Pyelonephritis - what is this disease? Pathology occurs quite often: among the variety of kidney diseases, this ailment is in the "honorable" second place after urolithiasis. Women suffer from pyelonephritis more often, the average age of incidence is difficult to distinguish. Both very young patients and the elderly are ill. Often, after receiving a diagnosis, patients want to know what the disease is. Pyelonephritis is a non-specific renal pathology, the appearance of which is provoked by the activity of pathogenic microorganisms.
The article describes the varieties of the disease, its forms (acute, chronic), causes, methods of treatment, main symptoms. Tips are also given on how to prevent recurrence of pyelonephritis.
Acute and chronic pyelonephritis
Depending on how the disease proceeds, it differs andsymptoms and performance of the patient. In medicine, it is customary to classify pyelonephritis as acute or chronic, each of which, in turn, can be specific or non-specific (uncomplicated).
- Acute pyelonephritis - what is this disease? The uncomplicated form is characterized by the presence of such phenomena as bacteriuria, slight proteinuria and microhematuria. You can determine them after laboratory tests. For a general blood test, leukocytosis and an increase in ESR are characteristic. In about 30% of cases, an increase in nitrogenous slags is noted in a biochemical blood test. Acute pyelonephritis in a complex course is life-threatening and requires immediate medical attention. It occurs in both men and women. The stages of pyelonephritis in an acute course are difficult to distinguish: often bacteriuria contributes to the reproduction of pathogenic microflora on neighboring organs (in particular, the bladder), and the symptoms become more and more pronounced - the patient is unable to work, and he needs urgent professional medical care.
- Chronic pyelonephritis is often diagnosed during a medical examination in middle-aged people. What is this disease and how does it differ from an acute course? Pyelonephritis can occur without severe symptoms, when the number of pathogenic bacteria is not excessive. Such a process can last for years - this is the chronic course of pyelonephritis. At the same time, the kidneys gradually lose their working capacity: in most cases, sooner or later, such a patient will be diagnosed with chronic renal failure. Often pyelonephritis acquires a chronic form due to the fact that the treatment of acute pyelonephritis was poorly carried out. bacteria remain either in the pelvis or in the ureters - as a result, pathogenic bacteria are again deployed in the kidneys.
At the place of dislocation there can be bilateral pyelonephritis or unilateral. Accordingly, the bacteria are concentrated either in both kidneys at once, or in one of them. When prescribing treatment, it practically does not matter whether pyelonephritis is bilateral or unilateral: the principles of therapy will be the same in any case.
Symptoms of pyelonephritis
As a rule, both men and women, regardless of age, have the following symptoms of chronic pyelonephritis:
- Drawing pains in the lumbar region (may be absent, their presence depends on the type of pathogen and the individual characteristics of the patient.
- Painful urination, most of the time the urine comes out in normal portions, but becomes cloudy, its color changes.
- The subfebrile temperature is about 37 degrees.
- In some cases, chronic pyelonephritis leads to an increase in body temperature up to 39-40 degrees: in this case, an ambulance should be urgently called, the patient's examination and relief of the condition should be carried out in a hospital.
- Swelling of the extremities, less often of the face (occurs due to a violation of the removal of fluids from the body and a violation of the water-s alt balance).
- General weakness, poor appetite, pale skin,frequent headaches and susceptibility to overwork, both physical and psychological.
Features of the course of the disease
Acute pyelonephritis in adults is much more noticeable than chronic: urination is disturbed, while the volume of urine excreted may decrease markedly. In this case, the patient suffers from a sharp increase in body temperature, fever, chills, nausea. Appetite disappears. There is pain in pyelonephritis, but they are not pronounced. Since there are no nerve endings in the kidneys, there are no obvious painful symptoms. Pain in pyelonephritis is more of a pulling, aching character.
It should be noted the difference in the course of the disease in women: due to the proximity of the organs of the reproductive and urinary systems, bacteria often also enter the tissues of the genital organs. As a result, the course of pyelonephritis is also complicated by the presence of women's problems.
The symptoms of inflammation of the kidneys of a bacterial nature in children are the same as in adults. If a parent has noticed that the frequency of urination and the color of urine in a child has changed, this is already a good reason to see a doctor.
Causes of pyelonephritis
Many patients are caught off guard by the symptoms of pyelonephritis. The reasons why the disease develops, by and large, can be identified only two:
- the inability of the body to resist the activity of pathogenic bacteria;
- getting into the tissues of the kidneys, pelvis, ureters or bladder of pathogenic bacteria.
How infection can occur and why the focus is deployed inurinary system? Common reasons are:
- anomalies in the development of the kidneys - both congenital and acquired;
- endocrine pathology;
- hypothermia of the legs, feet, lower back;
- autoimmune diseases;
- non-observance of elementary rules of personal hygiene;
- Microtrauma from sexual contact;
- lumbar injury;
- diagnostic manipulation or surgical intervention on the urinary tract;
- often the appearance of pyelonephritis is associated with the onset of sexual activity, especially in the absence of proper protection;
- remote lithotripsy (crushing of urinary stones);
- Using an indwelling urethral catheter;
- pregnancy (hypotension of the ureters in this condition is quite common);
- use of intrauterine contraceptives.
Diagnosis of the disease: which doctor should I contact?
Diagnosis of pyelonephritis is quite simple. As a rule, after receiving the results of a biochemical blood test, it already becomes clear that the cause of the patient's ailment is a violation of kidney function. This is eloquently evidenced by increased levels of urea and creatinine. By the way, if the creatinine exceeds a certain level, then we can conclude that the patient develops chronic renal failure. Also, the patient needs to pass urine tests - it is necessary to identify the volume of daily excretion, and also to find out which traces of bacteria are present in the urine. This is necessary so that the doctor can prescribeadequate antibiotic therapy.
Which doctor should I contact if the patient suspects pyelonephritis? Kidney diseases are diagnosed and treated by a specialist doctor - a nephrologist. However, for starters, you can take a ticket to a regular therapist. In his competence is the appointment of standard tests, the results of which will make it possible to conclude the presence or absence of pyelonephritis.
ICD-10 pyelonephritis code is classified according to course:
- acute pyelonephritis - N10;
- chronic - N11;
- calculous pyelonephritis - N20.9.
The patient is en titled to sick leave. In most cases (regardless of the type of disease), treatment should take place in a hospital. The ICD-10 pyelonephritis code is indicated on the sick leave for the patient. The document is certified by the seal of the medical institution and subsequently transferred to the accounting department of the organization where the patient works.
Treatment of pyelonephritis in a hospital setting
The first task that doctors face when a patient enters is to bring down the high temperature. All necessary tests should be taken as soon as possible to accurately assess the clinical condition. As a rule, the treatment of chronic pyelonephritis takes longer. It is much easier to stop the symptoms of acute pyelonephritis, but many patients subsequently develop a form of a chronic course. This is because the bacteria were not completely destroyed. The main danger of transition to a chronic form is a gradualdevelopment (it can last up to 10 years) of kidney failure.
If there are obstacles to the removal of fluid from the body, the doctor needs to restore the normal passage of urine. Restoration of the outflow of urine is performed promptly (nephropexy with nephroptosis, removal of stones from the kidney of the urinary tract, and similar necessary procedures and surgical interventions). The elimination of obstacles that interfere with the passage of urine, in many cases, allows to achieve relief of the condition - along with the urine, bacteria also come out. At this stage, nursing care for pyelonephritis is important - checking the placement of catheters, their timely processing, etc.
Drugs should be prescribed by a nephrologist or urologist. It is very important to correctly and timely prescribe antibiotic therapy for both acute and chronic course of the disease. Antibacterial drugs are prescribed taking into account the data of the antibiogram. Before determining the sensitivity of microorganisms (for this purpose it is necessary to wait for the results of the tests), therapy with broad-spectrum antibacterial drugs is carried out.
Features of the course of the disease and its treatment in children
The causes of pyelonephritis in children are the same as in adults: due to the inability of the body to resist and resist pathogenic bacteria, inflammation develops. In children, acute pyelonephritis is more common, which, if treated incorrectly or too short, can flow into a chronic form.
Children are more likely to suffer from hyperthermia (increasedtemperature to critical values), while self-medication is unacceptable: parents should call a qualified doctor. Most likely, hospitalization and treatment in a hospital will be required. When treating children with pyelonephritis, it is imperative to re-test after a course of medications to make sure that the recovery has taken place and that there is no protein, no white blood cells, or sediment left in the urine tests. You should also regularly monitor the level of creatinine and urea in a biochemical blood test.
Many antibacterial drugs are contraindicated for children, so you can not choose an antibiotic yourself. Only an experienced nephrologist, based on the clinical picture of the condition and after receiving the antibiogram data, can prescribe the drug. Attempts by parents to choose an antibiotic on their own are often not only useless, but also harmful: the child is getting worse, and an incorrectly selected antibiotic violates the already weak defenses of the body.
Drugs for the treatment of pyelonephritis
What drugs to take for pyelonephritis? There are a number of drugs that act pathogenetically, i.e. reduce the severity of the symptoms of the disease and reduce the factors contributing to the development of pathology:
- "Kanefron" is a safe drug, which includes herbal extracts. It reaches its maximum concentration in the excretory system of the kidneys, where it has a local anti-inflammatory, mild analgesic, antimicrobial and antiseptic effect. It relieves spasm of the urinary tract (it is due to thisa decrease in pain syndrome is achieved) due to the effect on the smooth muscles of the kidneys. "Kanefron" has a diuretic effect, it helps to reduce swelling in the patient.
- "Biseptol" is a combined anti-inflammatory agent. Regular intake helps to reduce the concentration of pathogenic bacteria in the tissues of the kidneys. As a rule, "Biseptol" is prescribed in conjunction with other drugs, since the action of "Biseptol" alone is not enough to get rid of the chronic form of pyelonephritis.
- "Phytolysin" is a thick paste of dark green color with a specific herbal smell. The drug has anti-inflammatory, antiseptic and mild antimicrobial action. With prolonged use, it promotes crushing and removal of stones from the kidneys. It is prescribed for chronic pyelonephritis, often in conjunction with antibiotic drugs.
- "Furamag" is a popular antimicrobial agent for the treatment of pyelonephritis from the group of nitrofurans. The release form of the drug is capsules (25, 50 mg). Appointed by a doctor. Despite the fact that the drug is active against most bacteria, the activity of which can provoke inflammation of the kidneys, in some cases, with pyelonephritis, Furamag may be useless. Therefore, you should consult your doctor before taking it.
- "Furadonin" is a tableted synthetic antimicrobial agent. Of course, today there are many safer drugs with fewer side effects. When taking Furadonin, indigestion, rash, dermatological problems of a different nature can be observed. However, low cost is the main argument in favor of Furadonin in the treatment of pyelonephritis.
Is it possible to get rid of pyelonephritis using traditional methods of treatment?
Often, patients refuse hospitalization and try to treat themselves at home. It is important to understand: if you decide to refuse treatment in a hospital, you will still have to take tests before choosing a medicine. This is necessary for an accurate diagnosis.
Many patients are distrustful of the methods of modern medicine and pharmacology and prefer to treat their kidneys with folk methods. Alas, with pyelonephritis it is dangerous: in the absence of an antimicrobial effect, all methods of therapy are doomed to failure. For example, millet for the treatment of kidneys is a popular method of cleansing this paired organ. Millet should be steamed, let it brew and eat several tablespoons on an empty stomach. Millet for the treatment of kidneys is really useful, but it will not work on the symptoms of pyelonephritis. Moreover, while the patient tries these or those alternative methods of treatment, bacteria multiply and the disease progresses.
Exception - medicinal herbs. Infusions of bear ears, calendula, cucumber leaves havediuretic and anti-inflammatory effect. However, in terms of effectiveness, herbal infusions still cannot be compared with pharmacological preparations, so the choice in favor of pharmacy drugs is obvious.
How to prevent a recurrence of the disease
Prevention of complications of pyelonephritis is one of the main tasks facing both the patient and the doctor. After the therapeutic course has ended, it is necessary to pass urine tests and a biochemical blood test. If any of the indicators are elevated, you must continue to take medication.
Diet is very important. With pyelonephritis, one should adhere to the nutritional rules described in the medical diet No. 7. It involves limiting the intake of protein foods and certain types of fats and carbohydrates. The patient must refrain from drinking alcohol, adhere to a special drinking regimen. If, after recovery from pyelonephritis, you do not follow the diet and drink, then there is a high risk of complications or that chronic pyelonephritis will quietly develop again.
You should dress warmly, exclude the possibility of hypothermia of the feet and lower back. Swimming in cold or dirty water is prohibited. At home, you can not walk barefoot on the cold floor. Shoes should not leak, feet should always be warm and dry.
