Chronic pyelonephritis is a disease caused by pathogenic microflora due to insufficient treatment of the acute form. It occurs in women, especially during pregnancy, in children, less often in men. The danger is expressed in structural changes in the urinary organ and the development of renal failure.
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Causes of chronic pyelonephritis
The main cause of the disease is bacteria (E. coli, staphylococci, streptococci, protea, etc.). With untimely diagnosis and treatment in the early stages, there is a greater risk of the transition of an acute form to a chronic one.
Provoking factors:
- diseases of the urinary system - acute pyelonephritis, cystitis, urethritis, kidney stones;
- congenital pathologies;
- bacterial infections occurring in the body - prostatitis, sinusitis, otitis media, pharyngitis, enterocolitis, etc .;
- inflammatory processes in the vagina - candidiasis, genital infections;
- hormonal changes - pregnancy, childbirth, active sex life and its onset;
- hypothermia of the body;
- some other diseases - diabetes, overweight and obesity;
- lack of hygiene;
- in women - when using daily pads, wearing synthetic underwear.
Symptoms and signs of the disease
Signs depend on the stage, gender and age, individual characteristics (pregnancy, medical history).
With a latent form of the disease, patients complain of the following symptoms:
- fatigue, general malaise;
- low-grade body temperature up to 38 degrees;
- headache;
- moderate increase in blood pressure;
- in urinalysis, a small protein content, low relative density of the discharge and a large allocated volume per day.
With exacerbations, the picture of the disease looks different:
- aching lower back pain;
- violation of urination, pain, frequent urination;
- periodic fever and fever;
- pressure surges and anemia are possible.
Among women
Secondary pyelonephritis often occurs in women due to the location of the urinary system. The anus and urethra are very close, due to which bacteria can pass from one hole to another.
Symptoms of chronic pyelonephritis in women - like everyone else, there may additionally be aching pain in the lower abdomen, as during menstruation, frequent urination and the inability to urinate. And also burning near the urethra during and after emptying the bladder, the appearance of morning swelling of the legs, arms, face.
In men
Men’s disease is often caused by prostate adenoma, prostatitis, or blockage of the ureters or pelvis. In this case, the general symptoms of the disease are characteristic.
In children
In young children, characteristic symptoms may not be observed, except for satisfactory health and low temperature. Diagnostic measures are needed to determine the disease.
Older patients may experience complaints of back discomfort, headache, nausea, chills. Parents notice that the child is lethargic, sleepy, does not want to eat and drink.
Diagnostic measures
To identify the disease, symptoms alone are not enough.
Conducting research:
- general urinalysis to determine the presence of protein, relative density, concentration of leukocytes and salts;
- urine analysis according to Nechiporenko to identify the inflammatory process by the concentration of blood elements in 1 ml of liquid;
- Ultrasound of the kidneys - whether there is sand or stones, obstruction of the ducts, expansion of the pelvis;
- urine for sterility to establish a provoking microorganism and further therapy;
- general blood test - the presence of inflammation.
Treatment of inflammatory process in the kidneys
Before treating chronic pyelonephritis, it is necessary to determine the bacterium that has become the causative agent of the disease. The choice of an antibacterial agent depends on this.
Therapy of the disease includes compliance with the drinking regime and diet, taking antibiotics and drugs to relieve symptoms, physiotherapy. If chronic obstructive pyelonephritis has developed against a background of another pathology, its treatment is also necessary.
Antibacterial agents
The choice of this group of drugs is made by the doctor based on the nature of the disease, sterility analysis, individual characteristics of the patient (the presence of concomitant diseases, allergic reactions and intolerance to the components, age). The course of treatment is from 10 days to 6-8 weeks and is determined by a specialist, while urine parameters are monitored, an ultrasound examination of the kidneys is performed.
The most commonly prescribed antibacterial, antimicrobial agents:
- Nitroxoline (5-NOC);
- Levofloxacin;
- Amoxicillin;
- Amoxicillin with clavulanic acid (Amoxiclav, Flemoclav);
- injections of cefazolin, ceftriaxone, cefotaxime;
- Oletetrin;
- Ciprofloxacin;
- Abactal;
- Ampioks;
- Furamag;
- Nalidixic acid (Nevigramon, Negram);
- Biseptolum and others.
These drugs can cause nausea, vomiting, diarrhea, so they are recommended to be used during or after meals.With a tendency to intestinal disorders, it is desirable to supplement them with drugs that restore the microflora based on bifidobacteria and lactobacilli (Bifidumbacterin, Bifidumbacterin forte, Linex, Linex forte, Hilak forte).
Some medicines (such as Nitroxoline) may cause the urine to turn bright red or orange.
Antispasmodic and painkillers
To reduce cramping and pain during urination and in the lower back, No-shpa, Baralgin are prescribed in injections and tablets. These drugs are preferably used after meals to prevent negative effects on the gastric mucosa.
At elevated temperatures, headaches, painkillers, anti-inflammatory drugs based on paracetamol (Efferalgan), ibuprofen (Mig, Nurofen) or combined forms (Next, Ibuklin) are used.
Antihypertensive drugs
The medicine is picked up by the doctor. It is possible to prescribe drugs that lower blood pressure and additionally contain diuretic components. For example, enalapril with hydrochlorothiazide, Dopegit.
Immunobiological preparations - bacteriophages
For the appointment, it is necessary to diagnose the phagosensitivity of the pathogen. Method of application - orally inward or by drainage of the renal pelvis and bladder.
Other drugs
Additionally, the following funds may be prescribed:
- antiplatelet agents to improve blood circulation in an inflamed organ (Curantil, Trental or Pentoxifylline);
- diuretics to eliminate hidden and visible edema (Veroshpiron, Furosemide or Lasix, Diuver);
- herbal remedies, to reduce the inflammatory process in the kidneys, can additionally have a diuretic, antimicrobial effect (Kanefron, Fitolizin, Cyston, Urolesan, Hofitol);
- herbal preparations and individual herbs (Brusniver, Fitonefrol, Diuretic collection No. 2, lingonberry, Herva, bearberry);
- iron-containing drugs in the presence of anemia (Sorbifer durules, Maltofer, Ferropleks);
- with intoxication - Regidron.
Vitamin therapy
Folic acid, vitamins B12, A, E are used to strengthen immunity, provide antioxidant effects. Ascorbic acid is allowed only during remission, without exacerbation.
Physiotherapy
The following types of physiotherapy are especially effective:
- electrophoresis;
- galvanization;
- hemodialysis;
- sodium chloride baths;
- ultrasound;
- SMT therapy.
Diet and proper nutrition
Inflammation of the kidneys is characterized by intoxication, to neutralize the symptoms, it is necessary to drink up to 3 liters of pure water.
Diet for chronic pyelonephritis - table number 7, based on boiled fish and meat, dairy products and vegetables. In this case, it is necessary to exclude salted, smoked, pickled, spicy, carbonated products, as well as sweets. During attacks, salt is removed from the diet. Alcohol and coffee are contraindicated.
With puffiness, you can drink cranberry juice and rosehip decoction.
Possible complications
Due to the latent, asymptomatic course, a visit to a doctor and treatment of chronic pyelonephritis occurs out of time. This leads to renal failure, purulent process in the tissue of the organ, necrosis or death, wrinkling of the kidney.
In severe cases, the infectious process spreads through the blood throughout the body and leads to urosepsis, heart failure, stroke.
The prognosis for people with pyelonephritis
Depending on the frequency of exacerbations of the disease, its form, the patient’s behavior when symptoms occur, the prognosis for people with pyelonephritis is different. With careful attention to the body and the latent (hidden) course of the disease, conducting complex treatment, the patient maintains the previous quality of life.
Frequent relapses can lead to kidney failure, disability and a threat to human health and life.
Prevention
To reduce relapse, the following recommendations should be followed:
- constantly observed by a nephrologist: once every six months to take a urine test and do an ultrasound of the affected and healthy kidney;
- in the presence of kidney stones, take medications for excretion and crushing;
- for the purpose of prevention, drink antibacterial, anti-inflammatory fees, decoctions of herbs of a similar effect - a leaf of lingonberry or bearberry, Brusniver, Fitonefrol;
- avoid hypothermia;
- timely treat kidney disease, prostate gland;
- Do not start the course of bacterial infections in the body;
- strengthen immunity, practice a balanced diet, if necessary, take multivitamin complexes twice a year;
- avoid stress.
Chronic pyelonephritis requires constant attention of the patient to the body: it is important not only to diagnose and treat the disease in a timely manner, but also to follow a diet and preventive measures. In this case, a favorable prognosis of the course of the disease is guaranteed.
