that affects women to a greater extent. With pyelonephritis, an inflammatory process of one or both kidneys is manifested. As a rule, the disease is bacterial in nature. Microorganisms enter the human kidneys from the focus of infection in the body with the bloodstream, or from the bladder and urethra through the ureters. In the latter case, pyelonephritis of the kidneys manifests itself as a complication after or .
The prevalence of the disease among girls and women is explained, first of all, by the fact that the urethra in females is shorter than in men. Very often, the symptoms of pyelonephritis appear in people who have problems with the immune system, diabetics . The disease often occurs in children preschool age. Pyelonephritis often occurs in pregnant women, as well as in those who have already experienced or starts having sex. In men, the factor provoking the development of pyelonephritis of the kidneys often becomes prostate . Due to problems with the outflow of urine in a person, a favorable environment is created in the body for the development of bacteria. Patients with pyelonephritis also suffer from kidney stones . Such formations often become a certain refuge for bacteria, which subsequently provoke inflammation.
Types of pyelonephritis
Pyelonephritis of the kidneys is usually divided into spicy and chronic . Also exists primary and secondary form of the disease.
It is customary to distinguish sharp and chronic form of pyelonephritis. In acute pyelonephritis, a person suffers from a very severe chill, while there is intense sweating, an increase in body temperature up to forty degrees, pain sensation in the lumbar region, nausea and vomiting. Urinalysis reveals a significant number of microbes and .
In contrast to acute pyelonephritis, the chronic form of the disease can be hidden for years. At the same time, there are no clear symptoms of pyelonephritis in humans, and signs of the disease can only be detected during a urine test. In the process of development, the disease can periodically become severely aggravated. Then the signs of the disease will be similar to the symptoms of the acute form of the disease. Treatment of chronic pyelonephritis must be adequate and timely, otherwise it may be significantly disrupted. excretory function kidneys.
Acute pyelonephritis
Acute pyelonephritis occurs in the patient due to the impact on his body endogenous or exogenous microorganisms that enter the kidneys. In this case crucial with the development of the disease, it has a number of factors: violation of the passage of urine due to obstruction by a stone and other reasons; urinary obstruction due to adenomas , prostate cancer , etc. In addition, the occurrence of pyelonephritis determines general state human body. The body's resistance is negatively affected wrong approach to nutrition, hypothermia, hypovitaminosis , frequent colds, ailments of a number of body systems.
Depending on the stage of the disease, the presence of its complications, symptoms of pyelonephritis appear. Determining the stages of the disease occurs after studying morphological changes in the kidney.
On the initial stage sickness a person suffers from serous pyelonephritis , which can last from six to thirty-six hours. Further, the disease passes into the following stages, which are characterized by the presence of purulent, destructive changes. As a rule, such changes have a clear sequence. First manifested apostematous pyelonephritis , Further - kidney carbuncle , kidneys , and the change process ends purulent paranephritis.
On the stage apostematous pyelonephritis in humans, small multiple pustules appear on the surface of the kidney and in its cortical substance. If these pustules in the process of development begin to merge, or the microbial embolus is in the final arterial vessel kidneys, a person has a carbuncle of the kidney. This condition is characterized by the development necrotic , ischemic , purulent-inflammatory processes.
Due to purulent fusion of the parenchyma, kidney abscess . , which appeared in the focus of the carbuncle of the kidney or the fusion of apostems, is sometimes emptied into the perirenal tissue. After that it develops purulent paranephritis , sometimes there is also a phlegmon of the retroperitoneal space.
Most often, purulent forms of pyelonephritis occur as a result of obstruction of the upper urinary tract.
At secondary acute pyelonephritis
local symptoms of the disease are more pronounced. At the same time, in the development primary pyelonephritis
, first of all, there are common features infections, but the symptoms of a local nature at first may not appear at all. As a result, errors are possible during the diagnostic process. Symptoms of pyelonephritis mostly become noticeable throughout the day. The patient complains about general weakness and malaise, on the background of which there is severe chills, body temperature can rise up to 41 °C. Chills are characterized by severe headache, vomiting, and nausea. There is a noticeable muscle pain in the body, sometimes the patient is annoyed diarrhea
,
.
Secondary acute pyelonephritis begins with manifestation renal colic. After this, chills appear, against the background jump body temperature, which can rise to 41 ° C. Further, the patient develops symptoms similar to those of secondary pyelonephritis. After the temperature drops to normal or subnormal levels, the person begins to sweat profusely. He feels a certain improvement, the pain in the lower back becomes less intense. However, in this case there is an imaginary improvement, which the doctor cannot regard as a cure for the patient. Indeed, in the case of an obstruction of the upper urinary tract, an attack of pain and chills will resume after a few hours.
If the patient develops purulent form of pyelonephritis , then the symptoms of the disease become even more pronounced. At the same time, lumbar pain from paroxysmal becomes permanent, it is accompanied by chills and. On the side where the lesion is observed, the muscles of the anterior abdominal wall and lumbar region. The kidney is painful, on palpation its increase is determined. Grows in the body intoxication resulting in a worsening condition. The state of dehydration is gradually aggravated, so the person's facial features noticeably sharpen, the condition becomes severe, and in some cases is accompanied. However, the described symptoms of kidney pyelonephritis with purulent-destructive changes in the kidney are not always expressed. If a person is weakened, sick, then clinically the condition can manifest itself perversely.
Chronic pyelonephritis
Chronic pyelonephritis is a fairly common disease. However, such a diagnosis is rather difficult to establish due to very few pronounced general clinical symptoms. In most cases, chronic pyelonephritis is a continuation of acute pyelonephritis. Especially often this disease occurs in those patients who have a disturbed passage of urine along the upper urinary tract. This phenomenon is provoked by stones in the ureters and kidneys, chronic delay urine and other phenomena.
Approximately one third of patients suffer from chronic pyelonephritis since childhood: the disease develops as a non-specific sluggish inflammation of the parenchyma pelvicalyceal system and kidneys. In most cases, the disease is discovered many years after it occurs. Chronic pyelonephritis affects both one and two kidneys.
This disease is characterized by polymorphism and foci of changes in the kidney tissue. Gradually, the following sections of the kidney tissue are involved in inflammation, therefore, the tissue gradually dies, and manifests itself .
The manifestation of chronic pyelonephritis is undulating: periodically there are exacerbations of the disease, which are replaced by remissions. Depending on the spread of inflammation in the kidneys and its activity, the clinical picture may vary. With an active inflammatory process, the symptoms converge with signs of acute pyelonephritis. When the period of remission begins, the manifestations of pyelonephritis are expressed by non-specific signs. So, a person can complain about headache, lack of appetite, weakness, chills, bouts of nausea and periodic jumps in body temperature to subfebrile. In some cases, there is a dull pain in the lower back.
With the subsequent progression of the disease, the person complains of attacks arterial hypertension . Ten to fifteen years after the onset of the disease, the patient develops chronic kidney failure .
Diagnosis of pyelonephritis
In order to correctly diagnose kidney pyelonephritis in a patient, the doctor, first of all, examines the patient, paying Special attention on the condition of his skin, noting whether there is moisture and pallor skin. The doctor also notes a dry, furred tongue, determines the presence tachycardia , hypotension .
In the process of laboratory blood tests, it is found leukocytosis , acceleration . If there are purulent forms of the disease, the patient has dysproteinemia , anemia , high level urea and serum creatinine. Also, in the process of diagnosis, a urine test is mandatory. It is important to conduct a bacteriological study and determine the sensitivity of microorganisms to antibacterial drugs. Laboratory studies must include bacteriological culture urine.
Ultrasound diagnostics of the kidneys is often prescribed as additional diagnostic methods. If at this survey there is limited mobility of the kidney, then such a sign can be regarded as an additional criterion in the process of diagnosing acute pyelonephritis. Thanks to ultrasound, you can not only diagnose the disease, but also determine the causes that led to its appearance - the presence of kidney stones, defects in the urinary system.
It is also possible to accurately determine the destructive forms of pyelonephritis in children and adults using CT or MRI.
In the absence of the ability to ultrasound diagnostics it is possible to differentiate primary and secondary pyelonephritis based on the results of chromocystoscopy and excretory urography. In acute pyelonephritis, it is important to conduct a differential diagnosis with infectious diseases, acute ailments of the genitals and abdominal organs.
It is very difficult to diagnose chronic pyelonephritis in a person, because given form disease has a long latent period. In view of this, it is important to study the results of laboratory tests very carefully, even if visible external signs diseases are absent.
In the process of ultrasound examination, the only sign that is characteristic of the chronic form of the disease is the presence of shriveling of the kidney . In this state, the kidney decreases, there is an unevenness of its contour.
This condition is also characterized by a decrease in the secretory function of the kidney.
Treatment of pyelonephritis
The manifestation of acute pyelonephritis in children and adults is the reason for the immediate hospitalization of the patient and his subsequent treatment in a hospital. However, the treatment of pyelonephritis of the kidneys of the primary and secondary forms is carried out using different approaches. If the patient is diagnosed with secondary pyelonephritis, the most important action required is to restore the outflow of urine from the kidney that was affected. If the disease began to manifest itself no earlier than two days and there are no purulent-destructive changes in the kidney, then the outflow of urine is restored by catheterization of the pelvis.
After the outflow of urine has been restored, as well as in primary pyelonephritis, it is used pathogenetic treatment, the main point of which is the application antibacterial drugs . It is important to assign antibacterial drugs, which have a wide spectrum of action and affect the gram-negative flora.
Drugs in the treatment of pyelonephritis are administered parenterally, using the maximum therapeutic dose. In the process complex treatment pyelonephritis, other drugs are also prescribed: non-steroidal anti-inflammatory drugs, drugs that activate blood circulation, methods of intoxication therapy are also used. If at right approach to treatment for a day and a half, there is no improvement effect, then the doctor concludes that there is a progressive purulent-destructive process in the kidney. This is a direct indication for open surgery.
The operation is carried out in order to stop the purulent-inflammatory process or prevent complications, ensuring the improvement of blood and lymph circulation in the kidney. For this purpose, a decapsulation kidneys. This method helps to reduce intrarenal pressure, expand the lumen of blood vessels. If 2/3 or more of the renal parenchyma is involved in the purulent-destructive process, then it is possible to perform nephrectomy during the operation.
As rehabilitation treatment therapy after surgery antibacterial , anti-inflammatory , detoxification means.
At the beginning of the treatment of chronic pyelonephritis, it is important to find out what is the cause of the violation of the passage of urine and circulatory disorders. Taking into account the results of bacteriological studies, the doctor prescribes antibacterial agents. For this, several courses of treatment are used, each time using a different drug due to the rapid emergence of resistant strains of microbes. In addition, for the treatment of pyelonephritis are used sulfanilamide drugs, herbal products, vitamin complex , immunocorrective funds. Treatment of chronic pyelonephritis lasts at least two months. If chronic pyelonephritis does not respond to treatment, the patient needs to undergo a nephrectomy.
Given the fact that pyelonephritis is an infectious disease, its therapy is carried out using
. A very important point is that the treatment of pyelonephritis with antibiotics should be prescribed only by a specialist. After all, when choosing a drug, a number of individual features, namely, what type of microorganism provoked the disease, the degree of its sensitivity to a certain drug. The duration of taking the drug, as well as its dosage, is determined taking into account the state of the patient's kidneys on this moment. Treatment of pyelonephritis with antibiotics will give a faster effect if you start it from the very first day of an exacerbation of the disease.
If a patient is diagnosed with a chronic form of the disease, then the treatment of pyelonephritis in this case will be longer: for example, the course of taking antibiotics is from six to eight weeks. Further approach to therapy is determined by the attending physician.
The doctors
Medications
Treatment of pyelonephritis at home
Parallel to drug treatment pyelonephritis often practiced the use of some helper methods and therapies available at home. If there is an exacerbation of the disease, it is best for the patient to observe strict bed rest for some time, while constantly staying warm. In this case, the blood flow in the kidneys will be activated, and the inflammation will subside much faster.
With pyelonephritis, a certain drinking regimen is important: if a person has never suffered arterial hypertension , and he does not have edema, then every day he should drink about three liters of fluid. In this case, it is recommended vitamin drinks, mineral water, fruit drinks, kissels, compotes. by the most healthy drinks there will be fruit drinks from cranberries and lingonberries, because they also have an anti-inflammatory effect.
Compliance with particularly strict the treatment is not required: it is enough to refuse spicy and salty foods, alcohol, smoked meats. At the same time, you need to include in your daily diet as much as possible. more products With large quantity vitamins. With pyelonephritis, the body should replenish the supply of potassium, as well as vitamins of group B, C, R. Food that has a diuretic property is also recommended: pumpkin, melon, watermelon.
Treatment of pyelonephritis with herbs
There are a lot of traditional medicine recipes that are successfully used to alleviate the condition of a patient diagnosed with pyelonephritis. Herbal treatment involves the use of special fees that must be drunk for several days.
One of these collections includes the herb of lemon balm, knotweed, elder flowers, bearberry leaf, St. John's wort, calamus root, kidney tea leaf, fennel fruit.
Another collection for the treatment of pyelonephritis includes chamomile flowers and blue cornflower, common juniper fruits, nettle leaf and peppermint, marshmallow root, flax seeds, tricolor violet herb and prickly tartar.
To prepare these fees, you need to take three tablespoons of crushed and mixed ingredients, pour half a liter of boiling water and insist for six hours. Drink herbal tea should be warm, half an hour before meals.
In addition, in the treatment of pyelonephritis folk remedies practicing the use of the collection of medicinal plants that have a positive effect on the body's resistance.
Such a collection of herbs consists of the fruits of wild strawberry, juniper and wild rose, horsetail grass, birch, plantain, bearberry, black currant, nettle. For a decoction, you need to take ten grams of a mixture of herbs, pour boiling water over it and boil in a water bath for thirty minutes. After that, the herbal decoction is infused for another thirty minutes. It should be taken warm before meals.
For the treatment of pyelonephritis, you can also use a special herbal tea, which is sold in pharmacies. However, you can prepare such a tool yourself. To do this, you need to combine meadowsweet, raspberries, willow, birch leaves, elderberry, Ivan tea, celandine, burdock, chamomile, dandelion, lingonberries. Such tea is effective in the stage of exacerbation of the disease. It can be used for a long time - even several months. To make tea, two tablespoons of medicinal plants should be poured with one liter of water and simmered for about twenty minutes.
Decoctions of other herbs are also an effective remedy for pyelonephritis: you can prepare a tincture of bedstraw herb, toadflax herb. The dried herb is poured with boiling water and boiled in a water bath for 15 minutes.
Patients diagnosed with pyelonephritis are often treated with herbs along with antibiotic therapy. However, the use of such a method must be reported to the doctor.
There are also a number of alternative methods that are additionally used in the treatment of pyelonephritis. As a rule, these are herbal decoctions, which include blackberry leaves, bearberry, flax seed, birch leaf, nettle, horsetail grass. Decoctions are taken warm several times a day.
Treatment of pyelonephritis with folk remedies includes not only the use of herbal decoctions and infusions. So, with such an ailment, the intake of carrot juice effectively affects the general condition of the body. Also, before eating, people with pyelonephritis are advised to eat about 100 g of grated carrots.
Pyelonephritis in pregnant women
Pyelonephritis in pregnant women often occurs as a result of the intensive growth of the uterus, which, as it grows, presses on the ureters and makes it difficult to drain urine. In addition, pyelonephritis in pregnant women is more common due to noticeable hormonal changes in a woman's body. Due to intense hormonal changes, peristalsis of the ureters can be noticeably hampered.
In addition, daily activity is important for the proper functioning of the urinary system, which is not always typical for a woman carrying a child.
Most often, pyelonephritis occurs in those pregnant women who have previously suffered cystitis or pyelonephritis .
It is important to consider that pyelonephritis negatively affects the course of pregnancy and the fetus. This disease can provoke anemia, late and even termination of pregnancy. Therefore, when symptoms of pyelonephritis appear, it is important for a woman carrying a child to immediately seek medical help.
All women who have had pyelonephritis during pregnancy are under the supervision of a doctor after childbirth.
Diet, nutrition for pyelonephritis
Diet involves careful selection of the diet during the treatment of the disease, and after recovery. In the first days of the disease, patients with acute pyelonephritis are encouraged to consume only berries, fruits, melons, mashed potatoes from some vegetables. Later, you can gradually introduce protein products, but the diet for pyelonephritis involves energy value nutrition is not higher than 1800-2000 kcal.
In the very first days of illness, it is important to consume at least two liters of liquid - weak tea, herbal decoctions, fruit juices diluted with water. It is recommended to use lingonberry and cranberry fruit drinks.
A salt-free diet for pyelonephritis is not required, but salt intake should be limited to 6 g per day. It is important to eat with high content vitamins.
At the same time, the disease of chronic pyelonephritis does not imply a special . However, it is important to follow the principles of a healthy diet, drink plenty of fluids, and do not limit salt intake. To improve the body, you can periodically arrange fasting days.
Complications of pyelonephritis
As complications of pyelonephritis in children and adults may develop acute pyelonephritis in the opposite kidney
, sepsis
, bacteriotoxic shock
.
Most serious complication acute pyelonephritis is a bacteriotoxic shock, due to which 45 to 55% of patients die. This disease manifests itself in the appointment of antibacterial agents with unrecovered outflow of urine.
In this condition, a person drops sharply to critical levels, the return of blood to the heart decreases, destruction occurs and platelets . As a result, processes leading to the development of multiple organ failure occur.
In chronic pyelonephritis as a complication occurs nephrogenic arterial hypertension and chronic renal failure .
List of sources
- Loran O.B., Sinyakova L.A. Inflammatory diseases of the urinary system. - M.: MIA, 2008.
- Pereverzev A.S., Kogan M.I. Infections and inflammation in urology.- M.: ABV-press, 2007.
- Tiktinsky O.L. Pyelonephritis / O.L. Tiktinsky, S.N. Kalinin. - St. Petersburg: Media Press, 1996.
- Shekhtman M.M. midwife. nephrology. M., Triada X, 2000.
is an infectious and inflammatory disease of the kidneys. The disease develops as a result of the spread of pathogenic microorganisms penetrating the kidneys from the lower parts of the urinary system. The most common cause of pyelonephritis is Escherichia coli - E. Coli. It is found when performing a urine test in sick women in large numbers. Less commonly, the causative agents of the disease are other gram-negative bacteria, staphylococci and enterococci. In 20% of cases, pyelonephritis occurs as a result of a mixed infection.
Pyelonephritis is serious illness, characterized severe course. Patients suffer from severe pain, general well-being is violated. Experts are unanimous in the opinion that the disease is much easier to prevent than to get rid of it.
Pyelonephritis refers to infections of the urinary system. If pathogenic bacteria capture its lower sections, and therapy antibacterial agents is selected incorrectly or is completely absent, then microorganisms begin to multiply rapidly with spread to the kidneys. This leads to the symptoms of pyelonephritis. The nephrologist deals with the diagnosis and treatment of the disease.
Facts and statistics about pyelonephritis
It has been established that female representatives suffer from pyelonephritis more often than men by 5 times. The acute form of the disease is diagnosed more often in women. reproductive age leading an active sex life.
In the United States of America, 1 in 7,000 people gets sick every year. 192,000 patients need and receive hospitalization every year.
With adequate treatment, up to 95% of all patients report significant improvement already in the first two days.
Pyelonephritis affects children, both girls (in 3% of cases) and boys (in 1% of cases). In childhood, the disease is dangerous for its complications. Thus, cicatricial changes in the kidney parenchyma are diagnosed in 17% of children who have been ill, hypertension in 10-20% of children.
Abundant fluid intake is an essential condition for the treatment of the disease. For drinking, it is necessary to use clean water, which normalizes the balance in the body, thins the blood, promotes the speedy removal of pathogenic microorganisms and toxic products of their vital activity. The effect is achieved by increasing the number of urination as a result of plentiful drink.
You should not refuse to drink plenty of water because of pain during bladder emptying, as this is the only way to remove bacteria from the body. You should urinate as often as possible so that there is no such serious complication as blood poisoning, as a result of which a person may die.
Alcoholic drinks, coffee, carbonated water - all this is prohibited in pyelonephritis. It is believed that cranberry juice can help in the fight against the disease. It is consumed in pure form or diluted with water.
Symptoms of acute pyelonephritis are as follows:
The occurrence of a feeling of nausea, which may be accompanied by vomiting.
High body temperature with chills. Sweating increases, appetite disappears, headaches occur.
Increased fatigue, malaise and weakness.
Painful sensations with localization in that side from which the kidney is damaged. Pain can also be girdle in nature with predominant localization in the lower back. "Spillage" of pain occurs with a bilateral inflammatory process. An exacerbation of the disease is characterized by Pasternatsky's symptom, which boils down to the appearance of pain when tapping in the lumbar region and, for a short time, an increase in erythrocyturia. When changing the position of the body, the intensity of pain does not change, but they increase during deep breathing and on palpation of the abdomen.
An increase in the number of urination, regardless of the sex of the patient.
Minor swelling.
Laboratory tests of urine and blood indicate inflammation. Pathogenic bacteria and leukocytes are found in the urine.
If pyelonephritis is purulent, then the body temperature can manifest itself abruptly - rise to high values and fall to subfebrile levels several times a day. Most often, the fever lasts for a week.
Bacterial shock is typical for 10% of patients.
There are also non-specific symptoms for acute pyelonephritis that may indicate the disease:
An increase in body temperature to high values, up to the development of a feverish state.
Tachycardia.
Dehydration of the body.
If the disease has become chronic (which often occurs with an untreated acute stage of the disease, although sometimes chronicization of the process without a previous exacerbation is possible), then the symptoms of pyelonephritis may be less pronounced, but they persist for a long time period. When donating blood for analysis, signs of inflammation may not be detected. Leukocytes are present in the urine, but the bacterial component may be absent. When remission of pyelonephritis occurs, then all laboratory parameters will be normal.
In addition, every third sick person notes the following symptoms(characteristic of inflammation of the lower urinary system):
Pain during emptying of the bladder of the type of pain.
The presence of blood impurities in the urine.
Constant desire to empty bladder even when it's not full.
Darkening of urine, the presence of turbidity in it, the presence of an unpleasant fishy smell.
Ascending entry of bacteria into the kidneys
The development of the disease is provoked by bacteria. They, through the urethra, enter the urinary system and inseminate the bladder. If the infection is not eliminated, then gradually it will rise higher and higher, capturing the organs located in its path and eventually affecting the kidneys. In 90% of cases, the disease occurs due to the penetration of Escherichia coli into the bladder. She, having begun her vital activity in the intestines, penetrates into the urethra from the anus. Most often this happens during the emptying process. Due to the fact that urethra and anus in women it is located nearby, and the main source of infection is E. coli, they suffer from pyelonephritis much more often.
In addition, the urethra in women is short, and the anatomy of the external genital organs is such that it is not difficult for E. coli to penetrate the bladder and then the kidneys. Therefore, the ascending route of infection is the most common cause of infection, resulting in acute pyelonephritis.
However, not always only E. coli leads to inflammation of the kidneys.
Other causes of pyelonephritis include:
-
Enterobacter.
Enterococci;
Mycotic microorganisms;
Vesiculourethral reflux (vesicoureteral reflux)
This pathology is characterized by the fact that from the bladder, urine flows back into the ureters and is partially thrown into the renal pelvis. When the disease remains undetected early stage, it leads to regular stagnation of urine, reflux and reproduction of pathogenic agents in the tissues of the kidney, which leads to an inflammatory process.
The more exacerbations of pyelonephritis the child suffers, the more the structure of the kidneys is disturbed. As a result, normal tissue is replaced by scar tissue and the organ is unable to perform its functions in the same volume. This development of the disease is typical mainly for young children who have not reached the age of five. However, scarring of the tissues of the kidneys and in adolescence against the background of the disease.
It is children's kidneys that are more prone to scarring, since:
Backflow or reflux in childhood occurs under less pressure than in adults.
The immune system of children is more vulnerable to the pathogenic influence of bacterial agents than in adulthood. This is especially true for children under one year old.
Pyelonephritis is more difficult to detect in younger age especially in infancy.
Vesico-dream reflux is found in most children under six years of age suffering from pyelonephritis (from 20 to 50% of all patients), while in adults this pathology is diagnosed only in 4% of cases.
Pyelonephritis, transferred at an early age, leads to irreversible changes kidney tissues. So of all patients on hemodialysis, 12% were sick with acute pyelonephritis in childhood.
As for other causes of pyelonephritis, they are of low prevalence. It is possible for the pathogen to penetrate not from the bladder, but through the blood flow from other organs.
Risk factors
There are risk factors that increase the likelihood of developing the disease, among them:
Deposition of stones in the kidneys.
Pathologies of the development of the organs of the urinary system of a congenital nature.
Changes in the urinary system due to age.
Neurogenic dysfunction of the bladder, which is observed in diabetes mellitus. This condition requires re-insertion of the catheter, which increases the risk of developing the disease.
Damage spinal cord as a result of injuries.
The period of bearing a child, which can lead to a decrease in tone and a decrease in ureteral perilstatics. This is due to their compression by the growing uterus, with polyhydramnios, with narrow pelvis, at large fruit, or against the background of existing insufficiency of the vesicoureteral valves.
Full or partial displacement of the uterus outside the vagina.
The introduction of a catheter into the bladder, which leads to its obstruction.
sexual activity young woman. During intercourse, the muscles of the urogenital diaphragm contract as a result of massaging the urethra, which increases the risk of infection along the ascending pathway.
Operations on the organs of the urinary system.
Diagnosis in a typical case is not difficult. The patient's complaints about pain in the lumbar region, intoxication syndrome become the basis for testing and passing instrumental examination which makes it possible to diagnose pyelonephritis.
Instrumental research is reduced to:
Ultrasound of the kidneys, which allows you to detect the presence of stones in them, provides information about the size of the organs, about changes in their density. At chronic course disease, the echogenicity of the parenchyma increases, and with acute course decreases unevenly.
CT makes it possible to assess not only the density of the parenchyma, but also the state of the perirenal tissue, vascular pedicle and pelvis.
Excretory urography gives information about the limitation of the mobility of the affected kidney, the tone of the urinary tract, the condition of the cups, etc.
Cystography is performed to detect intravesical obstruction and vesicoureteral reflux.
Angiography of the arteries of the kidneys is used more often with the already diagnosed chronic pyelonephritis, since this method is not routine for detecting the acute stage of the disease.
Women should definitely undergo a gynecological examination.
What tests are given for pyelonephritis?
With pyelonephritis, it is necessary to pass the following tests:
Urinalysis according to Nechiporenko.
Zimnitsky test.
Bacteriological examination of urine.
It is possible to perform a prednisolone test, which allows you to identify the latent course of the disease. Why is it given intravenously? special preparation(Prednisolone with Sodium chloride), after which, after an hour, after two and after three hours, and then, after a day, urine is collected and analyzed.
Pyelonephritis of the kidneys (from Lat. Pyelonephritis) is a fairly common infectious and inflammatory disease that affects the renal pelvis and its own tissue.
This pathology very often develops against the background of concomitant kidney diseases, for example, such as urolithiasis disease or glomerulonephritis. Today it is customary to distinguish chronic, acute and purulent form of pyelonephritis.
In terms of frequency of occurrence this disease, it should be noted that among the adult population it is approximately 10 out of 1000 people, and among children - 10 out of 2000. Most of the cases belong to the middle age group - from 26 to 44 years. An interesting fact is that more than 70% of all patients are young women who fell ill shortly after the first sexual intercourse. Among childhood diseases, inflammation of the kidneys securely holds the 2nd position immediately after various respiratory diseases(bronchitis, pneumonia, etc.).
Causes of pyelonephritis
To date, no one has been able to identify a specific causative agent of pyelonephritis. Therefore, it is believed that the cause of the development of the disease can be both endogenous (own) microorganisms of a person, and exogenous (infiltrated from outside). In the vast majority of cases, these are all kinds of cocci or E. coli. Approximately 20% are mixed infections.
There are the following ways of penetration of infectious agents into the kidney:
- Urogenic (through infected urine);
- Lymphogenous (through the lymph that comes from nearby affected organs);
- Hematogenous (together with blood).
Factors contributing to the development of pyelonephritis:
- General. These include:
- chronic stress;
- Weakness;
- Lack of vitamins;
- Chronic fatigue;
- Decreased activity of immunity, etc.;
- Local. Typically, they include pathological conditions, in which there is some kind of obstacle to the normal passage of urine.
Depending on the nature of the course, the following forms of pyelonephritis are distinguished:
- chronic;
- Acute;
- Purulent.
Chronic form of pyelonephritis
It is characterized by a sluggish course and periodic relapses in the form of acute pyelonephritis. As a result, there is a gradual replacement of normal renal tissues with connective (or non-functional) ones. Often complicated by the addition of renal failure and (or) arterial hypertension.
Acute pyelonephritis
It appears suddenly and develops rapidly. Depending on the pathogen, this form can take up to 20 days. However, with timely treatment, the prognosis is almost always positive.
Purulent pyelonephritis
In most cases, it develops against the background of chronic pyelonephritis and multiple problems with the genitourinary system. This pathology affects mainly people over 30 years of age who neglect treatment at the onset of the disease. As a rule, purulent pyelonephritis affects adjacent to the kidney adipose tissue(a kind of protective capsule).
Symptoms of pyelonephritis
The symptoms and treatment of pyelonephritis are closely interrelated, so it is extremely important to know the fundamental differences in the clinical manifestations of various forms of the disease.
acute form
- Changes in the urine: a cloudy or slightly reddish hue is possible, a pungent and fetid odor is felt even at a distance;
- dumb and sometimes sharp pains in the joints and (or) the lower back. Often they radiate to the groin. Patients note an increase in pain when bending forward;
- Constant nausea with bouts of vomiting;
- Sudden rise in temperature against the background of complete well-being, chills;
- Gradually increasing headache;
- Loss of appetite, general weakness.
Chronic form
Very often it is asymptomatic, which greatly complicates it. early diagnosis. Periodically, relapses are observed, which in their manifestations are very similar to acute pyelonephritis.
damaged kidney
There are the following types of chronic pyelonephritis:
- Latent (or asymptomatic). Rare rises in temperature are observed, which, nevertheless, can last for quite a long time. They arise mainly after the transferred acute form of the disease;
- Recurrent. There are general symptoms in the form of weakness, subfebrile temperature, dizziness, etc., as well as specific changes in the urine. This course often leads to the development of renal failure, hypertension and even anemia.
Features of this pathology in children
An extremely unpleasant and rather difficult childhood kidney disease is pyelonephritis. His distinctive feature in this age category is that it becomes the cause of the child's development of severe consequences. One of the most formidable complications kidney failure is considered, which in 60% of cases leads to disability of the child.
Unfortunately, in recent times the incidence among children of early and middle age has significantly increased. Moreover, newborn boys are more often ill. However, already at the age of 5-6 years, pyelonephritis mainly affects girls, which is probably due to the peculiarities of their genitourinary system.
Attention! In no case should we forget that pyelonephritis in children is often asymptomatic. You can notice the approach of the disease only by the following signs:
- Unexplained increased urination;
- Paleness of the skin;
- Frequent mood swings;
- Unreasonable fatigue of the child.
Despite all the warnings of doctors, parents often neglect the above symptoms, which often leads to very backfire. Currently, children's pyelonephritis is most often detected during a routine examination.
Pyelonephritis during pregnancy
Gynecologists note an increase in cases of pyelonephritis in pregnant women by about 22-25 weeks. It is during this period that the activity of immunity weakens, and the woman becomes an easy target for all kinds of infections.
The course of pyelonephritis during pregnancy has practically no features. Only sometimes painful urination joins the usual symptoms. If treatment is started on time, then there is no threat to the health of the baby or mother. The prognosis is good in 95% of cases.
Diagnostics
The main thing you need to know in order to cure pyelonephritis is the cause of its occurrence and the nature of the course. That's what everyone needs diagnostic measures which are prescribed exclusively by the attending physician.
Acute pyelonephritis
In this situation, a very important point is the patient's complaints (back pain, high fever, chills and urination disorders).
In addition, a general urinalysis is performed, which usually reveals great amount pathogenic bacteria and leukocytes, and sometimes erythrocytes.
A urine test according to Nechiporenko is mandatory, in which, as a rule, a significant increase in the number of leukocytes is determined.
Often these data are enough for the doctor to make a diagnosis, but sometimes there is a need for additional methods diagnostics such as ultrasound, x-ray examination and chromocystoscopy.
Chronic pyelonephritis
Diagnosis of this form is quite difficult, since a person very often simply does not notice the symptoms and, accordingly, does not make any complaints. In such a situation, everything depends on the doctor, or rather on his qualifications and experience. After all, only correctly selected questions can clarify the picture of the disease.
However, sometimes it is possible to identify chronic pyelonephritis only with the help of laboratory tests or when the first symptoms of renal failure appear.
Doctors recommend! In order to avoid severe consequences, which often leads to chronic pyelonephritis, you need to monitor your health. To do this, you must systematically visit your doctor and, following his instructions, undergo certain diagnostic and preventive procedures.
In general, the following diagnostic methods are used to detect chronic pyelonephritis:
- Urinalysis according to Nechiporenko and Zemnitsky's test;
- X-ray examination using a contrast agent;
- CT scan;
- Renography and scintigraphy;
- Immunological study;
- Kidney biopsy.
Treatment of pyelonephritis
Treatment of this pathology consists of several separate stages:
- Strict diet;
- The use of drug therapy;
- Surgery.
Diet
This is enough important point in the treatment of pyelonephritis, on which the success of treatment as a whole largely depends.
First, you need to increase the amount of fresh fruits and vegetables you eat. Secondly, you should drink more than 3 liters of water daily. And thirdly, it is worth excluding spicy, fried and excessively fatty foods from the diet.
If a we are talking exclusively about the chronic form, here the recommendations are somewhat different:
- The amount of liquid - more than 2 liters per day;
- Daily intake of multivitamin complexes;
- Limited consumption of meat and fish broths. Seasonings are not recommended. You can only eat well-cooked meat;
- The daily maximum salt is 7-8 grams.
Medical therapy
The basis for pyelonephritis is antibacterial drugs. They are accepted in courses lasting at least 7 days. With a complicated course - at least a month. Drug therapy for chronic and acute forms is practically the same.
Remember! Method of application and dosage necessary drugs should only be prescribed by a doctor. In this situation, self-medication is unacceptable. It can cause a significant deterioration in the patient's condition, up to death.
Surgical treatment of pyelonephritis
In situations where conservative methods of treatment with the use of antibiotics and other drugs do not bring the desired result and the patient's condition continues to deteriorate, surgical intervention is indicated.
Operations are predominantly purulent form(carbuncles, kidney apostemes). And the degree surgical intervention determined directly during the operation. It depends not only on the extent of the lesion, but also on the pathogenesis of the disease.
The main goal of the surgical operation is to prevent the development of a purulent-inflammatory process in the damaged kidney and to prevent the occurrence of a similar situation in a healthy kidney. If the patient had a violation of the normal outflow of urine, then during the operation it is also eliminated.
Prevention
Prevention of pyelonephritis is quite simple, but requires a certain amount of care, especially if it is carried out among children. For this you need:
- Use enough fluids per day (1.5-3l). This will ensure a normal outflow of urine;
- Do not delay urination for a long time;
- Timely and completely treat all infectious diseases;
- Avoid prolonged hypothermia;
- Observe the basic rules of personal hygiene;
- Adopt a healthy lifestyle that includes:
- General strengthening therapy courses;
- moderate physical activity;
- Balanced diet;
- Periodic intake of multivitamins;
- Regularly see a urologist. This is especially true for men who have a predisposition to prostatitis;
- Periodically take urine for analysis.
Pyelonephritis is one of the most common infectious diseases kidneys, accompanied by the development of an inflammatory process in the pelvis, calyces or parenchyma of the organ. It may occur on its own or as concomitant complication against the background of other pathologies (nephrolithiasis, glomerulonephritis, etc.).
The causative agents of infection are most often pathogenic or opportunistic gram-negative microorganisms that can get into the kidneys. different ways. Prompt medical attention and adequate therapy reduce the risk of possible complications and the transition of pathology into a chronic form. The incidence rate is about 1% among adults and 0.5% among children. More than half clinical cases, kidney pyelonephritis is detected in young and middle-aged women.
Causes
The main reason for the development of pyelonephritis is the appearance in the kidneys of potential pathogens of infectious diseases. These can be microorganisms that constantly live in the body or enter from the outside.
There are three ways for infection to enter the kidneys:
- Hematogenous. Infectious agents enter the kidneys with blood when there are foci of acute or chronic inflammation. For example, sinusitis, tonsillitis, furunculosis, osteomyelitis, influenza, tonsillitis, etc.;
- Lymphogenic. Pathogenic microorganisms enter the kidney from the nearest infected organs (intestines, genitals, etc.) with the lymph flow;
- Urinogenic. The pathogen enters the organ from the lower parts of the urinary system - the bladder or ureters. This mechanism of infection is realized when the patient has vesicoureteral reflux (reverse flow of urine from the bladder into the ureters).
Among the most frequently found bacterial culture urine of pathogens of pyelonephritis, the following microorganisms are present:
- Enterococci;
- para-intestinal coli;
- Pseudomonas aeruginosa;
- Protea;
- Streptococci;
- Klebsiella;
- Staphylococci.
In about 20% of cases, patients with pyelonephritis have a mixed pathogenic microflora, and not one specific pathogen. With a long course of the disease, there are cases of accession of a fungal infection.
coli is the most common causative agent of pyelonephritis
Important: The penetration of a potential pathogen into the kidney does not always lead to pyelonephritis. In addition, the body must have favorable conditions for active growth, vital activity and reproduction of an infectious agent.
For the development of pyelonephritis, reasons are necessary that contribute to the reproduction and active life of pathogenic microflora in the kidneys. These include the following states:
- violation of urodynamics due to nephroptosis, kidney dystopia, the presence of stones in the organs of the urinary system and other factors;
- hypovitaminosis;
- decreased immunity;
- hypothermia;
- pathology endocrine system(for example, diabetes mellitus);
- frequent nervous stress;
- chronic inflammatory diseases;
- weakness, fatigue.
An increased risk of developing kidney pyelonephritis is noted in children under 6 years of age, which is explained by the peculiarities of the structure of the urinary tract and not fully formed immune system. Quite often, the disease is found in women during pregnancy against the background of reduced immunity, squeezing and weakening of the tone of the urinary tract. Also at risk are men over 60 years of age suffering from prostatitis, urethritis or prostate adenoma.
Types of disease
In medical practice, there are several principles for classifying a disease. According to the localization of the inflammatory process, unilateral and bilateral pyelonephritis is distinguished. Taking into account etiological factors there is a primary (in the absence of any pathologies of the kidneys and disorders of urodynamics) and a secondary form of the disease. Depending on the presence of violations of the patency of the urinary tract, kidney disease pyelonephritis can be obstructive and non-obstructive. The most commonly used classification of pyelonephritis according to the nature of the flow. According to this criterion, acute and chronic forms of the disease are distinguished.
Acute pyelonephritis
Acute pyelonephritis can occur in two versions - serous and purulent. In this case, the inflammatory process is localized mainly in interstitial tissue.
With serous pyelonephritis, the organ increases in size and acquires a dark red color. In the interstitial tissue, multiple infiltrates are formed, alternating with healthy renal tissue. There is swelling of the interstitial tissue, accompanied by compression of the renal tubules. In some cases, there is also inflammation and swelling of the perirenal fatty tissue. With timely and adequate treatment, there is reverse development diseases. In severe cases, serous pyelonephritis can turn into purulent.
Purulent pyelonephritis is characterized by the presence in the interstitial tissue of a large number of pustules of various sizes. Small pustules can join together to form a carbuncle - a large abscess. With spontaneous opening of abscesses, pus enters the renal pelvis and is excreted along with urine. During recovery, connective tissue forms at the site of abscesses, forming scars. The degree of involvement in the inflammatory process of certain parts of the body depends on the route of infection. With the urinogenic pathway, more pronounced changes are observed in the pelvis and calyx, and with hematogenous pathway infection primarily affects the cortical substance.
Chronic pyelonephritis
Chronic pyelonephritis of the kidneys is most often the result of an untreated acute form of the disease. The inflammatory process covers separate parts of the kidney in the lower or upper pole. The course of chronic pyelonephritis is characterized by a change in periods of remission and exacerbations. With each exacerbation, new areas are involved in the inflammatory process. renal tissue. With the progression of the disease, there is a violation of the function of the glomeruli and tubules, which is fraught with the development of renal failure.Against the background of chronic pyelonephritis, the development of nephrogenic arterial hypertension is often noted. On the last stage disease, patients present with a shriveled kidney pattern, scarring, and tubular replacement with connective tissue. The prognosis of the disease depends on its duration, the activity of the inflammatory process and the number of exacerbations.
Important: The diagnosis of chronic pyelonephritis is made if clinical and laboratory signs are observed for more than one year.
Prevention methods
Prevention of pyelonephritis is not difficult, but, nevertheless, reduces the risk of the disease and its severe consequences. It includes the following steps:
- timely treatment of any infectious diseases;
- consumption of at least 1.5 liters of fluid per day for normal functioning urinary system;
- timely (without long delays) emptying the bladder;
- daily observance of rules of personal hygiene.
Also, to prevent the onset of the disease, it is important to avoid hypothermia, as they often become a provoking factor for the spread of infection.
Maintaining physical fitness, giving up bad habits, a balanced healthy diet that includes everything essential vitamins, macro- and microelements, help strengthen the body as a whole and increase its resistance to various diseases including pyelonephritis.
People with a predisposition to the development of the disease should be regularly observed by a nephrologist and take urine tests to assess kidney function and timely identify any abnormalities.
Tip: Prevention of pyelonephritis should be started from a very early age, as children under six years of age are at risk.
Pyelonephritis is an infection of the renal pelvis or parenchyma, usually caused by bacteria.
The kidneys filter the blood by producing urine. Two tubes called ureters carry urine from the kidney to pyelonephritis.php. From the bladder, urine is expelled from the body through the urethra (urethra).
In most cases, pyelonephritis is caused by the spread of infections from the bladder. The bacteria enter the body from the skin around the urethra. Then they rise from the urethra to the bladder and then enter the kidneys, where pyelonephritis develops.
Sometimes, bacteria escape the bladder and urethra by traveling through the ureters from one or both kidneys. The resulting kidney infection is called pyelonephritis.
Pyelonephritis can be acute or chronic.
Acute uncomplicated pyelonephritis presents as a sudden onset of inflammation of the kidneys and is usually associated with an ascending infection when bacteria enter the body from the skin around the urethra and then travel up from the urethra to the bladder and on to the kidneys. In uncomplicated cases, the causative agent of the disease is usually E. coli (75%).
Chronic (long-term) pyelonephritis is a rare disease, usually caused by birth defects in the kidneys, and usually results in progressive damage and scarring of the kidneys. This can eventually lead to kidney failure. As a rule, chronic pyelonephritis is found in childhood.
But also chronic pyelonephritis can develop as a result of undertreated acute pyelonephritis, when acute inflammation was removed, but it was not possible to completely destroy all pathogens in the kidney, nor to restore the normal outflow of urine from the kidney. It is usually asymptomatic and is often found on urinalysis or ultrasound.
Severe variants of pyelonephritis occur with complicating factors, such as:, a structural defect, or diabetes.
Causes and risk factors of pyelonephritis
Most often, the bacteria that cause pyelonephritis are the same as those that cause common urinary tract infections. Bacteria found in stool, such as E. coli and Klebsiella, are the most common.
Common reasons:
Urinary tract infections.
- 75% of cases of pyelonephritis are caused by Escherichia coli.
- 10% to 15% are caused by other Gram-negative bacteria: Klebsiella, Proteus, Enterobacter, Pseudomonas, Serratia Citrobacter.
- 5-10% Gram-positive bacteria such as Enterococcus and Staphylococcus aureus.
- Fungal bacteria, especially Candida spp, develop in immunocompromised patients and in patients with diabetes.
- Salmonella, leptospira, mycoplasma, chlamydia.
Accumulative or predisposing factors:
Diseases or conditions that cause stagnation of urine in the urinary tract, promoting the multiplication of pathogens in the urinary tract and, as a result, the ascension of infection.
- Diseases that weaken the immune system, contributing to the multiplication of microorganisms in the urinary tract and the ascension of infection.
- The presence of devices (catheters, urinals, Foley catheter) in the urinary tract that promote the multiplication of microorganisms in the urinary tract and the ascension of infection.
Conditions that obstruct or reduce the normal flow of urine, with highly likely lead to pyelonephritis. When the flow of urine is slowed down or disrupted, bacteria can easily enter the ureters. Some reasons that prevent normal urine flow include:
Benign prostatic hypertrophy.
- Abnormal development of the urinary tract.
Cancer associated with the renal tract, eg renal cell carcinoma, bladder cancer, tumors of the ureters, cancers outside the kidney, eg colon cancer, prostate cancer.
- Radiation therapy or surgical injury ureters
Neurological disorders, for example,.
- Polycystic kidney disease.
- Neurogenic bladder after injury or neurological disorders such as diabetic neuropathy.
Immune disorders:
- HIV.
- Myeloproliferative diseases.
- Diabetes.
- Organ transplantation
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Other reasons:
Age. Acute pyelonephritis is more common in
- Floor. Women get pyelonephritis more often than men because women have a much shorter urethra than men, which is one of the reasons why women are more vulnerable to urinary tract infections. Women are more likely to develop pyelonephritis when she is pregnant. Pyelonephritis and other forms of urinary tract infection increase the risk of preterm birth. Acute pyelonephritis is more common in sexually active women.
- Genetics. Vesicoureteral reflux is hereditary and occurs in about 10% of first-degree relatives of the affected person. Polycystic kidney disease also has an autosomal dominant inheritance.
- Socio-economic status.
Symptoms of pyelonephritis
Symptoms of pyelonephritis can vary depending on a person's age and may include the following:
Malaise
- Fever and/or chills, especially in case of acute pyelonephritis
- Nausea and vomiting
- Pain in the side under the lower ribs, in the back, radiating to the iliac fossa and suprapubic region.
- Confusion of consciousness.
- Frequent, painful urination.
- Blood in the urine (hematuria)
- Turbid urine with a pungent odor
- Children under 2 years of age may have only high fever without urinary tract symptoms.
- Older people may not have any urinary tract symptoms. They may exhibit confusion, incoherent speech, or hallucinations.
- Chronic pyelonephritis is usually asymptomatic, but may constantly disturb the patient with dull aching pains in the small of the back, especially in damp cold weather.
Diagnosis of pyelonephritis
The diagnosis of acute pyelonephritis is usually straightforward and includes:
- Physical examination (general appearance, temperature, heart rate, ) and palpation of the abdomen;
- Urine culture to determine the specific type of bacteria that caused the development of pyelonephritis;
- Blood cultures in case pyelonephritis has spread to the blood;
- Blood analysis. An important indicator is creatinine. He is by-product from the normal breakdown of muscle tissue. Creatinine is filtered through the kidneys and excreted in the urine. The ability of the kidneys to process creatinine is referred to as creatinine clearance, and it measures the rate glomerular filtration- the rate of blood flow through the kidneys, or, more simply, the degree of blood purification. Normal level creatinine in the blood ranges from 71-106 µmol/l in adult men and from 36-90 µmol/l in adult women.
- Analysis of urine. Microscopic analysis of urine almost always shows signs of infection. The presence of white blood cells and bacteria in the urine indicate an infection
- Ultrasound. Ultrasound can help identify abscesses, stones and causes of urinary retention, urinary tract birth defects;
- Computed tomography (CT). CT is usually not needed, but if ultrasound fails to see complete picture, CT may be appropriate;
- Gynecological examination. Usually in women, the symptoms of pyelonephritis are similar to those of certain sexually transmitted diseases therefore a gynecological examination may be recommended.
Treatment of pyelonephritis
Antibiotics are usually used to treat pyelonephritis. In most cases, treatment for uncomplicated pyelonephritis usually lasts 10 to 14 days. They can be administered orally or intravenously, depending on the clinical condition of the patient. As a rule, they are applied orally, and their choice will depend on the specific situation: laboratory tests for the bacteria that caused the disease, the presence of allergies, pregnancy, etc. Commonly used the following antibiotics: penicillin, trimethoprim, sulfamethoxazole (Bactrim), ciprofloxacin, cefotaxime, cefaclor, cefuroxime, cephalexin, ceftazidime, or levofloxacin.
In the treatment of pyelonephritis in pregnant women, a group of broad-spectrum antibiotics, nitrofurans, is prescribed. These include furagin and furadonin. As a prophylactic, drugs containing nalidixic acid are used.
With exacerbations of chronic pyelonephritis, a drug is prescribed - nitroxoline.
Below is a table of sensitivity to antibiotics of the main pathogens of pyelonephritis:
| The causative agent of pyelonephritis | Sensitivity to drugs (uroantiseptics) |
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Patients with complicated pyelonephritis, with concomitant diabetes, stones, known damage kidneys, known renal anatomical abnormalities, and pregnancy hospital treatment
When high temperature, chills, severe nausea and vomiting, there is a high chance of dehydration. In this case, hospital treatment may also be required and intravenous administration antibiotics. Fever and chills can also be signs that an infection has spread from the kidneys to the blood.
AT rare cases, pyelonephritis can progress with the formation of a focus of infection - an abscess. Abscesses that are difficult or impossible to treat with antibiotics should be drained. This is most commonly done with a tube inserted through the skin on the back into a kidney abscess. This procedure is called a nephrostomy.
Along with antibiotic therapy treatment with herbs that have anti-inflammatory and diuretic effects is indicated. Phytotherapy is also successfully used in the treatment of chronic pyelonephritis.
Medicinal plants used in chronic pyelonephritis:
- Altey
- Cowberry
- black elderberry
- Elecampane
- St. John's wort
- Corn silk
- Nettle
- angelica root
- birch leaves
- wheatgrass
- kidney tea
- Horsetail
- Chamomile
- Rowan
- bearberry
- cornflower flowers
- Cranberry
- strawberry leaves
Complications of pyelonephritis
Acute infection from the renal pelvis or parenchyma
- Formation of an abscess
- Scar formation in the kidneys
- Kidney failure
- Chronic renal failure
- Hypertension
- Sepsis, shock, and hypotension may occur in severe cases
- Rarely can lead to acute papillary necrosis or, if obstructed, may progress to chronic pyelonephritis
- In children with chronic pyelonephritis, apathy, convulsions, bloating, irritability, weight loss, enuresis, diarrhea, vulvar itching are observed.
Pyelonephritis prognosis
A single episode of uncomplicated pyelonephritis rarely results in kidney damage in healthy adults. However, repeated episodes of pyelonephritis can lead to chronic (long-term) kidney disease in children with diabetes and adults who have structural abnormalities of the urinary tract or nerve disease that impair bladder function.
Pyelonephritis can become chronic if the infection cannot be cleared up due to kidney stones or other urinary tract abnormalities.
Most patients with uncomplicated pyelonephritis report that their symptoms begin to improve after one to two days of antibiotic treatment. However, even after symptoms improve, antibiotics are usually prescribed for a 10 to 14 day course.
- Drink several glasses of water every day. Water helps flush out bacteria from the urinary tract and prevents their growth. It also helps prevent the formation of kidney stones, which can increase your risk of developing pyelonephritis.
- To prevent the spread of intestinal and skin bacteria from the rectum to urinary tract Women should always wipe with toilet paper after defecation or urination from front to back.
- Reduced spread of bacteria during sex. A woman must urinate after intercourse to flush out bacteria from her bladder.
- Practice safe sex, avoid frequent shift sexual partners.
- Treat any inflammatory diseases in a timely manner, regardless of their severity.
- Upgrade regularly defensive forces body and immunity. Accept multivitamin complexes lead an active, healthy lifestyle.
- Keep your legs, lower back and kidney area warm, do not sit on cold surfaces.
- In case of structural problems with the urinary system, such as blockage of the ureters by a stone, or developmental anomalies, consider surgery to restore normal function genitourinary system and prevent future episodes of pyelonephritis.
