Pyelonephritis - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Urinary Systems.

paranephritis - pyo-destructive meltdown perinephric tissue that develops as a result of the spread of the inflammatory process with the renal parenchyma.In its origin paranephritis can be primary, when the inflammation begins in the tissue directly, or secondary, when purulent process moves to the kidneys.

reasons paranephritis

As already mentioned, paranephritis begins due to the spread of purulent process with the kidneys, and thus causes paranephritis are inflammatory diseases of the body.Among these, first of all, one can distinguish acute pyelonephritis.It occurs due to contact with the body of pathogens, which can occur in several ways: urinary, or hematogenous lymphogenous.

considerable importance in the development paranephritis has a state of the immune system, state of the kidneys and timely treatment of the body inflammation.If even with the abolition of the immunity and completely healthy kidneys, time does not treat acute pyelonephritis, he will surely go into pyonephrosis and paraneph


Primary inflammation of the perinephric fat is quite rare.Most often such a situation can be seen after traumatic damage to the lumbar region, especially sharps.The infection, which is entered in the wound channel, perfectly develops perinephric tissue.This leads to rapid melting and purulent inflammation of the latter.

are cases when paranephritis developed as a result of contact with the spread of pelvic or abdominal cavity.The most common causes of the disease are inflammation of the ascending or descending obodovyh gut, as they are, and kidneys are retroperitoneal.

also not excluded paranephritis development of hematogenous spread of germs from other organs.As the foci of infection may make chronic sinusitis, tonsillitis, cystitis, or cholecystitis.Delay microbes in the perinephric tissue vascularization is due to a good final.

Symptoms paranephritis

the first place when paranephritis serves local clinical symptoms, manifested by pain in the lumbar region.Pain observed both at rest and with a slight effleurage on this site.Palpable also notes painful protrusion in the art that moves to the beat of breathing.

Together with local and general symptoms develop.Patients complain of severe fatigue, general weakness, shortness of breath, insomnia, weight loss.At the height of the disease there may be a sharp rise in temperature to febrile digits.

addition, marked changes in the urine, which manifest a decrease in its amount, the presence of haze and sediment with a lot of flakes.On standing patient urine paranephritis it forms three layers.The first falls renal detritus, in the second - a purulent detritus, and the third is the actual urine.

Many patients who have chronic kidney disease, neglect the similar symptoms.In their situation, it is important not to miss a moment of transition in paranephritis pyelonephritis.To do this, you must periodically examined by a urologist or at least refer to it in case of clinical symptoms, which may indicate an inflammatory disease of perinephric fat.

Diagnostics paranephritis

First of all patients with typical symptoms paranephritis appointed by common blood and urine tests.Typically, an increased amount of blood leukocytes is detected with the shift left and leukocyte increase ESR.In general, the analysis of the urine is marked increase in the number of white blood cells, the presence of renal epithelium, and a large number of bacteria.All this leads to an increase in the specific gravity of urine.

holding ultrasound makes it possible to determine the presence of a rounded education, filled with liquid.It can be confused with a kidney cyst, so you need to pay attention to the clinical picture of the disease.

paranephritis on uzi

excretory urography, which involves X-ray study of the kidneys after intravenous injection of contrast, makes it possible to determine the deterioration of renal function.The same results were observed during and radioisotope renografii.

Computed tomography, which is preferably carried out in the presence respectively of equipment and facilities, gives more accurate results about the nature and location of education.

used fine needle aspiration needle biopsy for final diagnosis verification.It is recommended to be carried out under the control of ultrasound or x-rays.It gives the most accurate results on the nature of the pathological neoplasms, which is located in the lumbar region.

biopsy under ultrasound

Treatment paranephritis

For fast and effective recovery of the patient is recommended to perform surgery in the hospital as soon as possible.The operation is the dissection of the skin abnormal protrusion and drainage of abscess.If the reason was the paranephritis purulent kidney meltdown, the operation is supplemented by removal of the organ.Duration of surgery at paranephritis ranges from 1 to 3 hours, depending on the volume of the abscess.

Postoperatively, patients received heavy doses of antibiotics in order to avoid potential postoperative wound inflammation.As to achieve this effect is rather difficult, the use of strong antibiotics, fluoroquinolones and carbapenems.They are dispensed at the pharmacy on prescription.

Period total in-patient treatment is about two weeks, while the ambulatory patient can be treated up to six months, until he will clean nephrostomy.

paranephritis Treatment folk remedies

Treatment folk remedies at paranephritis provides, as in any other, and inflammation, the use of local compresses.When applied to the area of ​​purulent melting hot compress, nothing but the spread of the process, should not be expected.Therefore, any kind of national treatment are not valid when paranephritis.They can only delay the time that could be spent on effective conventional therapy.

Feeding habits and lifestyle with paranephritis

Features food at paranephritis lies in the fact that the food is not provided additional load on a single kidney, which remained.This can be achieved by excluding from the diet of the patient those products that enhance the formation of urine.It is sour and savory.With regard to salts, it is necessary to try and eliminate, or generally used in minor amounts.Among the fruits can not eat watermelon because they have a fairly powerful diuretic effect.

Those patients that after surgery are forced to walk with a nephrostomy, ie, a tube to drain urine, should be able to properly care for it.It is important to carefully take care of the urinal, as it can serve as a source of secondary surgical wound infection.But as practice shows, those patients who develop secondary paranephritis, have a very low survival rate.Therefore, in nephrostomy it is very important daily dressings and the frequent change of the reservoir.

rehabilitation after illness

Rehabilitation of patients after paranephritis, first of all, is to restore normal intestinal microflora, which is broken due to the use of a large number of antibacterial drugs.Their action affects not only pathogens, but also in the normal microbes, which is not very pleasant fact for digestion.Therefore, all patients who have had an active course of antibiotic therapy, probiotics are appointed.

In the future patients after paranephritis possible use of physical therapy.Among the most popular can be called ultraviolet irradiation and thermal effect on the area of ​​post-operative field.Less effective, but is less popular massage treatments, mud therapy and vibration therapy.

It is very important to maintain normal functional rehabilitation of the health status of the kidney, since it is now the big load.This is possible using the same diet or spa treatment.

Complications paranephritis

The most severe complication is paranephritis hematogenous generalization of the process, in which the pus from a local outbreak spreads throughout the body.This is exacerbated by the overall symptoms and there may be pockets of purulent inflammation in other organs.

whole group paranephritis complications is necessary to consider opening an abscess, which can occur in different cavities of the human body.When you break an abscess in the lumen of the colon in patients temporarily improves the general condition.At the same time, it changes the character of the chair.It can be a liquid admixture with pus.A little later, there is an additional wound infection stool, which leads to the emergence of a second wave of disease.

When you break an abscess and emptying into the abdominal cavity in patients with marked sharp pain in the abdomen, strong tension of the abdominal wall muscles and the positive symptoms of irritation of the peritoneum.This clinical condition is called "acute abdomen" or peritonitis and requires immediate surgical intervention.

With the opening of the abscess into the pleural cavity indicated a sharp pain on one side of the chest and shortness of breath.This disease is called pyothorax that means presence of pus in the pleural cavity.It can be evacuated by puncture of the chest wall or through the operation incision that is more effective.

It is rarely possible opening of the abscess out of what is called renal fistula.Treatment of this complication is the long-term redevelopment of the resulting wound with regular dressings.

Prevention paranephritis

The main focus in the prevention paranephritis is to prevent purulent inflammation of the kidneys.This can be achieved by maintaining normal levels of immunity.Each year, you must rest on the seaside resorts and occasionally take vitamin courses.Also, to control the level of immunity must be periodically examined in immunologist to determine their immune status.Naturally, routinely conduct is not economically feasible, so these consultations are recommended only for patients who are prone to colds or kidney disease.

Ed.urologist Astashin EE