The kidneys are part of the human excretory system. The proper functioning of the body depends on their health. Most often, acute pyelonephritis affects them. If the inflammatory process in the kidneys is not treated, the disease passes into a purulent form, from which every fifth patient dies.
Material Content:
Causes of acute pyelonephritis
Acute pyelonephritis is the most common infectious pathology of the urinary system. Due to the anatomical structure, women suffer from it 6 times more often than men.
The cause of the disease is the multiplication of pathogens that have got into the kidneys in one of the following ways:
- ascending - from the lower urinary tract, in which there is pathogenic microflora;
- hematogenous - is introduced by the flow of blood from any diseased organ;
- with lymphatic current;
- with injuries or operations.
When the number of pathogens exceeds that with which the local immunity of the kidneys can cope, inflammation begins.
Pyelonephritis is a non-specific disease.
The following bacteria can cause kidney inflammation:
- enterobacteria, mainly Escherichia coli;
- staphylococci, more often - golden;
- Pseudomonas aeruginosa.
One of the most common causes of acute pyelonephritis in children is vesicourethral reflux, when part of the urine is thrown back from the ureter into the renal pelvis. Stagnant urine is one of the causes of pregnant pyelonephritis, which every twenty expectant mother encounters.Most often this occurs in the second or third trimester of pregnancy, when the growing uterus puts more pressure on the ureters and kidneys.
There are factors that are not the cause of the disease, but increase the risk of its occurrence:
- anomalies in the structure of the organs of the urinary system, congenital or acquired;
- immunodeficiency of any etiology;
- nephrolithiasis - the presence of kidney stones or bladder;
- diabetes - in the presence of sugar, bacteria multiply faster;
- age - in older people, the disease is more common;
- foci of chronic infection in the body;
- prostate diseases in men.
Symptoms and signs
This inflammatory disease mainly affects small and large renal cups, pelvis and interstitial tissue of the kidneys. Acute pyelonephritis has both local and general symptoms. The first are directly caused by inflammation - dull, aching pains on the side of the lesion of different intensity (from low to high).
Common symptoms indicate intoxication of the body:
- high, sometimes up to 40 degrees temperature;
- malaise and weakness;
- headache;
- recurring chills;
- poor appetite;
- nausea, sometimes accompanied by vomiting.
If pyelonephritis takes a purulent form, all the symptoms become brighter.
Sometimes the general manifestations of the disease prevail over the local ones, which makes diagnosis difficult.
Features of symptoms depending on age and gender:
- symptoms of acute pyelonephritis in women are more pronounced. Their disease is often accompanied by inflammation of the bladder - cystitis;
- in men and the elderly, the clinical manifestations of the disease are more erased;
- children often have a different localization of pain - they complain of pain in the suprapubic area.
Diagnostic measures
For the correct diagnosis of acute pyelonephritis, it is important to collect the patient’s history - information about the presence of abnormalities in the development of the urinary system, associated diseases.
The clinical picture is evaluated:
- the intensity and localization of pain, Pasternatsky’s symptom is checked - it is detected when the lumbar region is striated in the projection of the kidneys (remember about their possible omission);
- temperature is measured;
- information is collected about the general malaise and its manifestations.
Important diagnostic tests are laboratory tests:
- general blood test and its biochemistry;
- general analysis of urine, as well as tests according to Nechiporenko and Zimnitsky;
- seeding for the detection and identification of microflora with the specification of the sensitivity of the pathogen to antibiotics.
To clarify the diagnosis, the following studies are performed:
- Ultrasound
- survey and excretory urography;
- retrograde pyeloureterography.
If necessary, computed tomography and radionuclide research methods are used for diagnosis.
When diagnosing acute pyelonephritis in children, especially young children, it must be remembered that any disease accompanied by fever and malaise without signs of a cold requires the appointment of blood and urine tests.
If a woman is sick, she will need to consult a gynecologist for the detection of diseases of the female genital area - a possible cause of acute pyelonephritis. Men must necessarily check the condition of the prostate gland.
Treatment of kidney disease in children and adults
The decision about placement in the hospital is made by the doctor. In the uncomplicated course of the disease, outpatient treatment is possible under the supervision of a nephrologist. The exception is pregnant women: they are always hospitalized.
First of all, antibiotics are prescribed to patients - at first a wide spectrum of action, and when determining the causative agent of the disease after receiving the results of sowing, it is changed to one that effectively suppresses it. In severe cases, the first 2-3 injections of antibiotics are administered intravenously. A course of antibiotic therapy can last up to 2 weeks.In parallel, they monitor the maintenance of the water-salt balance. Anti-inflammatory, detoxification and kidney-improving microcirculation, diuretics are prescribed. If necessary, other uroseptics are prescribed: Nitroxoline, Furazolidone.
Of the general recommendations for patients, it is important:
- observe bed rest;
- to get a plentiful drink, herbal teas with lingonberries, cranberry fruit drinks are especially good.
The same treatment tactics are followed with exacerbation of pyelonephritis.
In the treatment of acute pyelonephritis, antibiotic therapy is important until it is completely cured so that it does not become chronic.
In the treatment of children suffering from this disease, the role of parents is especially important. The complete cure depends on how carefully they will comply with all medical recommendations.
Diet and proper nutrition
Sick kidneys need a strict diet that excludes foods that irritate them. In the acute phase of the disease, table number 7a is prescribed with the exception of products with a high content of extractive substances and protein.
The basic principles of clinical nutrition during this period:
- 350 g of carbohydrates per day, 4/5 of them are slow;
- up to 25 g of protein, animals - 70%;
- up to 80 g of fat, a quarter of them are vegetable;
- cooking without salt and the exclusion of products containing it;
- boiling and baking, but not frying;
- eating 5 times a day.
After recovery, they gradually switch to an expanded diet.
Possible complications
All of them seriously reduce the quality of life, and some may be fatal:
- acute renal failure - occurs in a bilateral inflammatory process;
- chronic renal failure - the outcome of prolonged bilateral inflammation of the kidneys;
- nephrolithiasis - the formation of kidney stones;
- pyonephrosis - the outcome of purulent pyelonephritis: the kidney is completely filled with pus;
- hypertension of renal origin.
Prevention
No one is immune from diseases, but there are measures that will help minimize the risk of developing acute pyelonephritis:
- cure all foci of chronic infections;
- not supercool;
- drink plenty of fluids;
- urinate immediately after the urge to urinate.
Acute pyelonephritis is a serious disease that requires long-term treatment and the careful implementation of all medical recommendations.
