The structural features of the female body are the reason that the fair sex is 6 times more likely to suffer from pyelonephritis than men. This is a non-specific kidney disease characterized by inflammatory processes caused by bacteria. At the time of inflammation, the kidney parenchyma and renal pelvis are damaged.
There are several pathogens: inflammatory processes are provoked by Pseudomonas aeruginosa, Escherichia coli, Enterococcus, Staphylococcus, Proteus. If a person has difficulty with the outflow of urine, it is thrown into the kidney, and the pathogen gets there with it. Also, the cause of urine reflux into the kidney may be intravesical pressure due to hypertonicity with a structural anomaly, the presence of stones, or a banal overflow of the bladder. The same problems arise whenenlarged prostate in men.
What is the danger of chronic pyelonephritis
Chronic forms of a disease are those with which a person will have to live for the rest of his life. These are incurable forms of the disease, which from time to time very sharply remind of themselves, and the patient needs medical help during this period. In the case of pyelonephritis, each new exacerbation spreads the inflammatory process to he althy areas of kidney tissue. At the site of the lesion, he althy tissue dies and a scar forms, so over time, the functional part of the tissue decreases. Everything leads to the fact that, in the end, the kidney ceases to function. If chronic pyelonephritis has affected two kidneys, then renal failure occurs and the patient needs constant help from the “artificial kidney” device.
How is the diagnosis made?
To correctly diagnose, it is necessary to apply a set of measures. Diagnosis of chronic pyelonephritis is based on anamnesis and laboratory diagnostics, and the urologist also takes into account the clinical picture.
One or more of the following methods are used:
- General analysis of urine and blood.
- Bacterial urine culture.
Urine is examined in laboratory conditions, with this disease you can see that it is cloudy, a precipitate appears. The laboratory assistant notes the presence of bacteria, s alts, protein and epithelium in the test material, the level of leukocytes is increased.
When s alt and protein appear in the urine, this is alreadya sign that there is an inflammatory process in the kidneys and the blood filtration mechanism is broken. Diagnosis of chronic pyelonephritis is carried out by urologists, and when such a diagnosis is made, then the issue must be kept under control and urine must be systematically taken for examination in order to monitor the work of the kidneys. This will need to be done constantly. Also used:
- Ultrasound of the kidneys. At the time of inflammation, the PCS (pyelocaliceal system) usually expands, and this can be seen on ultrasound.
- X-ray examination.
- Radioisotope renography. This is a good method for diff. diagnosis of pyelonephritis. A radioactive marker accumulates in the organs of the urinary system, it can be used to track how quickly urine is excreted from the kidneys, to evaluate the work of the kidneys, the dynamics of renal processes.
Features of chronic pyelonephritis
In the chronic form of this disease, one or two kidneys may be affected, so pyelonephritis is divided into unilateral and bilateral. It is also divided into types, depending on the severity of the course of the disease. In the latent form, the patient experiences little discomfort, so they may ignore the problem altogether.
In recurrent pyelonephritis, periods of subsidence of the disease and exacerbation alternate. The frequency of relapses depends on a number of factors. Reduced hemoglobin levels and anemia are observed in chronic pyelonephritis. Differential diagnosis allows a diagnosis to be made where symptoms overlap with other kidney diseases. Atin the azothemic form, there is already renal failure, and in the hypotensive form, blood pressure rises.
Some of these symptoms accompany other diseases, but it is important to establish the correct diagnosis, because different diseases are treated differently.
At the first stage, there is an active inflammatory process with severe symptoms. The latent stage has an erased clinical picture. In this case, the disease can be diagnosed through laboratory tests. The third stage is remission, during this period all manifestations of the disease are absent. If there are no exacerbations for 5 years, then the doctor confirms a complete recovery.
Prognosis for chronic disease
It is difficult to predict how the life of a person with chronic pyelonephritis will turn out and what its duration will be. If you follow all the doctor's recommendations, then even with such a diagnosis, you can live happily and for a long time. When a sick person smokes, does not carry out appropriate treatment, abuses alcohol and ignores medical recommendations, then his life can be significantly reduced. Methods for diagnosing pyelonephritis make it possible to establish a diagnosis with 100% certainty, therefore, treatment can be carried out in a timely manner and with good results.
To prevent the disease, it is necessary to respond in time to all unhe althy manifestations, especially if they concern the genitourinary system. In urology, you do not need to self-medicate, you need clear recommendations from a doctor. The kidneys do not like hypothermia, this must be monitored and, preferably, not to use non-steroidalpainkillers. A he althy person needs to drink at least 2 liters of water per day in order to prevent a high concentration of harmful substances in the urine, otherwise the risk of developing pathological flora increases.
During pregnancy, the risk of developing pyelonephritis is increased. Diagnosis and treatment should be carried out immediately. During pregnancy, especially in the later stages, the outflow of urine worsens, so you need to monitor your well-being. It is important to always follow the rules of personal hygiene, adhere to a he althy lifestyle in both nutrition and physical activity.
Disease does not occur out of the blue
The word "chronic" indicates that the disease is present in a person's life for a long period. But the transition to the chronic form begins with an acute one, when the wrong antibiotic therapy was carried out or the treatment was short and did not reach its logical conclusion. The reason for the deterioration of he alth may be the late diagnosis and treatment of chronic pyelonephritis.
The disease does not occur out of the blue, there are often concomitant factors: kidney stones, prostatitis or prostate adenoma, narrowing of the urinary tract or prolapse of the kidney. Disease-carrying bacteria may become more resistant to external influences after treatment has been interrupted. It seems to the patient that relief has come, but after a while the disease returns.
A number of factors contribute to the development of the disease. Pregnancy and childbirth, congenital anomalies in the development of the kidneys or structural features of the genitourinary system, due tofor which the normal urodynamics changes, can serve as a start for the onset of the disease. With the onset of sexual activity, there are also risks.
Symptoms that can identify the disease
This disease is not always easy to diagnose. Symptoms are often mild, mild, or non-existent. Differential diagnosis of pyelonephritis allows you to identify the disease according to various criteria. The level of hemoglobin in the blood is lowered, but this may be with other diagnoses, the number of leukocytes in the urine and red blood cells is also increased.
Symptoms depend on the stage of the disease. Chronic pyelonephritis is accompanied by aching pain in the lower back with low intensity, the pain is asymmetric. If the patient has prolapsed kidneys, the pain may appear in the abdomen.
Chronic pyelonephritis should be diagnosed and treated by a doctor. Even if a person finds similar symptoms in himself, this does not mean that he has this particular disease. After a long walk or standing in the back area, discomfort appears. In the morning, swelling of the face, feet and hands becomes noticeable, at night there is frequent urination. The patient's pressure rises, the temperature jumps up, reaching 38 degrees, especially in the evening.
When a person feels bad, naturally, his mood will disappear, a state of weakness and weakness comes, headaches may appear. It seems that everything is dry in the mouth and you constantly want to drink. If a patient has chronic pyelonephritis, differential diagnosis will allowreveal it.
Treatment by prescription only
Medical workers spend more than one year to acquire a speci alty, and narrow specialists constantly improve their skills, but even they make medical mistakes. What can we say about when a person prescribes a treatment for himself? This can be not only ineffective, but also dangerous. When the doctor has used all possible methods for diagnosing chronic pyelonephritis, he prescribes treatment.
In the appointment there may be antibiotics of the penicillin group, they have a wide spectrum of action and are as gentle as possible for the kidneys. New generation cephalosporins are usually administered intramuscularly and are widely used in this disease. If a person is in a hospital, then injections are made on the spot by medical staff.
In treatment, you need to use drugs that have a minimal negative effect on the kidneys, such antibacterial drugs include fluoroquinolones, they effectively fight bacteria that affect the urinary system. But pregnant women and children should not be prescribed. During their use, you need to protect yourself from exposure to ultraviolet rays as much as possible. The solarium and the beach will have to wait.
When the doctor spent dif. diagnosis of chronic pyelonephritis, he can prescribe oxyquinolines, they are often used in urology. Nitrofurans are rarely used, despite their effectiveness, because they have pronounced side effects.
Treatment is carried out for 14 days, at the end of thistime to re-test. In parallel with anti-inflammatory drugs, antispasmodics can be prescribed, they not only relieve pain, but also improve urine flow.
In the appointment there are drugs that improve venous outflow and renal blood flow. In the complex, the patient undergoes physiotherapy, electrophoresis and magnetotherapy. All these actions allow achieving stable remission and defeating chronic pyelonephritis. Etiology, clinic, diagnosis and treatment should be under the doctor's control.
When a patient has concomitant diseases, other drugs are used in therapy to correct disorders caused by pyelonephritis. The patient may be prescribed antipyretic drugs. If the disease is not in an acute stage, then herbal medicine can be used. Herbal treatment should also be under the supervision of doctors.
Dieting is a must
When chronic pyelonephritis is diagnosed, the patient may not feel obvious discomfort, but in fact the inflammatory process is already underway. The diseased organ should not be loaded additionally during this period. That is why the doctor gives recommendations on nutrition and drinking regimen. If there are no edema and high blood pressure, then the amount of water you drink can be increased to 3 liters per day. If swelling is present, then you need to drink about 2 liters of water.
In terms of food, you need to be reasonable: s alty and spicy dishes will not benefit the patient. Coffee consumption is best kept to a minimum. Allthe food consumed should be in the correct ratio of proteins, carbohydrates and fats. Dairy products can be eaten in any quantity, they will even help to improve bowel function, which can be disturbed due to the action of antibiotics. Beef, chicken, rabbit, boiled fish, boiled eggs, vegetables and cereals - all this should be in the diet. Any easily digestible food after the diagnosis of chronic pyelonephritis is welcome.
Children get pyelonephritis too
Young children are no exception when it comes to pyelonephritis. It manifests itself in the same way as any infectious disease, while the functional state of the kidneys is disturbed. Diagnosis of pyelonephritis in children is carried out from birth, and premature babies are more likely to suffer from this disease than children who were born at the right time. The disease may be with impaired or preserved kidney function. To diagnose pyelonephritis in very young children up to 3 months, screening tests are used. The diagnosis is based on bacteriuria and leukocyturia. In addition to conducting laboratory tests, the doctor pays attention to such symptoms in the child as fever, fever.
If the doctor suspects pyelonephritis in a child, then urine culture and microsporia should be performed, antibiotic therapy is prescribed according to the test results.
The doctor conducts all the necessary tests of urine and blood, performs an external visual examination of the genitals, measures blood pressure. Feces need to be checked fordysbacteriosis. Diagnosis of acute and chronic pyelonephritis is carried out using an ultrasound machine.
The treatment program includes a diet, just like adults. For the period of fever - bed rest. The doctor monitors the amount of urination of the child, they should be regular, according to age. There must be compliance with the rules of hygiene. During treatment, antibiotic therapy is carried out. In the first three days, antipyretic drugs and detoxification drugs are prescribed.
Similar diseases, how to distinguish?
Kidney disease can manifest itself in almost the same way, there is a slight difference in symptoms. Differential diagnosis of chronic pyelonephritis and glomerulonephritis is carried out by specialists. Glomerulonephritis is an immunoinflammatory disease. With this diagnosis, the glomerular apparatus of the kidneys is affected, the interstitial tissue and tubules are also involved in the inflammatory process. The disease occurs in acute and chronic forms. The causative agent is most often streptococcal bacteria, which are found in the body after tonsillitis, viral respiratory diseases, dermatitis and other infections.
Two weeks after the illness, the virus manifests itself as an infection in the kidneys. Glomerulonephritis can manifest itself only with edema, the same can be with pyelonephritis. Therefore, the instrumental method for diagnosing chronic pyelonephritis is so important. If the interstitial tissue of the kidneys is inflamed, then it is not so easy to identify the problem. When the anamnesis is not enough, then an instrumental diagnostic method is used. With the help of ultrasoundand an x-ray machine, you can see in detail what is happening with the organ, you can see if the kidney has been deformed, you can see the true size of the renal pelvis, if there is an extension, what is the structure of the parenchyma and if there are scars and thinning on it. Radionuclide and endourological diagnostics allow you to monitor the work of the kidneys. With the help of various tools, it is possible to accurately establish the diagnosis, even if the symptoms fall into this category of different diseases.
Features of acute pyelonephritis
If a person feels weak, has a headache, a temperature of 40 degrees and increased sweating, then we can say that he has acute pyelonephritis. Diagnosis is carried out in the same way as in the case of a chronic disease. There is such a strong state of nausea that a person can vomit. Dull pain in the lumbar region, which, however, can change intensity. Usually the pain is localized on one side. When the disease in an acute form is not complicated by other diseases, then there are no problems with urination.
Acute pyelonephritis is diagnosed, urine is examined, it has a cloudy consistency, there may be a reddish tint, it contains bacteria. Biochemical analysis shows an excess of the norm of nitrogenous slags in about a third of all cases. Treatment is carried out only with medication, most often in a hospital, until the acute symptoms are relieved. If the disease is not cured, then later it will manifest itself in a chronic form and it will be much more difficult to fight it.
Recommendations from experts
When a patient is faced with an acute form of the disease, he fulfills all the doctor's recommendations as much as possible in order to relieve pain symptoms, improve his general condition and return to his usual way of life as soon as possible. But you don’t always want to limit yourself to what you are used to when there are no obvious problems. Patients avoid recommendations, even when the diagnosis of chronic pyelonephritis has been made. Clinical recommendations depend on the form of the disease.
During the period of exacerbation, it is necessary to observe bed rest, sleep should be in sufficient quantity. The patient's room must be ventilated, and when he has enough strength, he must spend at least 4 hours in the fresh air. The good news is that you don’t have to give up sweet drinks, compote and weak tea can be drunk. Depending on the age of the patient, the rate of fluid intake per day is calculated. Urination should be regular so that the concentration of pathogenic organisms does not increase in the body.
During an illness, you should take care of yourself, do not allow strong physical exertion. Only two weeks after the onset of exacerbation of pyelonephritis, you can take a course of physiotherapy exercises.
The patient should eat 4-5 times a day food, steamed or boiled. Dairy products can be consumed. You don’t need to starve, it’s just worth switching to food that is easily digestible and does not create an additional burden on a weakened body. You can eat vegetarian soups and dishes with lean meat and poultry,any cereals, vegetables and soft-boiled eggs are allowed.
Prohibited foods include all kinds of smoked meats, canned food, spices, mayonnaise, ketchup and garlic. You can not eat rich soups, legumes and pickled vegetables. Carbonated drinks and alcoholic drinks are strictly prohibited.
With this diagnosis, constant monitoring by a nephrologist is necessary, to monitor the functional state of the kidneys, you need to periodically give urine. To prevent the disease, it is necessary to get rid of chronic foci of infection in the body. It can be sinusitis, caries, tonsillitis, etc.
To ensure the normal functioning of the kidneys, you need a balanced drink, the use of fruits and vegetables. It is necessary to minimize the use of foods that are high in oxalates, and these are: nuts, cocoa, spinach, bran, tea and a number of others.
If there is a tendency to form kidney stones, then your diet will always need to be monitored. It is easier to restrict yourself in some products than to remove kidney stones later. Some stones cannot be removed, they have to be removed only surgically. If there are stones in the kidneys, then the organ will not be able to function normally, and inflammatory processes will become a frequent companion of a person.
