Acute pyelonephritis in children is an inflammation of the kidney tissue and the pyelocaliceal system. In terms of distribution, it takes the fourth place among childhood diseases after infections, pathologies of the respiratory and food apparatus. Often diagnosed with pyelonephritis in children up to a year of life. Girls get sick more often than boys. This is due to the presence of a wide and short urethra, which helps to spread the infection from the lower urinary tract to the kidney tissue.
The mechanism of the occurrence of the disease
The question arises: what causes pyelonephritis in children? Why does inflammation of the kidney tissue occur? After all, these organs do not come into contact with the external environment, such as, for example, the bronchi and lungs?
In order for the infection to enter the kidney tissue, certain conditions are necessary, and above all, a violation of the normal flow of urine. Its advance along the urinary tract occurs as a result of unidirectional contraction of the muscle fibers of the renal pelvis and urethra, which in turn are regulated by the autonomic nervous system. In children, it can be disturbed, and there is a short-term throwing of urine in the opposite direction. This condition is called reflux. Violation of the natural flow of urine also occurs with congenital malformations of the kidneys, which, unfortunately, is not uncommon.
Causes of the disease
The emergence of acute pyelonephritis in young children is also facilitated by anatomical features: the lymphatic system of the renal pelvis in children is more closely associated with the intestines than in adults. It is because of this that the spread of infection from the intestine is possible along the lymphatic paths with the further development of the disease.
Violation of the metabolism of salts and their increased amount in the formed urine can also lead to small violations of its outflow, as well as to microscopic damage to the kidney tissue, and therefore cause pyelonephritis in children.
An ascending pathway of infection is still possible. In the case of inflammation of the external genital organs, as a result of insufficient strength of the protective barriers, the infection can spread to the bladder and kidneys and, accordingly, lead to the development of cystitis and pyelonephritis.
Almost all of the listed factors that provoke the appearance of this disease in children appear with a decrease in the protective function of the immune system. Diseases caused by bacterial infections can provoke a decrease in immunity.
Signs of the disease
Symptoms of the disease may vary depending on age. In children up to a year, pyelonephritis is characterized by the first, and at first, the only symptom - fever. Usually with respiratory viral diseases with its decrease, the condition becomes normal. And with pyelonephritis, the child remains weak, eats poorly, often spits up, loses weight, and often urinates. This is typical for sick babies. Anxiety or crying may be a symptom of pyelonephritis in children.
Older children complain of abdominal pain, worsening general condition, weakness, lethargy, and decreased appetite. Urine with pyelonephritis in a child may be cloudy due to the presence of pus and a large number of microbes. This visual sign indicates a disease.
The acute form of pyelonephritis in children begins abruptly: with a feeling of chills, fever, pain in the lower back and frequent urination.
Diagnosis tests
What kind of examinations in a child should be carried out, of course, is determined by the doctor.
First of all, these are clinical tests of urine and blood, which immediately make it possible to determine the diagnosis. According to them, the doctor determines the pathological processes that occur in the body. Changes in urine and blood tests indicate inflammation in the kidneys or urinary tract.
To find out the causes of pyelonephritis in children, urine is sown on the microbial flora. This analysis should be taken before treatment, but if this is not possible, you can do it later, especially if the treatment is not so effective.
Ultrasound and X-ray as a diagnosis
An ultrasound examination of the kidneys is mandatory. It reveals or excludes the development of organ abnormalities and the presence of inflammation of the kidney tissue.
In case of suspected congenital pathology, an X-ray examination with the introduction of a radiopaque substance into the blood or bladder will be needed. This analysis will help to more accurately identify violations of the structure of the kidneys, since ultrasound is not always quite informative.
Disease control
Treatment of pyelonephritis in children is carried out in a hospital with a general pediatric profile or in the nephrology department. Inflammation is relieved with medication. The appointment of antibiotics is necessary, since only with their help can the transition of the acute stage to chronic pyelonephritis in children be avoided. If the drug is selected correctly, then the temperature, the general condition of the child, changes in urine normalize quite quickly. But this is not a reason to stop taking them. Usually, more than one course of antibiotics is prescribed, and one has to put up with this. The question of discharge of the child from the hospital is decided by the parents together with the doctor, taking into account the condition of the baby and the ability of relatives to create the necessary treatment conditions and care at home.
Acute pyelonephritis, the occurrence of which is not caused by abnormalities in the structure of the kidneys or metabolic disorders, even in severe cases, with the correct and timely treatment started, in most cases ends with a complete recovery.
Additional treatments
Methods such as magnetotherapy, electrophoresis and physiotherapy perfectly complement the effectiveness of traditional treatments and are useful in chronic pyelonephritis to obtain a lasting result. In the presence of other diseases, therapy or medications are needed that can eliminate the damage caused. For example, with concomitant anemia, the doctor prescribes medications with iron content, with high blood pressure - medications to lower it. Also at temperature antipyretics are prescribed. In addition, additional medications are prescribed that enhance the effectiveness of the main therapy. Herbal medicine of chronic pyelonephritis is often prescribed. Herbal treatment is not carried out in the acute stage of the disease, and the dosage and frequency of taking decoctions and infusions is calculated only by a specialist. Herbal preparations are prescribed in a course of several months, and are also used for preventive purposes.
What depends on the parents?
Firstly, do not delay to see a doctor if the baby does not feel better.
Secondly, the exact implementation of specialist appointments and adherence to the daily routine. Do not forget that the child is recovering, the doctors only help him in this, and this requires strength. In the treatment of pyelonephritis in children, heavy drinking, bed rest is prescribed. Subcooling is not allowed.
Thirdly, as with other diseases, it is necessary to adhere to a diet. There are no particular restrictions, but it must be age appropriate. Dairy products, juices, diuretics are introduced into the diet.
What is impossible with pyelonephritis?
In addition, the following are excluded from the child’s diet:
- all hot spices;
- canned dishes;
- chocolate;
- coffee;
- smoked meats;
- salted cheeses;
- fresh bakery;
- strong broths;
- mushrooms;
- onion;
- garlic;
- legumes;
- mustard;
- citrus.
Such a diet must be followed after pyelonephritis in a child and the elimination of symptoms of the disease for 1 year.
Liquid mode
Water consumption is usually increased. This is necessary to remove harmful substances that appear during inflammation and the death of microbes. At the same time, a certain concentration of antibiotic should be in the child’s urine, therefore it is necessary to check with the attending physician what amount of liquid per day the child needs to drink. Cranberry or lingonberry juice, decoction of dried apricots, pears, rosehip infusion are prescribed.
How to prevent the development of a chronic form of pyelonephritis?
First of all, clearly follow all the doctor's prescriptions, including after discharge from the hospital. This condition is mandatory for this disease.
There is a Protocol for the treatment of acute pyelonephritis in children, which describes in sufficient detail the main therapeutic agents, respectively, which need to treat the child, and they are followed by the doctor.
Another important point is the elimination of the factors that provoke the disease. To do this, it is necessary to strengthen the body's defenses, adherence to sleep and rest, which is more true for older children and adolescents. It is very important for children with metabolic disorders, along with a diet, to adhere to the water regimen, to consume a sufficient amount of liquid. The elimination of chronic foci of infection is relevant at any age. In the case of congenital diseases that cause stagnation of urine, the issue is resolved individually with each patient.
The child is exempted from physical education in the general group for 6-12 months. These recommendations are rather arbitrary, as they depend on the causes of pyelonephritis, and on its course or treatment results. Prophylactic vaccinations are temporarily postponed - at least 6 months, then the issue is resolved with the help of specialist doctors.
The use of herbal medicine
Herbs are widely used in kidney diseases. But do not overestimate their value and, of course, you can not take them as a substitute for the prescribed antibiotics and other medicines. In chronic pyelonephritis in the absence of an exacerbation of the disease, their use is fully justified. Now there are countless preparations prepared on a plant basis, but, as before, collecting herbs provides significant assistance in the treatment of both adults and children. It is better to purchase herbs at the pharmacy - this to some extent guarantees their proper collection, preparation and storage.
One of the plant ingredients - bearberry, popularly referred to as bear ears - contains the substance arbutin, which, when it enters the body, breaks down into antiseptic and glucose. To prepare the infusion, take 30 g of bearberry per 0.5 l of boiling water, insist, use 2 tbsp. l 5-6 times a day. This plant is effective in the presence of an alkaline environment, and you need to take the drug along with mineral waters or soda solutions.
Lingonberry plant has anti-inflammatory and diuretic properties. A decoction of leaves is prepared from 2 tbsp. l raw materials per 300 ml of water, should be taken at 2 tbsp. l 5-6 times a day.
Healthy fruits and berries
The main goal of the diet during the treatment of pyelonephritis in children is to accelerate the outflow of urine from the kidneys. An abundant intake of fluid flushes the urinary canals, removes harmful substances from the body, and normalizes the water balance. Therefore, it is so important to consume vegetables, berries and fruits that saturate the children's body with vitamins and minerals and have diuretic properties:
- Gooseberry. Stewed berries are used to enhance urination.
- Cranberry. Juice and fruit drink from this berry has a pronounced bactericidal diuretic properties.
- Barberry. All parts of this plant have a diuretic antimicrobial effect.
- Pear. Fruits, juice and fruit compote are taken to enhance urination.
- Melon. Tasty pulp and seeds have diuretic properties.
- Watermelon pulp is eaten fresh, it has a strong diuretic effect, it is recommended for pyelonephritis.
- White cabbage. Due to the significant amount of potassium salts contained in it, when it is consumed in food, the elimination of fluid from the body is accelerated.
- Dill. Use infusion of seeds as a diuretic.
- Sowing salad also has a diuretic effect.
- Wild strawberries. An infusion of leaf berries has all of the following properties.
Should know
It is important to remember that a feature of kidney disease is that for a long time, pathological processes in them can occur almost asymptomatically. Signs of pyelonephritis in children can be lethargy, frequent fatigue, lack of appetite, and a frequent headache. If the child is small, parents will be wary of this, but in older and adolescent years these symptoms are often explained by high workload at school, non-observance of the daily regimen or stomach diseases. Often it is, but it is better to examine the child and consult a doctor in time so as not to miss the sluggish kidney disease. Moreover, even a congenital pathology can be detected much later.