Purulent pyelonephritis is a very dangerous and serious disease, which is accompanied by nonspecific inflammation of the renal structures. The pelvis, calyces and parenchyma are usually involved in the pathological process. In the absence of therapy, inflammation spreads to the glomeruli and blood vessels, while purulent masses begin to accumulate in the tissues.
Of course, many people are interested in more information. Why does purulent pyelonephritis of the kidneys develop? Symptoms and treatment, diagnosis and risk factors are important information that should not be ignored. So how dangerous is this disease and is it possible to somehow avoid its development?
Purulent pyelonephritis: ICD-10 and main characteristics
To begin with, it is worth understanding the basic information about this pathology. In some cases, inflammation of the tissues of the kidney is associated with the formation and accumulation of purulent masses - it is in this case that doctors talk about acute purulentpyelonephritis. ICD-10 refers this pathology to the group of tubulointerstitial nephritis, which is indicated by the code N10. If it becomes necessary to identify an infectious agent, additional codes are used - B95-B98.
The disease usually develops against the background of bacterial activity. In most cases, purulent pyelonephritis affects only one kidney, cases of bilateral inflammation are extremely rare.
Causes for the development of pathology
Purulent pyelonephritis is a very dangerous disease, which is accompanied by serious damage to the kidneys. The inflammatory process in this case is provoked by the activity of nonspecific opportunistic microorganisms, in particular staphylococci, streptococci, Escherichia coli, enterococci, Pseudomonas aeruginosa. Sometimes bacteria enter the kidney tissue through the urinary tract, and sometimes along with blood from other foci of inflammation.
It is worth noting that some patients are more prone to developing such pathologies. The list of risk factors is as follows:
- urolithiasis;
- various congenital anomalies in the development of the excretory system;
- neurogenic bladder syndrome;
- STDs;
- immunodeficiency states;
- diabetes mellitus;
- diseases of the endocrine system;
- long-term kidney drainage;
- prolonged bladder drainage with a catheter;
- previous kidney transplant;
- chronic forms of renalinsufficiency;
- vesicoureteral reflux;
- previous gynecological surgery (for women);
- benign prostatic hyperplasia;
- mechanical damage to the kidney;
- presence of foci of chronic inflammation in the body.
The main forms of the inflammatory process
The disease can take on various forms - much depends on the stage of development of the inflammatory process and other factors.
- The most common is apostematous (pustular) pyelonephritis. In this case, multiple small pustules, called apostemes, form in the tissues of the kidney.
- In about 40% of cases, pustular inflammation is complicated by the formation of a carbuncle. In this situation, we are talking about the formation of a limited seal in the cortex of the kidney, inside which purulent masses accumulate.
- Abscess is the most complex form of purulent pyelonephritis. With a similar form of the disease, a cavity is formed in the tissues of the kidney, protected by a capsule, inside which pus and other fluids accumulate. The abscess gradually increases in size and can sometimes rupture (even for no apparent reason), releasing purulent contents.
Purulent pyelonephritis: symptoms
The clinical picture depends on the stage of development of the disease and the presence of concomitant diseases. At the initial stages, there are general signs of the inflammatory process, in particular fever, body aches, chills, weakness, nausea, and drowsiness. Othe fact that there are problems with the kidneys is evidenced only by pain in the lower back - sometimes it is very pronounced. These are the first symptoms of purulent pyelonephritis in women and men.
If the outflow of urine is disturbed, the symptoms become more pronounced. Blood pressure drops sharply, the patient's state of he alth deteriorates significantly, there is a pronounced tachycardia.
With a significant accumulation of pus, symptoms of kidney failure appear - swelling is observed, the sclera of the eyes and the patient's skin become yellowish. The processes of urine formation slow down. In the urine itself, blood impurities can often be seen. In no case should you ignore purulent pyelonephritis. Surgery sometimes needs to be done immediately.
How dangerous is the disease?
Purulent pyelonephritis of the kidneys is a very serious disease. In no case should you refuse therapy or ignore the symptoms. As already mentioned, against the background of the inflammatory process, purulent foci are formed in the tissues of the kidney, and sometimes full-fledged abscesses. Sometimes an abscess ruptures, causing purulent masses to enter the abdominal cavity - this can lead to the development of peritonitis, and in especially severe cases, to sepsis, which is fraught with death.
In addition, against the background of the inflammatory process, the tissues of the kidney are damaged, the organ shrinks and partially, and sometimes completely, loses functionality. In this case, the patient must be constantly registered with a nephrologist - with further progression of the disease,transplant required.
Diagnostic measures
Purulent pyelonephritis is a disease that needs to be diagnosed as early as possible. As a rule, after a general examination and history taking, the doctor sends the patient for additional studies.
- The laboratory analysis of urine is informative - against the background of the inflammatory process, the level of protein increases. Also, erythrocytes and leukocytes appear in the urine.
- A blood test confirms the presence of foci of inflammation in the body.
- Ultrasound of the kidneys is performed, as well as urography (including contrast).
- The most informative is magnetic resonance imaging.
- Sometimes angiography is additionally performed - this allows you to evaluate the blood supply to the kidneys.
Therapeutic treatment
Treatment of purulent pyelonephritis of the kidneys necessarily includes taking antibiotics, since the inflammatory process is always associated with the activity of certain bacteria. In this case, drugs such as Amoxicillin, Ceftazidime, Gentamicin, Ofloxacin are used. Both tablets and intramuscular/intravenous solutions can be used.
It is worth noting that with this form of pyelonephritis, long-term therapy is required. Patients usually take antibiotics for 4-6 weeks, with the maximum dose required at first. The decision to stop antibiotic therapy is made by the doctor based on the results of the tests.
Sometimes the treatment regimen includesantifungal drugs, in particular Nystatin, Levorin (a bacterial infection is often complicated by a fungal one). Antihistamines, vitamin complexes, anti-inflammatory drugs and other auxiliary drugs are used.
Proper diet
Treatment of purulent pyelonephritis must necessarily include the right diet.
- The patient needs a complete diet, but the food should be light and quickly absorbed.
- It is important to stop eating s alt, as this product directly affects the functioning of the kidneys. The maximum daily amount of s alt is 6 g.
- Spicy food, smoked foods, spices are prohibited.
- Beverages containing alcohol are strictly prohibited.
- Fresh fruits and vegetables, dairy products, lean meats will be useful. Dishes can be boiled, baked, steamed, but never fried.
- It is important to maintain the correct drinking regime - at least 1.5 liters of clean water per day (still, purified).
It is very important to adhere to the above rules. This will help relieve stress on the excretory system and speed up the healing process.
When is surgery needed?
Purulent pyelonephritis is a serious disease. Unfortunately, surgery is inevitable in this case. During the procedure, the doctor dissects the fibrous capsule, after which he carefully examines the tissues of the kidney, checks for the presence of purulent cavities. Abscesses need to be openedclean from purulent masses and carefully treat with disinfectants and antibiotics.
Because the healing process is associated with the accumulation of pus and serous fluid, a temporary drain is installed. To drain urine, the surgeon will put a special tube - a nephrostomy. The drains are removed after the patient recovers - fistulas quickly heal on their own.
By the way, pus samples are often sent for laboratory analysis - the study makes it possible to accurately determine the pathogen and select an effective antibiotic.
Folk treatments
Immediately it should be noted that you can use any traditional medicine only with the permission of a doctor.
- Rose hips have pronounced antiseptic and antibacterial properties. 150 g of fresh fruits (frozen are also suitable) should be put in a liter jar and pour boiling water, then cover with a lid and let it brew. By the way, it is better to pre-cut the fruits - this way more useful substances will get into the infusion. You need to drink a glass of funds 3-4 times a day, after meals.
- A decoction of cowberry fruits will positively affect the state of the excretory system and immunity.
- For purulent pyelonephritis, a decoction of St. John's wort is also used.
- Chamomile flowers have pronounced anti-inflammatory properties - they can be brewed instead of tea.
The above medicines cannot replace full-fledged drug therapy. Self-medication with such a serious illness is unacceptable and ineffective.
Prognosis for patients. Preventive measures
Purulent pyelonephritis is an extremely dangerous disease, the treatment of which is associated with a lot of difficulties. Unfortunately, there is no specific prevention. But you can significantly reduce the risk of developing inflammation by following simple rules.
- It is important to try to avoid hypothermia (especially when it comes to the lower back and hips), always dress for the weather.
- It is worth adhering to the correct drinking regimen, consuming at least a liter of pure, non-carbonated water per day - this maintains the functioning of the kidneys at the desired level.
- All colds and inflammatory diseases should be treated in time, as pyelonephritis is often a complication of other pathologies.
- Doctors recommend following the rules of personal hygiene, avoiding casual sex.
- It is important to have regular medical examinations, even if there are no symptoms of any disorders, in order to detect the presence of the disease at an early stage of development.
- Proper nutrition, avoiding alcohol and smoking, physical activity - all this will positively affect the functioning of the immune system and make the body less susceptible to the effects of various risk factors.
Of course, the appearance of the first signs should be reported to a specialist. The sooner therapy is started, the higher the likelihood of a successful and complete cure.
