Problems with any internal organs of the human body are fraught with consequences. Sometimes pathologies reach an advanced stage and are chronic. Therefore, it is very important to undergo diagnostic measures in a timely manner and listen to the recommendations of doctors.
Chronic pyelonephritis in women, men and children is not diagnosed as often. However, it is worth learning a little more about this pathology in order to understand who exactly is at risk for this disease and how to avoid possible complications.
Chronic pyelonephritis according to ICD-10
First of all, it is worth learning a little about the classification of this pathological condition. According to medical practice, this ailment can develop after an exacerbation of the disease. According to ICD-10, chronic pyelonephritis was assigned the code N11. The description of the pathology states that such problems can begin in early childhood. This ailment proceeds unevenly and is rather mosaiccharacter. This makes timely diagnosis difficult.
What is the disease
Chronic pyelonephritis (according to ICD-10 code N11) cannot be considered a full-fledged diagnosis. In fact, this concept is used if we are talking about long-term harm that was caused against the background of a urinary tract infection that proceeded in a periodic form. It is not always possible to explain the reasons for the development of chronic pyelonephritis. In some situations, doctors do not diagnose any signs of an additional infection at all.
If we talk about the main signs of chronic pyelonephritis, characteristic of this pathology, then it is worth considering the normal functioning of body systems. Usually, urine begins to gradually flow out of the kidneys and through special channels enters the bladder. Each ureter contains a special one-way valve that prevents urine from flowing backwards. If one of these valves fails, reflux occurs. It is characterized by the fact that urine rushes in the opposite direction and enters the kidney. If there are certain infections in the bladder, or pathogenic bacteria are found directly in the fluid itself, then in this case, the kidney becomes infected.
Also, considering the diagnosis of chronic pyelonephritis, it is worth paying attention to the fact that pressure in the bladder is usually much higher than in the kidneys themselves. Accordingly, fluid reflux provokes an even greater load on these organs. Against this background, their damage and subsequentscarring.
If we are talking about vesicoureteral reflux, then in this case we mean a congenital condition, which is explained by poor functioning of the ureteral canal. Such disorders occur due to the fact that one of the internal segments of the brain has been damaged. Similar pathologies are diagnosed in childhood. Also, this disease can be acquired. For example, this often happens as a result of spinal cord injury.
Why an acute process becomes chronic
This question interests everyone who has had to deal with this problem. Acute and chronic pyelonephritis do often go hand in hand. One state may well pass into another.
If we talk about chronic pyelonephritis, then, as a rule, several factors can lead to it at once. In the first case, we are talking about poor-quality treatment of an acute form of pathology or that the patient simply did not follow the doctor's recommendations and advice. If there was a failure of dispensary treatment, then in this case the pathology may well turn into a chronic form.
You can also get chronic pyelonephritis in the history of your illness if the diagnosis was made out of time. Because of this, doctors were unable to prescribe the appropriate treatment, and the pathology acquired a different character.
Additionally, the development of the chronic form can also be affected by concomitant pathologies of the chronic type, which significantly impair the functioning of the immune system. For example, pyelonephritis can move to a new stage if a person suffersfrom diabetes, obesity, sinusitis, tonsillitis, problems with the pancreas or intestines.
Some varieties of pathogens that can enter the kidney tissue and stay in sleep mode for a long time can also lead to this. If they are activated, this leads to a significant increase in the protective functions of the body.
Classification
If we talk about the forms of this disease, there are several of them. According to the ICD, chronic pyelonephritis can occur in:
- Latent form. In this case, there are no special clinical manifestations. However, patients note general weakness, fatigue, frequent headaches. Sometimes the latent form is accompanied by a slight increase in body temperature. Some patients experience pain in the lumbar region, as well as swelling. It should be noted that with this form of pathology, the performance of the kidneys is slightly impaired. However, in the analyzes, you can notice a decrease in the density of urine. And in some situations, doctors additionally diagnose moderate anemia and a slight increase in blood pressure.
- Recurrent form. In this case, we are talking about changing the various periods of the course of the pathology. This means that a person can experience both an exacerbation and a remission. If we talk about the main symptoms during this period, then patients complain of pain in the lumbar region and a more noticeable increase in body temperature. There may also be chills. Somepatients begin to go to the toilet more often, as they suffer from frequent urination (sometimes accompanied by painful sensations).
- Asothermic form. In this case, we are talking about a pathology that has developed against the background of renal failure. As a rule, this happens due to a rather long latent development of the disease.
- Hypertonic form. In this case, chronic pyelonephritis is clinically manifested in the form of predominant arterial hypertension. Accordingly, patients begin to complain of severe headaches, dizziness and sleep problems. Many have stabbing pain in the heart area. In this state, hypertensive crises can be diagnosed. A person has constant shortness of breath. If you diagnose chronic pyelonephritis and get acquainted with urine tests, then no serious changes will be found. It is worth noting that in the case of pyelonephritis, hypertension, as a rule, manifests itself in the form of an additional pathology.
- Anatomically shaped. As a rule, in this case, patients are diagnosed with all the characteristic symptoms. This means that the volume of red blood cells in the bloodstream is significantly reduced. This type of pathology is much more common in those who suffer from acute pyelonephritis. In this case, the symptoms are more pronounced. However, when urinating, no serious violations are detected.
If we talk about the manifestation of exacerbation of chronic pyelonephritis, then in this case, experts pay attention to the fact that the clinical picturemore like acute inflammation. After the pathology begins to progress, hypertensive syndrome comes first. This means that a person suffers from severe headaches, dizziness. He may have problems in the work of the cardiovascular system. After this, anemia may develop.
Features of the disease depending on the individual patient
It is worth noting that in medical practice there is no clearly defined list of patients who may experience such problems. However, the treatment of chronic pyelonephritis is most often prescribed in women who bear children, and in babies themselves under the age of three years. Also, pathology occurs in girls who have just begun sexual activity, and in older people. Patients in these categories are advised to periodically undergo prophylaxis of this disease.
There are several groups of people in whom this pathology manifests itself a little differently. If we are talking about children, especially newborn babies and preschoolers, then in this case, as a rule, most often small patients complain of intoxication and severe pain. The risk group includes babies who have been diagnosed with a congenital or acquired form of uropathy. This condition is characterized by serious violations of the full movement and outflow of urine. As a rule, in children, such pathologies develop against the background of the activity of Escherichia or Pseudomonas aeruginosa.
If chronic pyelonephritis is not diagnosed in a timely manner and the pathology is left untreated for a long time, then thiscase, an allergy or autoimmune reaction may develop.
If we are talking about the elderly, then in this case the main causes of chronic pyelonephritis are age-related changes that every person faces. In addition, the immune system becomes weaker every year and cannot resist viruses and infectious diseases.
Urine and fecal incontinence can also lead to such an infection.
Chronic pyelonephritis can develop due to prolonged bed rest, which was assigned to a pensioner due to an injury or a more serious pathology.
Also, chronic pyelonephritis is often diagnosed in patients suffering from diabetes. According to statistics, after diagnosis, chronic pyelonephritis is detected in more than 27% of cases in people who have this endocrine pathology.
This nasty ailment can cause more serious complications. For example, in diabetes mellitus, necrosis of the renal papillae may develop. Against this background, there is a significant increase in the level of glucose in a person’s blood, which can lead to the rapid development of a urinary tract infection.
Also, a similar disease is often diagnosed in those who suffer from glomerulonephritis. This inflammation of the autoimmune type is the result of the development of an infection that is localized in the tonsils. This is also possible in the case of chronic tonsillitis. Streptococci begin to produce toxins that cause the body's immune system todestroy your own cells that are he althy. Therefore, there is severe damage to the kidneys. If a person additionally suffered from a bacterial infection, then this further complicates the situation.
Caution should also be exercised for people who have recently had a kidney transplant. Very often in medical practice there is pyelonephritis of a transplanted organ. Unfortunately, this happens to almost half of the patients. This is due to the fact that the natural defense system of the body begins to suppress the activity of the new organ. Appear motor damage, hypoxic and others. If the organ is transported incorrectly, an infection can get into it, which will be transplanted into the body of another person.
Chronic pyelonephritis can develop in those who have had one kidney removed. In this case, the symptoms will be more pronounced, and the pathology will begin to progress more rapidly.
Chronic pyelonephritis during pregnancy
Pregnant women should be singled out as a separate group. Also at risk are young mothers. The fact is that the process of treating chronic pyelonephritis in women during childbearing or after childbirth is complicated by the fact that during this period the fair sex cannot take potent drugs, as this can adversely affect the he alth of the baby.
Besides, ladies should be more careful, as their body is undergoing another hormonal adjustment. Moreover, there is a physicala change in the size of the uterus, against which the immune system begins to malfunction, its functions are significantly reduced, symptoms of chronic pyelonephritis appear. Treatment of a woman requires close attention if the lady had a difficult birth or a spontaneous miscarriage occurred. In this case, we are talking about the most difficult treatment. In this position, the fair sex also cannot take antibiotics, as her body is too weak.
Clinical manifestations
Chronic type pyelonephritis is characterized by latent inflammatory processes that occur in the connective tissues. Specific symptoms may not appear for years. Because of this, a person does not even suspect for a long time that he is suffering from a rather dangerous pathology.
At a standard examination, chronic pyelonephritis can only be detected if a person has donated blood for tests. Then the doctor will pay attention to the number of leukocytes, which will greatly exceed the norm. Also, the patient may notice the appearance of pain during urination. This symptom should not be ignored.
If we talk about exacerbation of chronic pyelonephritis, treatment should be started as soon as the patient began to show characteristic symptoms:
- General weakness.
- Decrease in appetite and ability to work.
- Painful sensations and severe discomfort in the lumbar region.
- Headaches and constant sleepiness.
- Chills, which are especially noticeable in the evening hours.
- Increasebody temperature.
Gradually, the symptomatology described becomes more and more pronounced. After a while, additional signs appear in the form:
- Persistent thirst and dry mouth.
- Frequent and disturbed urination.
- Paleness of the skin and itching.
- Anemia and persistent shortness of breath.
- Increased blood pressure (special attention should be paid to the lower value).
If the disease goes into an acute phase, then patients begin to empty the bladder more often. Also, patients notice that the urine itself has become cloudy. It may contain bloody inclusions. It is almost impossible to touch the lower back, in the area of the affected organ. A high fever appears, followed by chills.
If there is a remission, then all the unpleasant symptoms disappear. However, it is impossible to predict the likelihood of a complete cure.
Stages of pathology
Most serious illnesses occur in several stages. If we talk about the stages of chronic pyelonephritis, then there are three periods of the course of the disease:
- Initial. At this stage, the process of inflammation begins. Against this background, there is swelling of the connective tissues located on the inside of the urinary system. This leads to squeezing of blood vessels. Atrophy of the urethra develops.
- Second stage. At this stage, pathology can best be detected using a nephrogram. The doctor notes that there is a narrowing of the diffuse type, which affectskidney channel. The volume of the cortical substance is significantly reduced. Cannot identify interlobar arteries.
- Third stage. At this stage of the development of the pathology, there is a rather strong narrowing and change in the shape of those vessels that enter the urinary system. Gradually, the renal tissue begins to be completely replaced by scar tissue. The buds themselves shrink.
If you do not start timely treatment of pathology, then there is a risk of developing kidney failure.
Diagnostic measures
Diagnosis of chronic pyelonephritis begins with an appointment with a specialist (the urologist or nephrologist deals with these issues). The doctor needs to list all the diseases from which the patient has suffered throughout his life. Particular attention is paid to congenital pathologies and those ailments that affected the urinary system.
If a woman giving birth comes to the appointment, the specialist will definitely clarify if she had any problems with the bladder while carrying the baby. It is also possible that the lady got the infection after giving birth. All this can cause kidney problems.
If we are talking about men, then it is worth telling the doctor about all the injuries that occurred on the lower part of the spinal column. Often, the representatives of the stronger sex against the background of such injuries develop the so-called flaccid bladder syndrome.
In addition, it is worth considering that the patient may be diagnosed with:
- Kidney stones.
- Prostatic hyperplasia (found only in men).
- Chronicinflammation in the bladder (mainly in the fair sex).
- Prolapsed kidney.
The doctor also checks the patient for diabetes and gout.
The more the patient explains the symptoms and diseases he has, the easier it will be to make the correct diagnosis. You will also have to take blood and urine tests. Additionally, instrumental diagnostics are carried out.
After that, the doctor studies the course of chronic pyelonephritis and selects the appropriate therapy.
Features of treatment
The main therapeutic measures are aimed at eliminating the causes of the pathology that leads to disruption of the kidneys. For this, as a rule, antibacterial type medicines are used, as well as other medicines.
In addition, it is important to increase the protective functions of the body. In addition to drugs, physiotherapy procedures can be prescribed. If the doctor does not mind, then together you can carry out treatment using traditional medicine recipes.
Medicines
As a rule, doctors prescribe antibiotics first. However, if we are talking about the symptoms and treatment of chronic pyelonephritis in women who are pregnant or have recently given birth, then in this case not all drugs are indicated. It is important not to harm the baby.
If there are no restrictions and the person can take antibiotics, then the standard course of treatment is up to two months. In the course of therapy, additional laboratory tests are carried out, according tothe results of which the doctor decides to continue the course of treatment or stop it.
If the patient is in serious condition, then, according to clinical guidelines, chronic pyelonephritis should be treated in a complex manner using different types of antibacterial agents. They can be taken parenterally or administered intravenously. Dosage increases significantly.
Although a fairly wide list of all kinds of drugs for chronic pyelonephritis is on sale, you should never choose them yourself. Only a specialist can determine the medicines and their dosage. It all depends on the analysis of the patient. The effectiveness of tablets and injections is directly related to the level of urine acidity and other indicators.
Diet and proper nutrition
In the chronic course of the disease, it is important to completely revise your diet. With the development of this pathology, it is recommended to consume more cereals, dairy products and vegetarian dishes. You need to drink at least 2.5 liters of fluid per day. It can be both water and natural juices, fruit drinks and compotes.
Meat and fish broths, pumpkin dishes, watermelons and melons have a positive effect on he alth. If we talk about cooking, it is better to refuse frying. Better to use a steamer. Eat as many vegetables and fresh fruits as possible. But horseradish, radish and garlic, on the contrary, must be completely abandoned. You should also avoid spicy or very s alty foods.
Prophylacticevents
Even if a person does not notice any signs of developing a chronic pathology, it is worth visiting a doctor at least once a year and undergoing a full examination. Particular attention should be paid to the affected kidneys. If frequent problems with these organs are observed in the fair sex, then they are usually prescribed a course of Biseptol or Furadonin.
If we are talking about a pregnant girl, then in the first trimester of bearing a baby, she must definitely undergo a bacteriological examination of urine. If problems are identified, then urgent treatment is carried out using drugs of the penicillin group.
To avoid exacerbation, periodically it is worth taking a course of antibiotic treatment. As a rule, it does not last longer than 10 days. After that, you can take various decoctions for 20 days and drink mineral-vitamin complexes that will help strengthen the immune system. For example, products based on juniper fruits, cornflower and horsetail are considered effective.
In case of any deterioration in the condition, do not delay treatment. Seek medical attention immediately.
