In 2007, the International Classification of Diseases was adopted . It included a disease such as chronic pyelonephritis. This was the tenth revision of the list, and therefore it became known as the ICD-10. Let us consider in more detail what pyelonephritis is. ICD-10 codes for this disease will also be described in the article.
Causes of the disease
One of the most dangerous kidney diseases is chronic pyelonephritis (ICD-10 code No. 11.0), a pathology of a complex inflammatory course. The disease is characterized by painful symptoms, occurs when an infectious pathogen enters the urinary tract, which rises to the kidney through the urinary canal and enters the organ tissue.
With the initial penetration of infection, the body's immune resistance is significantly reduced, its secondary manifestation is already caused by the formation of microbial colonies, developing rapidly, but almost asymptomatically. Such chronic pyelonephritis is called obstructive (code in ICD-10 No. 11.1).
The disease in question cannot be called exclusively female, but, according to statistics, out of seven patients, only one is a man. The conditionality of such microbial selectivity lies in the complexity that the pathogenic bacteria have to face when climbing the narrow and long urinary canal of a man. As a rule, even halfway to the treasured kidney, the microbe dies or is excreted with the spent liquid. The female urinary canal is much wider and shorter, penetration to the organ through it does not pose any special difficulties for the bacterium.
Provocative factors
Low immunity alone is not able to withstand infection, but if the body is weakened by a concomitant disease or is in a state of particular susceptibility, then exacerbation of chronic pyelonephritis (ICD-10 code No. 11) will not be long in coming.
One of the factors that increase the susceptibility of an organism to microbial infection can be:
- diabetes;
- prolonged hypothermia;
- hereditary factor;
- frequent infectious diseases;
- pregnancy.
Nonobstructive chronic pyelonephritis (code according to ICD-10 No. 11.0), often occurs against a background of latent inflammatory processes, reflux, and often becomes a complication of any underlying disease.
Clinical picture
Tubulo-interstitial, not specified as acute or chronic, pyelonephritis (code according to ICD-10 No. 12) appears already at the stage of emergence of a microbial colony in the kidneys, when the renal tubules are clogged by the products of microorganisms and the filtering organ ceases to function normally. In this case, painful symptoms occur, which are often perceived as manifestations of osteochondrosis, lumbar backache or a common cold.
In some diseases, many symptoms characteristic of chronic pyelonephritis are manifested. Under the code according to ICD-10 84.0, for example, a pathology such as an endometrial polyp is encrypted. The clinical picture of this disease is very similar to the manifestations of the kidney disease in question. So, with these pathologies, there are:
- drawing pains in the lower back ;
- general swelling, especially noticeable in the morning in the nose and under the eyes;
- chills and temperature up to 39 degrees .;
- increase in blood pressure;
- foul-smelling urine due to the high content of pus in it;
- decreased sleep and appetite;
- headaches, muscle pains.
In acute pyelonephritis, therapy is mainly aimed at relieving pain. Promptly taken medications usually help quickly. Having got rid of painful symptoms, patients often give up treatment halfway through the course, stop dieting. If untreated, the disease from acute (code No. 10) goes into the chronic form of pyelonephritis (code according to ICD-10 No. 11).
Forms of pyelonephritis
Chronic pyelonephritis can take one of the following forms in appearance and severity of the clinical manifestation:
- anemic form - in which anemia appears in the first place due to intoxication, which negatively affects the production of erythropoietin;
- hypertensive - characterized by an unstable increase in blood pressure;
- nephrotic - expressed by severe malfunctions of protein and lipid metabolism in the body;
- septic - activated at times of severe exacerbations of the disease, with characteristic temperature spikes and signs of toxic poisoning;
- latent - proceeding in a latent form, often asymptomatic. This form of the disease debilitates the body and remains undiagnosed for a long time;
- recurrent - this form has a constantly changing nature - from sudden sudden exacerbations to long pauses in remission.
Pyelonephritis Stage
The consequence of an incomplete treatment or lack thereof is usually a gradual overflow of acute pyelonephritis into chronic (ICD-10 codes No. 11.1 or No. 11.0). It must be understood that the disease, even in the first stage of any form, is an irreversible phenomenon. You can stop its development and prolong remissions with competent treatment, but you can no longer completely cure the kidneys.
In decoding the code of chronic pyelonephritis according to ICD-10, unfortunately, there is no description of the stages of the disease. Therefore, we should dwell on their consideration in more detail.
- Stage I - a gradual loss of the functionality of the collecting tubules;
- Stage II - aggravated atrophy of the tubules and proliferation of connective tissue;
- Stage III - the death of a large number of renal glomeruli and deformation of the renal tissue, resembling the structure of the thyroid tissue;
- Stage IV - replacement of the cortical substance of the kidney with connective tissue.
Diagnostics
In the decoding of the pyelonephritis code according to ICD-10, the etiology and symptoms are not described. In this regard, in practice, problems often arise in the differentiation of pathologies. To eliminate errors, a set of diagnostic procedures must include laboratory tests of urinary sediment according to the methods:
- Kakovsky - Addis;
- Stengheimer - Malbina.
In addition, bacteriuria and a biopsy of the kidney tissue are performed to recognize the microbial environment. A general clinical blood test is also taken first, and already on the basis of these primary results, a further diagnostic strategy is built.
If an infectious agent that causes chronic pyelonephritis is detected, an additional code (B95-B97) is added to the ICD-10 code corresponding to the form of the disease.
During the diagnosis, they also perform:
- X-ray examination to establish visible changes in the kidneys and determine the tone of the upper urinary tract;
- renography;
- scannography;
- pyelography;
- histological examination of renal tissue.
The latter diagnostic method is rarely used, because the previous methods of establishing a diagnosis usually allow you to determine the nature of the course of the disease and make the right conclusion.
Drug treatment of pyelonephritis
During the entire treatment, the patient’s condition is monitored by monthly tests, designed not only to assess the patient’s health status, but also to confirm the effectiveness of the treatment and good susceptibility of the body to the prescribed drugs. Duration of treatment is rarely less than four months, but relief usually comes much earlier. It is important to complete the course so as not to allow the disease to go up a notch.
The treatment is based on broad-spectrum antibiotics that suppress the gram-negative flora, but do not have a toxic effect on the kidneys. These drugs include fluoroquinolone antibacterial agents: Cefuroxime, Ciprofloxacin, Cefenim, Norfloxacin.
Traditional treatment
Home treatment for any pyelonephritis is unacceptable and dangerous. However, many folk remedies can be used in combination with drug therapy prescribed by a doctor. They are especially good for acute forms of the disease, accompanied by severe inflammation and pain.
- To relieve acute symptoms of 1 tbsp. a spoonful of lingonberry leaves pour 250 ml of boiling water and simmer for about 10 minutes over low heat under a lid. Then the broth should be cooled, filtered and taken in 3 tbsp. tablespoons 3 r / day on an empty stomach.
- For severe lower back pain with pyelonephritis: make a 10% concentrate from ordinary edible salt and water, moisten a cotton cloth in it and fix it on the lower back overnight. You need to do this every day for 2 weeks.
- The oat grass is brewed with boiling water in a ratio of 1:10, then languished under the lid for half an hour, and after cooling it is filtered and drunk 150 ml 2 r / day. You can make a more concentrated solution and add it to the bath when bathing - the effect will be higher with a combined internal and external use of the decoction.
Prevention
For the prevention of pyelonephritis, there are several recommendations that are easy to follow, since they do not contradict the general rules for maintaining the body in a healthy tone:
- You need to try to eliminate factors such as alcohol, strong coffee and smoking from life, and passive smoking is no less dangerous than active.
- It is important to examine the entire body for a hidden source of infection. There are frequent cases when bacteria that enter the bloodstream, and then the kidneys, begin their journey from a carious tooth or sinusitis inflamed with sinusitis.
- If pyelonephritis was already present in the history, urine and blood tests should be taken at least twice a year.
- Try to undergo annual spa treatment with mineral waters or mud.
Even expensive treatment will not give any results against the background of a heavy, malnutritional diet with an uneven distribution of fats, proteins and carbohydrates. With pyelonephritis, the emphasis is on food of plant origin, mainly raw. Of animal proteins, white chicken and shallow fish are allowed.