Pyelonephritis - Causes, Symptoms and Treatment .MF .
Pyelonephritis - the disease is inflammatory kidney, which under adverse conditions caused by a number of microorganisms.
Pyelonephritis is dangerous because it is often asymptomatic, without compromising human health, so some patients relate to their problem lightly.The most common of the non-specific inflammatory diseases «upper urinary tract» , is about 2 / s of all urological diseases is acute and chronic pyelonephritis.
In its current pyelonephritis may be acute or chronic.
Acute pyelonephritis often begins suddenly, sharply raises the temperature to 39-40 ° C, there is a weakness, headache, sweating, nausea and vomiting.Simultaneously with the temperature appear pain, usually with one hand.The pains are dull in nature, but their intensity may vary.Urination in uncomplicated pyelonephritis form not violated.The content of nitrogenous wastes in the blood may increase the early days of the disease.In urine - pus, red blood cells, protein, a large number of bacteria.Symptom Pasternatskogo
Chronic pyelonephritis , as a rule, is the result of undertreated acute pyelonephritis , when it was possible to remove the acute inflammation, but was unable to either completely destroy all pathogens in the kidney, or to restore the normal outflow of urine from the kidney.Chronic pyelonephritis often discover when urinalysis or blood pressure measurement.There are complaints of general weakness, headache, loss of appetite, frequent urination, can permanently disturb the patient dull aching pain in the lower back, especially in damp cold weather.The skin is pale, dry.With the development of the disease decreased urine specific gravity, it is often detected hypertension.Progression of bilateral pyelonephritis leads to renal failure.In addition, chronic pyelonephritis, acute occasionally, and then the patient has all the hallmarks of the acute process.
Causes of pyelonephritis
pyelonephritis can get sick of any age, but more often they are ill:
- children up to 7 years, in which the disease associated with the development of anatomical features;
- girls and women 18-30 years old who have the appearance of pyelonephritis due to the onset of sexual activity, pregnancy or childbirth;
- older men suffering from BPH.
Besides the above, one of the most common causes of pyelonephritis is urolithiasis and frequent bouts of colic.
For all these diseases and conditions is violated the flow of urine from the kidney, which allows it to proliferate in microorganisms.
also contribute to the development of pyelonephritis factors such as the decline in the overall immunity of the body, diabetes, chronic inflammatory diseases.
Frequent hypothermia, lack of control over the state of the kidneys (in the general analysis of urine, if necessary - by a blood test) may lead to a deterioration of renal function due to the pronounced inflammation.Especially often pyelonephritis at the presence of salts or stones in the kidneys, so when detecting an ultrasound salts or stones, even if asymptomatic, special treatment is required.Sometimes (often women) disease begins with acute cystitis.
Symptoms of pyelonephritis
In bilateral acute pyelonephritis often show signs of kidney failure.Acute pyelonephritis can be complicated paranephritis, the formation of abscesses in the kidney (pyelonephritis apostematozny), abscess or carbuncle kidney, necrosis of the renal papillae, which is an indication for surgical intervention.
pyonephrosis - represents the end stage of purulent destructive pyelonephritis .Pionefroticheskaya kidney is an organ affected by purulent fusion consisting izotdelnyh cavities filled with pus, urine iproduktami tissue decay.
Even judging by these symptoms, diagnose pyelonephritis is not difficult, as patients complaints fairly characteristic.
Using urine tests reveal bacteria growth in the number of white blood cells and protein.Special test kits allow to identify the bacteria that led to inflammation in the urinary tract.
an important role in the diagnosis of playing indicate a history of recent acute purulent process or the presence of chronic diseases.Typically the combination of fever with frequent and painful urination, pain in the lumbar region, and with the changes in the urine.On plain film reveals an increase of one from the kidneys to the extent at excretory urography - marked limitation of mobility of the affected kidney during respiration, absence or late appearance of the shadow of the urinary tract on the affected side.Compression of the cups and pelvis, amputation of one or more cups indicate a carbuncle.
In primary acute pyelonephritis in most cases the treatment is conservative, the patient should be hospitalized vstatsionar.
main therapeutic measure is the impact of the disease navozbuditelya antibiotics and chemical antibacterial agents in accordance with the data of antibiogram, detoxification iterapiya povyshayushaya immunity in the presence of immunodeficiency.
In acute pyelonephritis treatment should begin with the most effective antibiotics or chemical antibacterial agents, which are sensitive to the microflora of urine, as quickly as possible to eliminate the inflammation in the kidney, non-admission of its transition vgnoyno-destructive form.
In secondary acute pyelonephritis treatment should begin with the restoration of the kidney massage urine, which is a principal.
Treatment of chronic pyelonephritis essentially the same as acute, but more time-consuming.
In chronic pyelonephritis treatment should include the following main activities:
- elimination of the causes of the violation of the passage of urine or renal circulation, especially venous;
- appointment of antibacterial agents or chemotherapeutic agents with allowance antibiogram data;
- increase the immune reactivity of the organism.
Recovery urine flow is achieved primarily using a particular type of surgery (removal of the prostate adenoma, stones izpochek imochevyh ways nephropexy at nephroptosis, plastic urethra or UPJ etal.).Often after these surgical procedures are relatively easy to manage to get a stable remission of the disease, and no long-term antibiotic treatment.Without the restored sufficiently massage urine use of antimicrobials is usually Ned's long-term remission of the disease.
Antibiotics ihimicheskie antibiotics should be prescribed with allowance for the sensitivity of the microflora of the patient's urine to antibiotics.Dopolucheniya data antibiogram prescribe antibiotics with a broad spectrum of action.Treatment of chronic pyelonephritis systematic and long-term (at least 1 year).Initial continuous course of antibiotic treatment is 6-8 weeks, since this time vtechenie necessary to achieve suppression of the infectious agent in the kidney and resolution of purulent inflammation therein without complications to prevent scar formation of connective tissue.In the presence of chronic renal failure appointment nephrotoxic antimicrobial drugs should be under constant supervision of their pharmacokinetics (imoche concentration in the blood).By reducing the parameters of humoral and cellular immunity using various drugs to enhance immunity.
After reaching the patient stage of remission antibacterial therapy should be continued intermittent.Dates breaks antibacterial treatment set vzavisimosti on the extent of kidney ivremeni onset of first signs of disease exacerbation, t. E. The onset of symptoms of inflammation of the lag phase.
Sanatorium treatment of patients with chronic pyelonephritis spend vTruskavtse, Zheleznovodsk, Jermuk, Sairme etal.It should be remembered that only a strict continuity of treatment of patients with pyelonephritis skhronicheskim vstatsionare, the clinic ina resort gives good results.Vsvjazi setim patients skhronicheskim vlatentnoy pyelonephritis inflammation phase should continue to antibacterial treatment of the Terms of the resort on the scheme recommended by the attending physician that the patient has sustained.
In addition, one of the basic rules for the treatment of this disease is a regular intake of "kidney" of herbs.