Problems with any internal organs of the human body are fraught with consequences. Sometimes pathologies reach an advanced stage and are chronic. Therefore, it is very important to undergo timely diagnostic measures and listen to the recommendations of doctors.
Chronic pyelonephritis in women, men and children is not diagnosed so often. However, it is worth learning a little more about this pathology in order to understand who exactly is at risk for this disease and how to avoid possible complications.
Chronic pyelonephritis according to ICD-10
First of all, it is worth learning a little about the classification of this pathological condition. According to medical practice, this disease can develop after an exacerbation of the disease. According to ICD-10, chronic code pyelonephritis is assigned the code N11. The description of the pathology says that such problems can begin from early childhood. This ailment proceeds unevenly and is rather mosaic in nature. This makes timely diagnosis difficult.
What is a disease?
Chronic pyelonephritis (ICD-10 code N11) cannot be considered a full-fledged diagnosis. In fact, this concept is used if it is a long-term harm that was caused by a urinary tract infection that proceeded in a periodic form. The reasons for the development of chronic pyelonephritis can not always be explained. In some situations, doctors do not diagnose any signs of additional infection.
If we talk about the main signs of chronic pyelonephritis characteristic of this pathology, then it is worth considering the normal functioning of the body systems. Typically, urine begins to flow out of the kidneys and through special channels into the bladder. Each ureter has a special one-way valve that prevents the likelihood of urine flowing in the opposite direction. If one of these valves fails, then reflux appears. It is characterized by the fact that urine rushes in the opposite direction and enters the kidney. If there are certain infections in the bladder or pathogenic bacteria are located directly in the liquid itself, then in this case the kidney becomes infected.
Also, when considering the diagnosis of chronic pyelonephritis, it is worth paying attention to the fact that in the bladder the pressure, as a rule, is significantly higher than in the kidneys themselves. Accordingly, fluid reflux provokes an even greater load on these organs. Against this background, their damage and subsequent scarring occurs.
If we are talking about vesicoureteral reflux, then in this case we have in mind a congenital condition, which is explained by poor-quality work of the ureteral canal. Such disorders occur due to the fact that one of the internal segments of the brain has been damaged. Similar pathologies are diagnosed in childhood. Also, this ailment can be acquired. For example, this often happens as a result of trauma to the spinal cord.
Why the acute process becomes chronic
This question interests everyone who has encountered this problem. Acute and chronic pyelonephritis really often go hand in hand. One state may well go into another.
If we talk about chronic pyelonephritis, then, as a rule, several factors can lead to it at once. In the first case, we are talking about poor-quality treatment of an acute form of pathology or that the patient simply did not adhere to the recommendations and advice of a doctor. If there was a breakdown of the dispensary treatment, then in this case the pathology may well turn into a chronic form.
You can also get chronic pyelonephritis in the history of your disease if the diagnosis was not done in time. Because of this, the doctors could not prescribe the appropriate treatment, and the pathology acquired a different character.
In addition, concomitant pathologies of the chronic type, which significantly impair the functioning of the immune system, can also affect the development of the chronic form. For example, pyelonephritis can go to a new stage if a person suffers from diabetes, obesity, sinusitis, tonsillitis, problems with the pancreas or intestines.
Some varieties of pathogens can also lead to this, which can get into the kidney tissue and stay in sleep mode for a long time. If they are activated, this leads to a significant increase in the protective functions of the body.
Classification
If we talk about the forms of this ailment, then there are several. According to the ICD, chronic pyelonephritis can occur in:
- Latent form. In this case, no special clinical manifestations are observed. However, patients noted general weakness, the appearance of fatigue, frequent headaches. Sometimes the latent form is accompanied by a slight increase in body temperature. Some patients experience pain in the lumbar region, as well as swelling. It is worth noting that with this form of pathology, the performance of the kidneys is slightly impaired. However, in the analyzes, a decrease in urine density can be seen. And in some situations, doctors additionally diagnose moderate-type anemia and a slight excess of blood pressure.
- Recurrent form. In this case, we are talking about a change in various periods of the pathology. This means that a person can experience both exacerbation and remission. If we talk about the main symptoms during this period, then patients complain of pain in the lower back and a more noticeable increase in body temperature. Chills may also appear. Some patients begin to visit the toilet more often, as they suffer from frequent urination (sometimes it is accompanied by painful sensations).
- Azothermal form. In this case, we are talking about a pathology that developed against the background of renal failure. As a rule, this happens due to a rather long latent development of the disease.
- Hypertensive form. In this case, chronic pyelonephritis is clinically manifested in the form of predominant arterial hypertension. Accordingly, patients begin to complain of severe headaches, dizziness, and trouble sleeping. Many have stitching pain in the heart. In this condition, hypertensive crises can be diagnosed. A person has a constant shortness of breath. If you diagnose chronic pyelonephritis and familiarize yourself with urine tests, then no major changes will be detected. It is worth noting that in the case of pyelonephritis, hypertension, as a rule, manifests itself in the form of an additional pathology.
- Anatomical shape. As a rule, in this case, patients are diagnosed with all characteristic symptoms. This means that the volume of red blood cells in the bloodstream is significantly reduced. This type of pathology is much more common in those who suffer from acute pyelonephritis. In this case, the symptoms are more pronounced. However, with urination, serious violations are not detected.
If we talk about the manifestation of exacerbation of chronic pyelonephritis, then in this case, experts pay attention to the fact that the clinical picture is more like acute inflammation. After the pathology begins to progress, hypertensive syndrome comes first. This means that a person suffers from severe headaches, dizziness. He may have problems in the work of the cardiovascular system. After this, anemia may develop.
Features of the disease depending on the specific patient
It is worth noting that in medical practice there is no clearly formed list of patients who may experience similar problems. However, treatment of chronic pyelonephritis is most often prescribed in women who bear children, and in babies themselves under the age of three years. Also, pathology occurs in girls who have just begun sexual activity, and in older people. Patients in these categories are advised to periodically undergo the prevention of this disease.
There are several groups of people in whom this pathology manifests itself in a slightly different way. If we are talking about children, especially newborn babies and preschoolers, then in this case, as a rule, most often small patients complain of intoxication and severe pain. The risk group includes babies who have been diagnosed with a congenital or acquired form of uropathy. This condition is characterized by serious violations of the full movement and outflow of urine. As a rule, similar pathologies develop in children against the background of the activity of Escherichia coli or Pseudomonas aeruginosa.
If you do not timely diagnose chronic pyelonephritis and leave the pathology untreated for a long time, then an allergy or an autoimmune reaction may develop.
If we are talking about older people, then in this case, the main causes of the appearance of chronic pyelonephritis are age-related changes that every person faces. In addition, the immune system is becoming weaker every year and can not resist viruses and infectious diseases.
Incontinence of urine and feces can also lead to such an infection.
Chronic pyelonephritis can develop due to prolonged bed rest, which was prescribed to a pensioner due to an injury or a more serious pathology.
Also, chronic pyelonephritis is often diagnosed in patients suffering from diabetes. According to statistics, after diagnosis, chronic pyelonephritis is detected in more than 27% of cases in people who have this endocrine pathology.
This unpleasant ailment can cause more serious complications. For example, with diabetes, necrosis of the renal papilla can develop. Against this background, there is a significant increase in glucose in the blood of a person, which can lead to the rapid development of an infection of the genitourinary system.
Also, a similar disease is often diagnosed in those who suffer from glomerulonephritis. This autoimmune type of inflammation is the result of the development of an infection that is localized in the tonsils. Also, this is possible in the case of chronic tonsillitis. Streptococci begin to produce toxins that cause the body's immune system to destroy their own cells, which are healthy. Therefore, severe kidney damage occurs. If a person is additionally affected by a bacterial infection, this further complicates the situation.
Caution should also be exercised for those people who have recently undergone kidney transplant surgery. Very often in medical practice, pyelonephritis of a transplanted organ is found. Unfortunately, this happens with almost half of the patients. This is due to the fact that the body's natural defense system begins to suppress the activity of a new organ. There are motor injuries, hypoxic and others. If the organ is not properly transported, an infection can get into it, which will be transplanted into the body of another person.
Chronic pyelonephritis can develop in those who have had one kidney removed. In this case, the symptoms will be more pronounced, and the pathology will begin to progress more rapidly.
Chronic pyelonephritis during pregnancy
Pregnant women should be singled out as a separate group. Also at risk are young mothers. The fact is that the process of treating chronic pyelonephritis in women during childbearing or after childbirth is complicated by the fact that during this period the fair sex can not take potent drugs, as this can adversely affect the baby’s health.
In addition, ladies should be careful, as their body undergoes another hormonal restructuring. Moreover, there is a physical change in the size of the uterus, against which the immune system begins to malfunction, its functions are significantly reduced, and symptoms of chronic pyelonephritis appear. Treatment of a woman requires close attention if the lady had a difficult birth or had a spontaneous miscarriage. In this case, we are talking about the most difficult treatment. In this position, the fair sex also can not take antibiotics, since her body is too weak.
Clinical manifestations
Chronic pyelonephritis is characterized by latent inflammatory processes that occur in the connective tissues. Specific symptoms may not occur for years. Because of this, a person for a long time does not even suspect that he is suffering from a rather dangerous pathology.
With a standard examination, chronic pyelonephritis can be detected only if the person has donated blood for analysis. Then the doctor will pay attention to the number of white blood cells, which will be very much higher than normal. Also, the patient may notice the appearance of pain during urination. This symptom should not be ignored.
If we talk about the exacerbation of chronic pyelonephritis, treatment should begin as soon as the patient began to appear characteristic symptoms:
- General weakness.
- Decreased appetite and disability.
- Painful sensations and severe discomfort in the lumbar region.
- Headaches and constant drowsiness.
- Chills, which is especially noticeable in the evening hours.
- Fever.
Gradually described symptoms are becoming more pronounced. After some time, additional signs appear in the form:
- Constant thirst and dry mouth.
- Frequent and impaired urination.
- Blanching of the skin and itching.
- Anemia and persistent shortness of breath.
- Increases in blood pressure (special attention should be paid to the lower value).
If the disease goes into the acute phase, then patients begin to empty their bladder more often. Also, patients notice that the urine itself has acquired a cloudy tint. Bloody inclusions may be present in it. The lower back, in the area of the affected organ, is almost impossible to touch. A strong fever appears, which is replaced by chills.
If remission is noted, then all the unpleasant symptoms go away. However, it is impossible to predict the likelihood of a complete cure.
Pathology stages
Most serious ailments occur in several stages. If we talk about the stage of chronic pyelonephritis, then there are three periods of the course of the disease:
- Initial. At this stage, the process of inflammation begins. Against this background, swelling of connective tissues located on the inside of the urinary system appears. This leads to vascular compression. Atrophy of the urethra develops.
- Second stage. At this stage, the pathology can best be detected with the help of the nephrogram. The doctor notes that there is a narrowing of the diffuse type, which affects the renal bed. The volume of cortical substance is significantly reduced. It is not possible to identify interlobar arteries.
- Third stage. At this stage of the development of pathology, a rather strong narrowing and a change in the shape of those vessels that enter the urinary system are observed. Gradually, the kidney tissue begins to be completely replaced by scarring. The kidneys themselves are wrinkled.
If you do not start timely treatment of pathology, then there is a risk of developing renal failure.
Diagnostic measures
Diagnosis of chronic pyelonephritis begins with an appointment with a specialist (a urologist or nephrologist deals with these issues). The doctor needs to list all the diseases from which the patient suffered throughout his life. Particular attention is paid to congenital pathologies and those ailments that affected the urinary system.
If a woman who has given birth has come to the reception, then the specialist will definitely clarify whether she had problems with the bladder during the gestation of the baby. It is also likely that the lady received the infection after childbirth. All this can cause kidney problems.
If we are talking about men, then it is worth telling the doctor about all the injuries that occurred on the lower part of the spinal column. Often, representatives of the stronger sex against the background of such injuries develop the so-called syndrome of flaccid bladder.
In addition, it is worth considering that the patient can be diagnosed with:
- Kidney stones.
- Prostate hyperplasia (found only in men).
- Chronic inflammation in the bladder (mainly in the fair sex).
- Omission of the kidney.
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Treatment features
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Medicines
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If the patient is in serious condition, then, according to clinical recommendations, chronic pyelonephritis should be treated comprehensively using different types of antibacterial agents. They can be taken parenterally or administered intravenously. The dosage is significantly increased.
Although a rather wide list of all kinds of drugs for chronic pyelonephritis is on sale, it’s not worth choosing them yourself. Only a specialist can determine the medicines and their dosage. It also depends on the analysis of the patient. The effectiveness of tablets and injections is directly related to the level of acidity of urine and other indicators.
Diet and proper nutrition
In the chronic course of the disease, it is important to completely review your diet. With the development of this pathology, it is recommended to consume more cereals, dairy products and vegetarian dishes. You need to drink at least 2.5 liters of fluid per day. It can be both water and natural juices, fruit drinks and compotes.
Meat and fish broths, pumpkin dishes, watermelon and melon have a positive effect on the state of health. If we talk about cooking, it is better to refuse frying. Better to use a double boiler. It is necessary to eat as much vegetables and fresh fruits as possible. But from horseradish, radish and garlic, on the contrary, you need to completely abandon it. It is also worth excluding spicy or very salty dishes.
Preventive actions
Even if a person does not notice any signs of the development of chronic pathology, it is worth visiting a doctor at least once a year and undergo a full examination. Particular attention should be paid to affected kidneys. If frequent problems with these organs are observed in the fair sex, then usually they are prescribed a course of "Biseptolum" or "Furadonin".
If we are talking about a pregnant girl, then in the first trimester of bearing a baby she must undergo a bacteriological examination of urine. If problems are identified, then urgent treatment is carried out using penicillin group preparations.
To avoid exacerbation, it is periodically worthwhile to conduct a course of antibiotic treatment. As a rule, it does not last longer than 10 days. After this, you can take various decoctions and drink mineral and vitamin complexes for 20 days, which will help strengthen immunity. For example, funds based on juniper fruits, cornflower and horsetail are considered effective.
In case of any deterioration, do not delay the treatment. Seek immediate medical attention.