Pyelonephritis - what is this disease? Pathology is quite common: among a variety of kidney diseases, this ailment is in the "honorable" second place after urolithiasis. Women often suffer from pyelonephritis, and it is difficult to single out the average age of the incidence. Both very young patients and elderly people get sick. Often, after being diagnosed, 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 types of the disease, its form (acute, chronic), the causes of the appearance, treatment methods, and main symptoms. Also given tips on how to prevent relapse of pyelonephritis.
Acute and chronic pyelonephritis
Depending on how the disease progresses, both the symptomatology and the patient's performance are different. In medicine, it is customary to classify pyelonephritis as acute or chronic, each of them, in turn, can be specific or nonspecific (uncomplicated).
- Acute pyelonephritis - what is this disease? The uncomplicated form is characterized by the presence of such phenomena as bacteriuria, minor proteinuria and microhematuria. You can determine them after laboratory tests. A general blood test is characterized by leukocytosis and an increase in ESR. In approximately 30% of cases, an increase in nitrogenous slag is noted in the biochemical analysis of blood. 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 the acute course are difficult to distinguish: often bacteriuria promotes the propagation of pathogenic microflora to neighboring organs (in particular, the bladder), and the symptoms become more pronounced - the patient is unable to work, and he needs urgent professional medical help.
- Often during a physical examination, middle-aged people are diagnosed with chronic pyelonephritis. What is this disease and what is its difference 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 takes on a chronic form due to the fact that acute pyelonephritis was poorly treated. bacteria remain either in the pelvis or ureter - as a result, pathogenic bacteria are again deployed in the kidneys.
At the place of dislocation, there may be bilateral pyelonephritis or unilateral. Accordingly, 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, in both men and women, regardless of age, the following symptoms of chronic pyelonephritis are observed:
- Drawing pains in the lumbar region (may be absent, their presence depends on the type of pathogen and individual characteristics of the patient.
- Painful urination, while most often the urine is excreted in normal portions, but it becomes unclear, its color changes.
- Low-grade 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 called urgently, examination of the patient 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 withdrawal of fluids from the body and a violation of the water-salt balance).
- General weakness, poor appetite, pallor of the 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 impaired, while the volume of urine released can decrease markedly. In this case, the patient suffers from a sharp increase in body temperature, fever, chills, nausea. Appetite is lost. There are pains with pyelonephritis, but they are not pronounced. Since there are no nerve endings in the kidneys, there is no obvious painful symptomatology. Pain with 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 genital 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 female problems.
The symptoms of kidney inflammation of a bacterial nature in children are the same as in adults. If the parent noticed that the frequency of urination and the color of the urine in the child have changed, this is a good reason to consult a doctor.
Causes of pyelonephritis
Many patients are taken aback 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;
- ingestion of pathogenic bacteria into the tissues of the kidneys, pelvis, ureters or bladder.
How can infection occur and why is the focus located in the urinary system? Common causes are:
- abnormalities of the development of the kidneys - both congenital and acquired;
- endocrine pathologies;
- hypothermia of legs, feet, lower back;
- autoimmune diseases;
- non-observance of elementary rules of personal hygiene;
- microtrauma resulting from sexual contact;
- trauma to the lumbar region;
- diagnostic manipulations or surgery 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);
- the use of a permanent catheter for the urethra;
- pregnancy (hypotension of the ureters in this condition is a fairly common occurrence);
- the use of intrauterine contraceptives.
Diagnosis of the disease: which doctor should I contact?
Diagnosing pyelonephritis is quite simple. As a rule, after obtaining the results of a biochemical blood test, it already becomes clear that the cause of the patient’s malaise is impaired renal function. This is eloquently indicated by increased rates of urea and creatinine. By the way, if the creatinine index exceeds a certain level, then we can conclude that the patient develops chronic renal failure. Also, the patient must pass urine tests - you need to identify the amount of daily excretion, as well as find out what traces of bacteria are present in the urine. This is necessary so that the doctor can prescribe adequate antibacterial therapy.
Which doctor should I see if my patient suspects pyelonephritis? Kidney disease is diagnosed and treated by a specialist doctor - a nephrologist. However, for starters, you can take a coupon to an ordinary therapist. In his competence - the appointment of standard tests, the results of which will make it possible to conclude the presence or absence of pyelonephritis.
The ICD-10 pyelonephritis code is classified according to the course:
- acute pyelonephritis - N10;
- chronic - N11;
- calculous pyelonephritis - N20.9.
The patient is entitled to sick leave. In most cases (regardless of the type of disease), treatment should take place in a hospital setting. The ICD-10 pyelonephritis code is indicated on the patient's disability sheet. 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
The first task that doctors face upon admission is to bring down the heat. As soon as possible, all necessary tests should be taken to accurately assess the clinical condition. As a rule, treatment of chronic pyelonephritis takes longer. It is much easier to stop the symptoms of acute pyelonephritis, however, many patients subsequently develop a form of a chronic course. This is because the bacteria were not completely destroyed. The main danger of a transition to a chronic form is the gradual development (it can last up to 10 years) of renal failure.
If there are obstacles to the withdrawal of fluid from the body, the doctor needs to restore normal passage of urine. Recovery of urine outflow is performed promptly (nephropexy with nephroptosis, removal of kidney stones from the urinary tract and the like, necessary procedures and surgical interventions). The elimination of obstacles that impede the passage of urine, in many cases, allows to achieve a 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.
Drug treatment should be prescribed by a nephrologist or urologist. It is very important to correctly and timely prescribe antibacterial therapy in both acute and chronic course of the disease. Antibacterial drugs are prescribed taking into account the data of the antibioticogram. Before determining the sensitivity of microorganisms (for this purpose, it is necessary to wait for the results of the analyzes), a broad-spectrum antibiotic therapy 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, with improper or too short treatment, can flow into a chronic form.
Children are more likely to suffer from hyperthermia (a rise in temperature 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-take the tests after a course of medication to make sure that the recovery has taken place and that in the urine tests there was no protein, no white blood cells, no sediment. You should also regularly monitor the level of creatinine and urea in a biochemical blood test.
Many antibacterial drugs are contraindicated in children, so you can not choose an antibiotic on your own. Only an experienced nephrologist, based on the clinical picture of the condition and after receiving antibioticogram data, can prescribe the drug. Parents' attempts 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.
Preparations for the treatment of pyelonephritis
What drugs to take with 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" - a safe drug, which includes extracts of herbs. It reaches 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 this that pain is reduced) due to the effect on the smooth muscles of the kidneys. "Kanefron" has a diuretic effect, this helps to reduce swelling in the patient.
- "Biseptolum" is a combined anti-inflammatory drug. Regular intake helps to reduce the concentration of pathogenic bacteria in the tissues of the kidneys. As a rule, Biseptolum is prescribed in conjunction with other drugs, since the action of Biseptolum 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 odor. The drug has anti-inflammatory, antiseptic and mild antimicrobial effects. With prolonged use, it helps to crush and remove stones from the kidneys. It is prescribed for chronic pyelonephritis, often in conjunction with antibiotic drugs.
- "Furamag" is a popular antimicrobial agent for treating pyelonephritis from the nitrofuran group. The form of release 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, before starting treatment, you should consult your doctor.
- "Furadonin" is a tabletted synthetic antimicrobial agent. Of course, today there are many safer drugs with fewer side effects. When taking Furadonin, digestive upset, 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 conduct treatment at home. It is important to understand: if you decide to refuse treatment in a hospital, you will still have to pass tests before choosing a medicine. This is necessary for an accurate diagnosis.
Many patients are mistrustful of the methods of modern medicine and pharmacology and prefer to treat kidneys with alternative methods. Alas, with pyelonephritis this is dangerous: in the absence of an antimicrobial effect, all methods of therapy are doomed to failure. For example, millet for kidney treatment is a popular method of cleansing this paired organ. It should be steamed millet, let it brew and eat on an empty stomach a few tablespoons. Millet for the treatment of kidneys is really useful, but it will not work in any way from the symptoms of pyelonephritis. Moreover, while the patient is trying one or another alternative treatment method, the bacteria multiply and the disease progresses.
The exception is medicinal herbs. Infusions of bear ears, calendula, cucumber leaves have a diuretic and anti-inflammatory effect. However, the effectiveness of herbal infusions still can not be compared with pharmacological drugs, so the choice in favor of pharmacy medicines is obvious.
How to prevent a relapse 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 is elevated, you must continue to take medication.
Diet is very important. With pyelonephritis, you should adhere to the nutritional rules described in medical diet No. 7. It implies a restriction in the intake of protein foods and certain types of fats, carbohydrates. The patient should refuse to drink alcohol, adhere to a special drinking regimen. If, after recovering from pyelonephritis, you do not follow the diet and drinking, then there is a high risk of complications or the fact that chronic pyelonephritis will imperceptibly develop again.
Dress warmly, eliminate the possibility of hypothermia of the feet and lower back. It is forbidden to swim in bodies of water with cold or dirty water. At home, you can’t walk barefoot on the cold floor. Shoes should not leak, feet should always be warm and dry.