In nephrological practice, kidney disease - pyelonephritis - is a fairly common disease. This non-specific disease is more often of an infectious nature, spreading to the renal parenchyma, interstitium and the pelvis of the organ. According to their beginning and course, chronic and acute pyelonephritis are distinguished. One kidney or both can be involved in the pathological process. Also, the disease can develop as an independent (primary) or proceed already against the background of existing diseases of the excretory organs.
Causes of the disease
The main microorganisms that cause the disease are Escherichia coli, staphylus or streptococci, Proteus. In most patients with a chronic form of pyelonephritis, the flora is mixed. Infection occurs through the ascending path (through the ureters), as well as with the blood. Acute pyelonephritis may occur with urinary stasis, in the presence of stones in the renal pelvis, in the presence of concomitant diseases and weakened immunity. Very often, an attack of the disease is preceded by latent jade.
Acute pyelonephritis is interstitial, serous and purulent. A serious complication is the formation of a carbuncle and the transition to aposthematous nephritis.
Clinical manifestations of the disease
The disease has an acute, sudden onset. A prodrome is noted, body temperature rises high figures (40 ° C), the patient sweats heavily, complains of pain in the area of the projection of the kidneys, thirst. Abdominal muscle tension may also be noted on the side with which there is kidney damage and severe pain during palpation in the costal vertebral angle. Often there are violations of urination, a decrease in the volume of urine excreted, it can be mixed with pus or blood. Due to severe intoxication, vomiting appears. When examining the patient, a positive symptom of striking (Pasternatsky) is noted . Renal failure may occur .
Diagnosis of the disease
The diagnosis of Acute pyelonephritis is made on the basis of characteristic complaints, examination and laboratory diagnostic data. The patient may indicate a recent purulent infection or the presence of chronic inflammatory diseases in the body. Acute pyelonephritis can cause hypothermia, in women chronic diseases of the genitals, in men, the presence of prostatic hyperplasia with impaired urine outflow. A characteristic feature of pyelonephritis is the presence of urination disorders, clouding of urine or the presence of blood in it, with severe lower back pain and high fever. However, it should be remembered that a change in the composition of urine may be a reaction to other inflammatory diseases.
In the analysis of urine, you can see a huge number of white blood cells, an increase in red blood cells and the presence of bacteria. In urine, protein rises slightly.
Ultrasound examination of the kidneys, the affected organ is increased in size, its mobility during breathing is sharply limited. Edematous parenchyma of the kidney. In rare and severe cases, an abscess or carbuncle of the kidney is visible on the sonograms , which require surgical intervention.
Treatment of acute pyelonephritis
A patient with pyelonephritis is subject to hospitalization in a nephrological or therapeutic department of a hospital. Table 7 is assigned. A high fluid intake of at least three liters per day is recommended. For the relief of pain, pain medications and antispasmodics are prescribed. Mandatory drugs in the treatment is antibiotic therapy. In the initial period of the disease, broad-spectrum antibiotics are administered, and after isolation of the pathogen, an antibacterial drug that acts against this microorganism. Infusion therapy is carried out in order to relieve intoxication, antiplatelet agents, uroseptics are prescribed. An effective auxiliary method of treatment is herbal medicine.