The structural features of the female body are the reason that the fair sex is 6 times more likely to suffer from pyelonephritis than men. This is a non-specific kidney disease characterized by inflammatory processes caused by bacteria. At the time of inflammation, the kidney parenchyma and renal pelvis are affected.
There are several pathogens: inflammatory processes are provoked by Pseudomonas aeruginosa, Escherichia coli, enterococci, staphylococci, Proteus. If a person has an outflow of urine, it is thrown into the kidney, and along with it the pathogen also gets there. Also, the cause of urine reflux into the kidney may be intravesical pressure due to hypertonicity with structural anomalies, the presence of stones or a banal overflow of the bladder. The same problems arise when the prostate gland in men is enlarged.
What is dangerous chronic pyelonephritis
Chronic forms of the disease are those with which a person will have to live the rest of his life. These are incurable forms of the disease, which from time to time are very sharply reminiscent of themselves, and the patient needs medical attention during this period. In the case of pyelonephritis, each new exacerbation spreads the inflammatory process to healthy areas of kidney tissue. At the site of the lesion, healthy tissue dies and a scar forms, so over time the functional part of the tissue decreases. All this leads to the fact that, in the end, the kidney ceases to function. If chronic pyelonephritis affects two kidneys, then kidney failure occurs and the patient needs constant help from the artificial kidney apparatus.
How is a diagnosis made?
To correctly diagnose, it is necessary to apply a set of measures. Diagnosis of chronic pyelonephritis is based on an anamnesis and laboratory diagnosis, and the urologist also takes into account the clinical picture.
One or more of the following methods is used:
- General analysis of urine and blood.
- Bacterial culture of urine.
In laboratory conditions, urine is examined, with this disease, you can see that it is cloudy, a precipitate appears. The laboratory assistant notes the presence of bacteria, salts, protein and epithelium in the test material, the level of leukocytes is increased.
When salt and protein appear in the urine, this is already a sign that an inflammatory process is going on in the kidneys and the mechanism of blood filtration is broken. Diagnosis of chronic pyelonephritis is carried out by urologists, and when such a diagnosis is made, the question must be kept under control and systematically pass urine for examination to monitor the work of the kidneys. This will need to be done constantly. Also used:
- Ultrasound of the kidneys. At the time of inflammation, the TLS (pyelocaliceal system) usually expands , and this is seen on an ultrasound scan.
- X-ray examination.
- Radioisotope renography. This is a good method for differential. diagnosis of pyelonephritis. In the organs of the urinary system, a radioactive marker accumulates, with it you can track how quickly urine is excreted from the kidneys, evaluate the work of the kidneys, and the dynamics of the renal processes.
Features of chronic pyelonephritis
In the chronic form of this disease, there may be damage to one or two kidneys, so pyelonephritis is divided into unilateral and bilateral. It is also divided into types, depending on the severity of the course of the disease. With a latent form, the patient experiences slight discomfort, so that he can generally ignore the problem.
In case of recurrent pyelonephritis, the periods of calming down of the disease and exacerbation alternate. Relapse frequency depends on a number of factors. Reduced hemoglobin and anemia are observed in chronic pyelonephritis. Differential diagnosis allows you to establish a diagnosis where the symptoms coincide with other kidney diseases. With the azotemic form, there is already renal failure, and with a hypotensive one, blood pressure rises.
Some of the symptoms accompany other diseases, but it is important to establish the correct diagnosis, because different diseases are treated differently.
The first stage is an active inflammatory process with severe symptoms. The latent stage has an erased clinical picture. In this case, the disease can be diagnosed through laboratory tests. The third stage is remission, during this period all manifestations of the disease are absent. If there are no exacerbations for 5 years, then the doctor confirms a complete recovery.
Predictions for the chronic form of the disease
It is difficult to predict how a person’s life will develop with chronic pyelonephritis and what its duration will be. If you adhere to all the recommendations of a doctor, then even with such a diagnosis you can live happily and long. When a sick person smokes, does not conduct appropriate treatment, abuses alcohol and ignores medical recommendations, his life can be significantly reduced. Diagnostic methods for pyelonephritis allow you to establish a diagnosis with 100% certainty, therefore, treatment can be carried out in a timely manner and with good results.
To prevent the disease, it is necessary to respond in time to all unhealthy manifestations, especially if they relate to the genitourinary system. In urology, you do not need to self-medicate, you need clear doctor's recommendations. The kidneys do not like hypothermia, you need to follow this and, preferably, do not use non-steroidal painkillers. A healthy person needs to drink at least 2 liters of water per day, so as not to allow a high concentration of harmful substances in the urine, otherwise the risk of developing pathological flora increases.
During pregnancy, the risk of developing pyelonephritis is increased. Diagnosis and treatment should be carried out immediately. During pregnancy, especially in the later stages, urine outflow worsens, so you need to monitor your well-being. It is important to always follow the rules of personal hygiene, adhere to a healthy lifestyle in both nutrition and physical activity.
The disease does not occur out of the blue
The word "chronic" indicates that the disease is present in human life for a long period. But the transition to a chronic form begins with an acute one, when improper antibacterial therapy was carried out or the treatment was short and did not reach its logical conclusion. The reason for the deterioration of health may be the late diagnosis and treatment of chronic pyelonephritis.
The disease does not occur out of the blue, often there are related factors: kidney stones, prostatitis or prostate adenoma, narrowing of the urinary tract or drooping kidney. Disease-causing bacteria may become more resistant to external influences after treatment is interrupted. It seems to the patient that relief has come, but after a while the disease returns.
A number of factors favor the development of the disease. Pregnancy and childbirth, congenital malformations of the kidneys or structural features of the genitourinary system, due to which the normal urodynamics change, can serve as a start for the onset of the disease. With the onset of sexual activity, risks also arise.
Symptoms that can identify the disease
This disease is not always easy to diagnose. Symptoms are often not expressed, are weak or not at all. Differential diagnosis of pyelonephritis allows you to identify the disease according to different criteria. The blood level of hemoglobin is lowered, but this can be with other diagnoses, and the number of leukocytes in the urine and red blood cells is also increased.
Symptoms depend on the stage of the disease. Chronic pyelonephritis is accompanied by aching lower back pain with weak intensity, the pain is asymmetric. If the patient has a prolapse of the kidneys, then pain may occur in the abdomen.
Diagnosis and treatment of chronic pyelonephritis should be carried out by a doctor. Even if a person finds similar symptoms in himself, this does not mean that he has this particular disease. After a long walk or standing in the back, discomfort appears. In the morning, swelling of the face, feet and hands becomes noticeable, at night, frequent urination. The patient’s pressure rises, the temperature jumps up, reaching 38 degrees, especially in the evening.
When a person is not feeling well, naturally, his mood will disappear, a state of weakness and weakness will come, headaches may appear. It seems that in the mouth everything is dry and constantly thirsty. If the patient has chronic pyelonephritis, differential diagnosis will allow him to be identified.
Treatment as directed by a physician
Medical workers spend more than one year to acquire a specialty, and narrow specialists constantly improve their skills, but even they make medical mistakes. What can we say about when a person prescribes treatment for himself? It can be not only not effective, but also dangerous. When the doctor has applied all possible methods of diagnosing chronic pyelonephritis, he prescribes treatment.
Penicillin group antibiotics can be prescribed, they have a wide spectrum of action and are most sparing for the kidneys. Cephalosporins of a new generation are usually prescribed intramuscularly, with this disease they are widely used. If a person is in a hospital, then injections are done on site by medical staff.
In treatment, you need to use drugs that have a minimal negative effect on the kidneys, fluoroquinolones are such antibacterial drugs, they effectively fight bacteria that damage the urinary system. But pregnant women and children can not appoint them. During their use, you need to protect yourself as much as possible from exposure to ultraviolet rays. With a solarium and the beach have to wait.
When the doctor conducted a differential. diagnosis of chronic pyelonephritis, he can prescribe oxyquinolines, they are often used in urology. Nitrofurans are rarely used, despite their effectiveness, because they have pronounced side effects.
Treatment is carried out for 14 days, at the end of this time it is necessary to re-take tests. In parallel with anti-inflammatory drugs, antispasmodics can be prescribed, they not only relieve pain, but also improve urine outflow.
There are drugs in the prescription that improve venous outflow and renal blood flow. In the complex, the patient undergoes physiotherapy, electrophoresis and magnetotherapy. All these actions allow achieving stable remission and defeating chronic pyelonephritis. Etiology, clinic, diagnosis and treatment should be under the supervision of a physician.
When a patient has concomitant diseases, other drugs are also used in therapy to correct the disorders caused by pyelonephritis. The patient may be prescribed antipyretic drugs. If the disease is not in an acute stage, then herbal medicine can be used. Herbal treatment should also be controlled by doctors.
Dieting required
When a diagnosis of chronic pyelonephritis is carried out, the patient may not feel obvious discomfort, but in fact the inflammatory process is already underway. The diseased organ should not be additionally loaded during this period. That is why the doctor gives recommendations on nutrition and drinking regimen. If there is no edema and high pressure, then the amount of drinking water can be brought up to 3 liters per day. If swelling is present, then you need to drink about 2 liters of water.
In terms of food you need to be reasonable: salty and spicy dishes will not benefit the patient. Coffee consumption is best reduced to a minimum. All food consumed should be in the right ratio of proteins, carbohydrates and fats. Sour-milk products can be eaten in any quantity, they will even help to establish the work of the intestines, which may be disturbed due to the action of antibiotics. Beef, chicken, rabbit, boiled fish, boiled eggs, vegetables and cereals - all this should be in the diet. Any easily digestible food after the diagnosis of chronic pyelonephritis is welcome.
Children also have pyelonephritis
Young children are no exception when it comes to pyelonephritis. It manifests itself in the same way as any infectious disease, while the functional state of the kidneys is impaired. Diagnosis of pyelonephritis in children is carried out from birth, and premature babies are more likely to suffer from this disease than children who were born at one time. The disease may be with impaired or retained kidney function. For the diagnosis of pyelonephritis in very young children under 3 months of age, screening tests are used. Based on bacteriuria and leukocyturia, a diagnosis is made. In addition to conducting laboratory tests, the doctor draws attention to such symptoms in the child as fever, fever.
If the doctor suspects pyelonephritis in a child, then urine culture and microsporia should be performed, antibiotic therapy is prescribed according to test results.
The doctor conducts all necessary tests of urine and blood, performs an external visual examination of the genitals, and measures pressure. Feces need to be checked for dysbiosis. Diagnosis of acute and chronic pyelonephritis is carried out using an ultrasound machine.
The treatment program includes a diet, as well as in adults. For the period of fever - bed rest. The doctor monitors the amount of urination of the child, they should be regular, according to age. Hygiene must be observed. During treatment, antibiotic therapy is performed. In the first three days, antipyretic drugs and detoxification drugs are prescribed.
Similar diseases, how to distinguish?
Renal diseases can occur almost identically, there is a slight difference in symptoms. Differential diagnosis of chronic pyelonephritis and glomerulonephritis is carried out by specialists. Glomerulonephritis is an immuno-inflammatory disease. With this diagnosis, the glomerular apparatus of the kidneys is affected, interstitial tissue and tubules are also involved in the inflammatory process. The disease proceeds in acute and chronic forms. The causative agent is most often streptococcal bacteria that are in the body after tonsillitis, viral respiratory diseases, dermatitis and other infections.
Two weeks after the disease, the virus manifests itself as an infection in the kidneys. Glomerulonephritis can manifest itself only by edema, the same can be with pyelonephritis. Therefore, the instrumental method for the diagnosis of chronic pyelonephritis is so important. If the interstitial tissue of the kidneys is inflamed, then identifying the problem is not so simple. When the history is not enough, then the instrumental diagnostic method is used. With the help of an ultrasound and X-ray machine, you can see in detail what is happening with the organ, see if the kidney is deformed, see the true size of the renal pelvis, is there an expansion, what is the structure of the parenchyma and whether there are scars and thinning on it. Radionuclide and endourological diagnostics allow you to monitor the work of the kidneys. With the help of various tools, you can accurately establish the diagnosis, even if different diseases fall into the symptoms according to the symptoms.
Features of acute pyelonephritis
If a person feels weak, he has a headache, a temperature of 40 degrees and increased sweating, then we can say that he has acute pyelonephritis. Diagnosis is the same as in the case of a chronic disease. There is such a strong state of nausea that a person can vomit. In the lumbar region, dull pain, which, however, can change the intensity. Usually the pain is localized on one side. When the disease in acute form is not complicated by other diseases, then problems with urination do not arise.
Diagnosis of acute pyelonephritis is carried out, urine is examined, it has a cloudy consistency, a reddish tint may be present, there are bacteria in it.Biochemical analysis shows an excess of the norm of nitrogenous slag in about a third of all cases. Treatment is carried out only medically, most often in stationary conditions, until the acute symptoms are resolved. If the disease is not treated, then later it will manifest itself in a chronic form and it will be much more difficult to fight it.
Recommendations of specialists
When the patient is faced with an acute form of the disease, he maximally fulfills all the doctor’s recommendations to relieve pain symptoms, improve the general condition and quickly return to his usual lifestyle. But one does not always want to limit oneself to what one is used to when there are no obvious problems. Patients avoid recommendations even when a diagnosis of chronic pyelonephritis has been performed. Clinical recommendations depend on the form of the disease.
During an exacerbation, it is necessary to observe bed rest, sleep should be in sufficient quantity. The patient's room must be aired, and when he has enough strength, he should spend at least 4 hours in the fresh air. The good news is that you do not need to give up sweet drinks, you can drink compote and weak tea. Depending on the age of the patient, the rate of fluid intake per day is calculated. Urination should be regular so that the concentration of pathogenic organisms does not increase in the body.
During the disease, you should take care of yourself, you do not need to allow strong physical exertion. Only two weeks after the onset of exacerbation of pyelonephritis, you can take a course of physiotherapy exercises.
The patient should eat 4-5 times a day with food, steamed or boiled. You can use dairy products. You don’t need to starve, you just have to switch to food, which is easily absorbed and does not create an additional burden on a weakened body. You can eat vegetarian soups and dishes with lean meat and poultry, any cereals, vegetables and soft-boiled eggs are allowed.
Forbidden foods include all kinds of smoked meats, canned food, spices, mayonnaise, ketchup and garlic. You can’t eat rich soups, legumes and pickled vegetables. Carbonated drinks and alcohol are strictly prohibited.
With this diagnosis, constant monitoring by a nephrologist is necessary; urine is periodically taken to monitor the functional state of the kidneys. In order to prevent the disease, it is necessary to get rid of the chronic foci of infection in the body. It can be sinusitis, caries, tonsillitis, etc.
To ensure the normal functioning of the kidneys, you need a balanced drink, eating fruits and vegetables. It is necessary to minimize the use of products in which there are a lot of oxalates, and these are: nuts, cocoa, spinach, bran, tea and several others.
If there is a tendency to form kidney stones, then you will need to always monitor your diet. It’s easier to limit yourself to certain foods than to remove kidney stones later. Some stones cannot be removed, they have to be removed only surgically. If there are stones in the kidneys, then the organ will not be able to function normally, and inflammatory processes will become a frequent companion of a person.