Purulent pyelonephritis is a very dangerous and serious disease, which is accompanied by non-specific inflammation of the renal structures. In the pathological process, as a rule, the pelvis, calyx and parenchyma are involved. In the absence of therapy, inflammation spreads to the glomeruli and blood vessels, while purulent masses begin to accumulate in the tissues.
Of course, many people are interested in additional information. Why does purulent pyelonephritis develop? Symptoms and treatment, diagnosis and risk factors are important information that should not be ignored. So how dangerous is this disease and is it possible to somehow avoid its development?
Purulent pyelonephritis: ICD-10 and main characteristics
To begin with, it is worthwhile to understand the basic information about this pathology. In some cases, inflammation of the kidney tissue is associated with the formation and accumulation of purulent masses - in this case, doctors talk about acute purulent pyelonephritis. ICD-10 refers this pathology to the group of tubulointerstitial nephritis, which is indicated by the code N10. If it becomes necessary to identify an infectious agent, additional codes are used - B95-B98.
The disease, as a rule, develops against the background of bacterial activity. In most cases, purulent pyelonephritis affects only one kidney, cases of bilateral inflammation are extremely rare.
Reasons for the development of pathology
Purulent pyelonephritis is a very dangerous disease, which is accompanied by serious kidney damage. The inflammatory process in this case is provoked by the activity of nonspecific opportunistic microorganisms, in particular staphylococci, streptococci, Escherichia coli, enterococci, Pseudomonas aeruginosa. Sometimes bacteria enter the kidney tissue through the urinary tract, and sometimes along with blood from other foci of inflammation.
It is worth noting that some patients are more likely to develop such pathologies. The list of risk factors is as follows:
- urolithiasis disease;
- various congenital anomalies in the development of the excretory system;
- neurogenic bladder syndrome;
- venereal diseases;
- immunodeficiency states;
- diabetes;
- endocrine system diseases;
- prolonged drainage of the kidneys;
- prolonged drainage of the bladder with a catheter;
- previously transferred kidney transplantation;
- chronic forms of renal failure;
- vesicoureteral reflux;
- previously undergone gynecological operations (if we are talking about women);
- benign prostatic hyperplasia;
- mechanical damage to the kidney;
- the presence in the body of foci of chronic inflammation.
The main forms of the inflammatory process
The ailment can take various forms - here a lot depends on the stage of development of the inflammatory process and other factors.
- The most common is apostematous (pustular) pyelonephritis. In this case, multiple small pustules, called apostems, are formed in the tissues of the kidney.
- In approximately 40% of cases, pustular inflammation is complicated by the formation of a carbuncle. In this situation, we are talking about the formation of a limited compaction in the kidney cortex, inside of which purulent masses accumulate.
- An abscess is the most complex form of purulent pyelonephritis. With this form of the disease, a cavity is formed in the kidney tissues, protected by a capsule, inside which pus and other fluids accumulate. An abscess gradually increases in size and can sometimes burst (even for no apparent reason), releasing purulent contents.
Purulent pyelonephritis: symptoms
The clinical picture depends on the stage of development of the disease and the presence of concomitant diseases. At the initial stages, there are common signs of an inflammatory process, in particular fever, body aches, chills, weakness, nausea, drowsiness. The fact that there are problems with the kidneys is indicated only by back pain - sometimes it is very pronounced. These are the first symptoms of purulent pyelonephritis in women and men.
If the outflow of urine is impaired, then the symptoms become more pronounced. Blood pressure drops sharply, the patient's well-being worsens significantly, severe tachycardia is observed.
With a significant accumulation of pus, symptoms of renal failure appear - swelling is observed, the sclera of the eyes and skin of the patient acquire a yellowish tint. The formation of urine is slowed down. In the urine itself, blood impurities can often be noticed. In no case can purulent pyelonephritis be ignored. The operation sometimes must be carried out immediately.
How dangerous is the disease?
Purulent pyelonephritis of the kidneys is a very serious disease. In no case should you give up therapy or ignore the symptoms. As already mentioned, against the background of the inflammatory process in the tissues of the kidney, purulent foci are formed, and sometimes full-fledged abscesses. Sometimes an abscess ruptures, as a result of which purulent masses enter the abdominal cavity - this can lead to the development of peritonitis, and in especially severe cases, to sepsis, which can be fatal.
In addition, against the background of the inflammatory process, the kidney tissues are damaged, the body shrinks and partially, and sometimes completely, loses its functionality. In this case, the patient should be constantly registered with a nephrologist - with further progression of the disease, a transplant may be required.
Diagnostic measures
Purulent pyelonephritis is a disease that needs to be diagnosed as early as possible. As a rule, after a general examination and medical history, the doctor sends the patient to additional studies.
- Informative is a laboratory analysis of urine - against the background of the inflammatory process, the protein level rises. Red blood cells and white blood cells also appear in the urine.
- A blood test confirms the presence of foci of inflammation in the body.
- An ultrasound of the kidneys is performed, as well as an urography (including contrast).
- The most informative is magnetic resonance imaging.
- Sometimes angiography is additionally performed - this allows you to evaluate the blood supply to the kidneys.
Therapeutic treatment
Treatment of purulent pyelonephritis of the kidneys necessarily includes taking antibiotics, since the inflammatory process is always associated with the activity of certain bacteria. In this case, drugs such as Amoxicillin, Ceftazidime, Gentamicin, Ofloxacin are used. Both tablets and solutions for intramuscular / intravenous administration can be used.
It is worth noting that with this form of pyelonephritis, long-term therapy is required. Patients, as a rule, take antibiotics for 4-6 weeks, and at the first time, maximum doses are required. The decision to discontinue antibiotic therapy is made by the doctor based on the results of the tests.
Sometimes antifungal drugs are included in the treatment regimen, in particular Nystatin, Levorin (a bacterial infection is often complicated by a fungal infection). Antihistamines, vitamin complexes, anti-inflammatory drugs and other auxiliary drugs are used.
Proper diet
Treatment of purulent pyelonephritis must necessarily include a proper diet.
- The patient needs a complete diet, but the food should be light and quickly absorbed.
- It is important to abandon the use of salt, as this product directly affects the functioning of the kidneys. The maximum daily amount of salt is 6 g.
- Spicy foods, smoked foods, spices are prohibited.
- Drinks containing alcohol are strictly prohibited.
- Fresh fruits and vegetables, sour-milk products, low-fat meats will be useful. Dishes can be cooked, baked, steamed, but never fried.
- It is important to maintain the correct drinking regime - at least 1.5 liters of clean water per day (non-carbonated, purified).
It is very important to adhere to the above rules. This will help relieve stress from the excretory system and speed up the healing process.
When is surgery necessary?
Purulent pyelonephritis is a serious disease. Unfortunately, surgery in this case is inevitable. During the procedure, the doctor dissects the fibrous capsule, after which he carefully examines the kidney tissue, checks for purulent cavities. Abscesses need to be opened, cleaned from purulent masses and thoroughly treated with disinfectants and antibiotics.
Since the healing process is associated with the accumulation of pus and serous fluid, a temporary drainage is established. To drain urine, the surgeon will put a special tube - nephrostomy. Drainage is removed after the patient recovers - fistulas quickly heal on their own.
By the way, pus samples are often sent for laboratory analysis - the study makes it possible to accurately determine the pathogen and choose an effective antibiotic.
Alternative methods of treatment
It is immediately worth noting that any means of traditional medicine can be used only with the permission of a doctor.
- Pronounced antiseptic and antibacterial properties have rose hips. 150 g of fresh fruit (suitable and frozen) must be put in a liter jar and pour boiling water, then cover and let it brew. By the way, it is better to cut the fruits beforehand - so more nutrients will get into the infusion. You need to drink a glass of the drug 3-4 times a day, after eating.
- Positively on the state of the excretory system and immunity will affect the decoction of the fruits of lingonberry.
- With purulent pyelonephritis, a decoction of St. John's wort grass is also used.
- Chamomile flowers have pronounced anti-inflammatory properties - they can be brewed instead of tea.
The above medicines can not replace full-fledged drug therapy. Self-medication with such a serious disease is unacceptable and ineffective.
Predictions for patients. Preventive actions
Purulent pyelonephritis is an extremely dangerous disease, the treatment of which is associated with a lot of difficulties. Unfortunately, specific prophylaxis does not exist. But you can significantly reduce the risk of developing inflammation by following simple rules.
- It is important to try to avoid hypothermia (especially when it comes to the lower back and hips), always dress according to the weather.
- It is necessary to adhere to the correct drinking regimen, drinking at least a liter of clean, still water per day - this supports the functioning of the kidneys at the right level.
- All colds and inflammatory diseases should respond to treatment on time, since pyelonephritis is often a complication of other pathologies.
- Doctors recommend that you follow the rules of personal hygiene, avoid accidental sex.
- It is important to regularly undergo medical examinations, even if the symptoms of any disorders are absent - so you can detect the presence of the disease at an early stage of development.
- Proper nutrition, refusal from alcohol and smoking, physical activity - all this will positively affect the functioning of the immune system and will make the body less susceptible to the effects of various risk factors.
Of course, the appearance of the first signs should be reported to a specialist. The sooner therapy is started, the higher the likelihood of a successful and complete cure.