Pyelonephritis is an inflammatory process in the kidneys and renal pelvis. This disease is most often found among children, it is inferior in frequency only to inflammatory diseases of the respiratory system. Due to the widespread prevalence of the disease among young children, along with the high probability of becoming chronic and the possibility of irreversible consequences, this disease is considered a very serious pathology that requires a careful approach to therapy both by pediatricians and by parents. In our article, we will talk about the prevention of pyelonephritis in children, as well as get acquainted with the tips and recommendations of pediatricians and nephrologists and find out what treatment methods they use.
Causes of the development of pathology in children
Pyelonephritis in children, like any inflammatory disease, is caused by microorganisms that enter the kidneys in various ways and begin to multiply actively. According to pathogenesis, in the vast majority of situations, this disease is caused by Escherichia coli, which enters the kidneys with a blood stream from the foci of a chronic infection. Such a focus of infection can be carious teeth along with chronic tonsillitis and otitis media. In rare cases, the infection can also come from the bladder or from the genital area. This is precisely the reason why girls, because of the short urethra, usually suffer from cystitis and pyelonephritis three times more often than boys.
Prevention of chronic pyelonephritis in children is very important.
Under normal conditions, the children's body is quite able to cope with pathogenic microorganisms. The main reason for the development of inflammation is considered to be a decrease in immunity, against which the defenses are not able to cope with the infection. There are many reasons that lead to a decrease in immunity, for example:
- Complications during pregnancy and childbirth.
- Short breastfeeding along with early feeding.
- Vitamin deficiency in the body.
- The presence of chronic inflammatory diseases of the respiratory tract.
- The presence of a hereditary predisposition.
Main symptoms
A feature of childhood pyelonephritis is that, depending on the age of the child, the symptoms of the disease manifest in different ways. Signs of pyelonephritis in a child are not difficult to suspect, usually the disease proceeds with characteristic manifestations.
For example, at the age of one year, children experience an increase in temperature of 39 ° C without signs of respiratory inflammation. In addition, sleep disturbance and loss of appetite may be noted.
At the age of one to five years, along with the temperature, abdominal pain and nausea occur. At the same time, children behave uneasily and cannot clearly indicate the place that hurts.
At the age of five, with this disease, the child may be bothered by aching pain in the lumbar region, as well as discomfort during urination. It is important to remember that the main distinguishing feature of renal inflammation from colds is the absence of a runny nose, sore throat and cough. The temperature against the background of full health rises immediately to high rates.
With the development of symptoms of general intoxication, children become lethargic, capricious and refuse food. Chills can be followed by fever. Against the background of temperature, a headache often appears.
To prevent this from happening, pyelonephritis should be prevented in children.
Diagnostic measures
It is not difficult for experienced doctors to diagnose pyelonephritis, especially if there have already been episodes of the disease in the history of the disease. As a rule, the diagnosis of pyelonephritis in children without fail includes a general analysis of urine and blood along with urine culture on microflora and ultrasound examination of the kidneys. Against the background of the presence of bacteria and white blood cells in the urine, the doctor can make a diagnosis.
Next, we turn to the treatment of this disease in children and the advice of pediatricians and nephrologists.
Below will be a memo on the prevention of pyelonephritis in children.
The basic principles of treatment
The treatment of any disease, especially as serious as pyelonephritis, cannot be limited to drugs alone. Treatment of this disease involves the use of a wide range of measures that should be aimed not only at eliminating the causes of the disease, but at preventing possible relapses. Nephrologists usually carry out complex treatment, which consists of the following therapeutic measures:
- Compliance with the regime.
- Following a strict diet.
- Conducting drug treatment.
- Physiotherapy and physiotherapy exercises.
All medical recommendations must be strictly observed for the early recovery and prevention of acute pyelonephritis in children.
Compliance: advice from pediatricians and nephrologists
During periods of severe manifestation of the disease, bed or at least half-bed rest is recommended. Doctors advise to forget about mental activities, and, besides, about walks and trainings. In the second week of illness, when the temperature drops and the back pain disappears, the number of active classes can be expanded, but it will be much better if the child is at home throughout the entire period of the illness.
For the prevention of pyelonephritis in children, as well as for a speedy recovery, a diet is important.
Dieting: Nephrology Tips
A diet in the presence of pyelonephritis is an essential attribute of a successful recovery. From the child’s diet, it is mandatory to exclude spicy, and, in addition, salty and fried foods. In addition, you need to limit the use of foods with a high protein content. On the tenth day of the course of the disease, nephrologists advise switching to a lactic acid diet with restriction of protein and salt. In addition, they recommend a plentiful drink, for example, compotes are suitable along with fruit drinks and weak tea, and in the presence of chronic pyelonephritis during remission, doctors prescribe a mandatory drink of slightly alkaline mineral water.
Drug therapy
Inflammatory diseases are treated with special antimicrobial medicines, that is, antibiotics. And children's pyelonephritis is no exception. Antibiotics for pyelonephritis are represented today by a relatively small assortment, since many of them are contraindicated before twelve or up to eighteen years of age, in connection with this, specialists usually prescribe the following drugs:
- Penicillins in the form of Augmentin and Amoxiclav. In addition to the usual pills, these antibiotics are released in the form of a sweet suspension for young children, and the dosage is made using a special spoon.
- Preparations of the cephalosporin group used in inpatient treatment, for example, Cefotaxime along with Cefuroxime and Ceftriaxone.
- Treatment with aminoglycosides in the form of "Sumamed" and "Gentamicin." These drugs are mainly used as an alternative and as part of combination treatment.
Nephrologists and pediatricians do not limit drug therapy to antibiotics alone. There are other important categories of drugs, which are uroantiseptics, for example, nalidixic acid. Such drugs are prescribed after a course of antibiotics for children over two years old.
At the end of the course of basic treatment, it is necessary to restore weakened immunity after the disease. For these purposes, immunomodulators are usually prescribed in the form of Viferon and Reaferon, and, in addition, a multivitamin complex in accordance with the age of the child.
Physiotherapy and physiotherapy exercises
Physiotherapy largely depends on the severity of the disease and is often prescribed by a doctor after a course of basic treatment, when the baby's condition is normal. Ultrasound techniques, UHF treatment and magnetotherapy have proven themselves well. When the inflammatory processes subside, pediatricians prescribe physical therapy in a lying or sitting position, which depends on the age and condition of the child.
Next, we turn to the prevention of childhood pyelonephritis and find out how it should be carried out.
Prevention of pyelonephritis in children
Pediatricians and nephrologists are strongly advised to comply with the following recommendations:
- Children need bed rest for the entire period of the disease.
- The child’s diet should be complete, it will correctly alternate plant and protein foods every five days. Due to this, unfavorable conditions will be created for further reproduction and growth in the number of bacteria. Doctors advise excluding spicy, as well as salty and allergenic foods from the diet.
- Against the background of an acute period of pyelonephritis, the following agents are used: sulfonamides, antibiotics, nitrofurans, as well as Nitroxoline. What else does the prevention of acute pyelonephritis in children require? For the treatment of children under the age of twelve, fluoroquinolone compounds are not used because of their excessive toxicity to the child's body. The question regarding the choice of antibacterial agent, the duration of the treatment course and the combination of different antibiotics is decided only by the pediatrician or nephrologist, depending on the clinic of the nature of the pathology and the selected microflora.
- Prevention of chronic pyelonephritis is also carried out. As part of the chronization of the process, antibiotic treatment is continued with intermittent courses for several months or even years under the control of general well-being and analysis parameters. In the event that pyelonephritis occurs against the background of anomalies in the structure of the urinary canals, the question of the advisability of surgical therapy is being decided. The use of phytotherapeutic drugs in the form of “Fitolizin”, “Urolesan” and renal collection at the second stage of the treatment of urinary tract infections for the prevention of primary pyelonephritis in children is highly effective.
- It is advisable to use homeopathic and immunomodulating agents to normalize the functions of the immune system and to prevent the exacerbation of inflammatory processes.
- After the acute manifestation of the infection, the older children can be sent to specialized sanatoriums.
- It is extremely important to carry out systematic monitoring of the condition of the child by a pediatrician and nephrologist with the study of the values of leukocyturia and pressure measurement in order to prevent exacerbation of pyelonephritis. Control ultrasound is performed once every six months. Systematic observation makes it possible to timely correct treatment and avoid the development of such consequences of infection as urolithiasis, renal failure, persistent arterial hypertension and the like.
Prevention of pyelonephritis in infants should also be carried out without fail.
This will not require any complex actions, but will help protect the baby from various inflammatory processes.
It is necessary to use disposable diapers, it is best to wear them before a walk or sleep. The genitals of the child should be in contact with the discharge as little as possible. This greatly reduces the risk of infection.
You should teach your baby to potty up to two years. It is constantly necessary to remind the child that you need to sit on the pot, you can not tolerate, because the more time the fluid is in the bladder, the more bacteria accumulate in it.
The prognosis for acute pyelonephritis is usually favorable. Against the background of chronic pyelonephritis, the prognosis improves if treatment is started in a timely manner. In case of untimely treatment, development of chronic kidney failure in 20% of children is possible.
On a note
As part of the prevention of pyelonephritis complications in children, it should be remembered that children who have chronic foci of infection are more likely to get sick. The cause may be inflammation of the gallbladder or stomach, as well as diseases such as chronic tonsillitis along with adenoids.
Influenza can also cause pyelonephritis. Parents should be sure to monitor the timely rehabilitation of the foci of infection in the child, since otherwise many pathogenic bacteria can enter the kidneys through the bloodstream, causing inflammatory processes in them.
In the event that there are adenoids and tonsils are often inflamed, doctors recommend resorting to surgery. Such a measure is, of course, extreme, but if necessary, it would be better for parents to heed this advice.
A child who has had pyelonephritis should be observed by a dentist without fail, and in case of dental caries it should be immediately treated.
Dynamic observation
The acute, exactly like the chronic, form of pyelonephritis in a child requires dynamic monitoring by a pediatric urologist, and, in addition, by a nephrologist and pediatrician with periodic studies. In addition, it is very important to regularly perform an ultrasound examination of the kidneys. It is worth adhering to the following scheme of medical observation:
- After an acute form of the disease or exacerbation of chronic pyelonephritis, tests should be given every ten days.
- During remission, this is done once a month.
- In the first three years after therapy, a study of the condition of the child is carried out every three months.
- Subsequently, it should be observed at least once a year.
Systematic observation allows you to avoid long-term complications of this disease and prevents the development of chronic kidney failure, hypertension and urolithiasis. We reviewed the treatment and prevention of pyelonephritis.