Pyelonephritis - symptoms of acute and chronic forms, treatment and drugs. Pyelonephritis - symptoms and manifestations in women and men. Signs of acute and chronic inflammation of the kidneys

is a non-specific infectious disease of the kidneys caused by various bacteria. The acute form of the disease is manifested by fever, symptoms of intoxication and pain in the lumbar region. Chronic pyelonephritis may be asymptomatic or accompanied by weakness, loss of appetite, increased urination, and mild back pain. The diagnosis is made on the basis of the results of laboratory tests (general and biochemical urinalysis, bakposev), urography and ultrasound of the kidneys. Treatment - antibiotic therapy, immunostimulants.

Asymptomatic course is often the cause of delayed diagnosis of chronic pyelonephritis. Patients begin treatment when kidney function is already impaired. Since pathology very often occurs in patients suffering from urolithiasis, such patients need special therapy even in the absence of symptoms of pyelonephritis.

Symptoms of pyelonephritis

The acute process is characterized by a sudden onset with a sharp rise in temperature to 39-40°C. Hyperthermia is accompanied by profuse sweating, loss of appetite, severe weakness, headache, and sometimes nausea and vomiting. Dull pains in the lumbar region of varying intensity, often unilateral, appear simultaneously with an increase in temperature. Physical examination reveals tenderness with tapping in the lumbar region (positive Pasternatsky's symptom).

The uncomplicated form of acute pyelonephritis does not cause urination disorders. Urine becomes cloudy or takes on a reddish tint. Laboratory examination of urine reveals bacteriuria, slight proteinuria and microhematuria. A complete blood count is characterized by leukocytosis and an increase in ESR. In about 30% of cases, an increase in nitrogenous slags is noted in a biochemical blood test.

Chronic pyelonephritis often becomes the outcome of an untreated acute form. Perhaps the development of a primary chronic process. Sometimes the pathology is discovered by chance during the study of urine. Patients complain of weakness, loss of appetite, headaches and frequent urination. Some patients have dull, aching pains in the lumbar region that are worse in cold, damp weather. Symptoms indicating an exacerbation coincide with the clinical picture of an acute process.

Complications

Bilateral acute pyelonephritis can cause acute renal failure. Sepsis and bacterial shock are among the most formidable complications. In some cases, the acute form of the disease is complicated by paranephritis. Perhaps the development of apostenomatous pyelonephritis (the formation of multiple small pustules on the surface of the kidney and in its cortical substance), carbuncle of the kidney (often occurs due to the fusion of pustules, is characterized by the presence of purulent-inflammatory, necrotic and ischemic processes) kidney abscess (melting of the renal parenchyma) and necrosis of the renal papillae .

If treatment is not carried out, the terminal stage of a purulent-destructive acute process sets in. Pyonephrosis develops, in which the kidney is completely subjected to purulent fusion and is a focus consisting of cavities filled with urine, pus and tissue decay products. With the progression of chronic bilateral pyelonephritis, kidney function is gradually impaired, which leads to a decrease in the specific gravity of urine, arterial hypertension and the development of chronic renal failure.

Diagnostics

Diagnosis is usually not difficult for a nephrologist due to the presence of pronounced clinical symptoms. The anamnesis often indicates the presence of chronic diseases or recent acute purulent processes. The clinical picture is formed by a characteristic combination of severe hyperthermia with lower back pain (usually one-sided), painful urination and changes in urine. Urine is cloudy or reddish in color and has a pronounced fetid odor.

Laboratory confirmation of the diagnosis is the detection of bacteria and small amounts of protein in the urine. To determine the pathogen, a urine culture is performed. The presence of acute inflammation is evidenced by leukocytosis and an increase in ESR in the general blood test. With the help of special test kits, the microflora that caused inflammation is identified. Diagnosis of structural changes in pyelonephritis is carried out using ultrasound of the kidneys. The concentration ability of the kidneys is assessed using the Zimntsky test. To exclude urolithiasis and anatomical abnormalities, CT of the kidneys is performed.

Plain urography revealed an increase in the volume of one kidney. Excretory urography indicates a sharp limitation of kidney mobility during orthoprobe. With apostematous pyelonephritis, there is a decrease in the excretory function on the side of the lesion (the shadow of the urinary tract appears late or is absent). With a carbuncle or abscess on the excretory urogram, the bulging of the contour of the kidney, compression and deformation of the calyces and pelvis are determined.

Treatment of pyelonephritis

An uncomplicated acute process is treated conservatively in a hospital setting. Antibacterial therapy is carried out. Medicines are selected taking into account the sensitivity of the bacteria found in the urine. In order to eliminate inflammation as quickly as possible, preventing the transition of pyelonephritis to a purulent-destructive form, treatment begins with the most effective drug.

Conducted detoxification therapy, correction of immunity. With a fever, a diet with a low protein content is prescribed, after the patient's temperature normalizes, they are transferred to a full-fledged diet with a high fluid content. At the first stage of therapy for secondary acute pyelonephritis, obstacles that impede the normal outflow of urine should be eliminated. The appointment of antibacterial drugs in case of impaired passage of urine does not give the desired effect and can lead to the development of serious complications.

Treatment of chronic pyelonephritis is carried out according to the same principles as the treatment of an acute process, but is more time consuming and labor intensive. The therapeutic program provides for the elimination of the causes that led to difficulty in the outflow of urine or caused renal circulation disorders, antibiotic therapy and the normalization of general immunity.

In the presence of obstructions, it is necessary to restore the normal passage of urine. Restoration of urine outflow is performed promptly (nephropexy for nephroptosis, removal of stones from the kidneys and urinary tract, removal of prostate adenoma, etc.). The elimination of obstacles that interfere with the passage of urine, in many cases, allows to achieve stable long-term remission. Antibacterial drugs are prescribed taking into account the data of the antibiogram. Before determining the sensitivity of microorganisms, therapy with broad-spectrum antibacterial drugs is carried out.

Patients with chronic pyelonephritis require long-term systematic therapy for at least a year. Treatment begins with a continuous course of antibiotic therapy lasting 6-8 weeks. This technique allows you to eliminate the purulent process in the kidney without the development of complications and the formation of scar tissue. If renal function is impaired, constant monitoring of the pharmacokinetics of nephrotoxic antibacterial drugs is required. To correct immunity, if necessary, use immunostimulants and immunomodulators. After achieving remission, intermittent courses of antibiotic therapy are prescribed.

During the period of remission, patients are shown sanatorium treatment (Jermuk, Zheleznovodsk, Truskavets, etc.). It should be remembered about the mandatory continuity of therapy. Antibacterial treatment started in the hospital should be continued on an outpatient basis. The treatment regimen prescribed by the doctor of the sanatorium should include taking antibacterial drugs recommended by the doctor who constantly monitors the patient. Phytotherapy is used as an additional method of treatment.

Pyelonephritis is a common ailment that is important to diagnose in time. Timely treatment of pyelonephritis in women and men prevents the development of severe and dangerous complications. What is pyelonephritis, what are the root causes of its manifestation? Diagnostic methods, what treatment of pyelonephritis in men and women, basic preventive procedures that will help get rid of the disease and prevent relapse.

Inflammation of the kidneys due to infections is not uncommon and requires immediate treatment.

general information

Pyelonephritis is an inflammatory process with the addition of a bacterial infection that affects and progresses in the renal tissues and pyelocaliceal system. The root cause of the disease is an infectious disease that arose against the background of a weakened immune system. If you do not know the characteristic symptoms and start treatment at the wrong time, there is a high risk of severe complications that can cause death. Psychosomatics also affects the development of the disease. Such psychosomatics as complexes, dissatisfaction with the current situation, self-criticism destroy the body and develop various serious illnesses.

Forms of the disease

In pyelonephritis, acute and chronic forms of the course are distinguished. With an exacerbation, a person’s health suddenly worsens, body temperature rises, pain develops in the transverse region, weakness, the urge to urinate becomes more frequent, and when going to the toilet, acute pain and burning sensation in the genitourinary tract are disturbed. If the acute form is not started adequately and on time to treat, the disease becomes chronic, which is much harder to deal with.

Depending on the degree of damage, a unilateral or bilateral form is distinguished. Pyelonephritis is also divided into primary and secondary. In the primary inflammatory process begins in the urinary tract and, due to untimely treatment, further affects the renal tissues. Secondary develops against the background of complications after other diseases caused by infection.

Causes of the disease in women and men

The cause of pyelonephritis in women and men is an infectious lesion of the organ by a pathogenic microorganism. The most common causative agents of the disease are E. coli, staphylococcus aureus, proteus, streptococcus and enterococcus. In addition to bacterial damage, fungal and viral infection can become the root cause of the disease. The pathogen enters the body in the following ways:

• Ascending, or urinogenic, when the external genital organs become inflamed, a bacterial complication joins and it spreads to the kidneys. This type of penetration provokes the development of pyelonephritis in women and girls.
• Hematogenous, when a dangerous inflammation develops in the body with the addition of an infection and, with untimely treatment, the pathogenic microflora spreads to more vulnerable organs, in the specific case of the kidney.

Pyelonephritis in men and women develops against a background of weakened immunity, with a congenital or acquired disease of the genitourinary system, with regular colds and tonsillitis, due to hypothermia, with incomplete emptying of the urinary tract, with urolithiasis and diabetes mellitus.

Symptoms

There are characteristic symptoms of pyelonephritis in women and men, the most common:

• increase in body temperature;
• chills and fever.

If there are no signs of acute respiratory infections (snot, wet cough), you need to be alert, because this signals internal inflammation, which rapidly flows into purulent pyelonephritis. Against the background of intoxication, the patient develops nausea and vomiting, increased fatigue and irritability.

Dull and aching pains are concentrated in the lower part of the lower back, the number of urges to urinate increases in a person, but there is little urine. Due to impaired functioning of the kidneys, edema is formed, which is difficult to get rid of. If the patient has a chronic disease, then the symptoms will be less pronounced, and sometimes the disease is asymptomatic.

Diagnostics

1. General blood test for the presence of inflammatory processes in the body. At the same time, the level of leukocytes and erythrocytes exceeds the norm.
2. A general urine test will show the presence of pathogenic microflora and infection in the organs of urination.
3. A biochemical blood test will show an increase in creatine, potassium and uric acid.
4. Instrumental diagnostic methods include ultrasound of the kidneys, MRI or CT. With inflammation, the organs are enlarged in size, while a thickening of the walls of the parenchyma and an increase in the pyelocaliceal system are visualized.

Treatment of pyelonephritis in adults

If the exacerbation passes with severe symptoms, the development of purulent processes and a decrease in blood pressure, the doctor decides on surgical intervention. Inpatient treatment is indicated for patients with severe symptoms of intoxication, vomiting, inability to take drugs orally. If pyelonephritis in men or women does not bring such discomfort and the signs are moderate, home therapy is allowed.

Conservative treatment

With pyelonephritis, symptomatic and antibacterial treatment is carried out. With a symptomatic patient, it is shown to observe bed rest, the temperature in the room should be no more than 20 degrees, the humidity should be at least 50-60%. The doctor prescribes nonsteroidal drugs for pain relief and lowering the temperature. These are drugs such as Metamizol, Diclofenac, Paracetamol. With inflammation of the kidneys in women or men, you need to dress warmly and not overcool. You need to rest regularly and empty your bladder at the first urge.

Antibacterial therapy

When diagnosing an illness, the doctor selects the first antibiotics for a week, and when more accurate tests show the presence of a specific pathogen, it is possible to replace the medicine. To cure pyelonephritis in women and men, drugs of the fluoroquinolone group are used, together with a beta-lactamase inhibitor. Due to the high level of concentration when taken orally, the antibiotic "Ciprofloxacin" is used in tablet form. Intravenous injections are done only in cases of severe vomiting.

If the patient's condition has not stabilized for 2-3 days, he is sent for CT or MRI of the abdominal organs. This type of diagnosis shows other pathologies that affect the patient's condition. A chronic illness is treated with antibiotics for at least 1.5-2 months with a periodic change of drugs, since pathogenic microorganisms quickly get used to the antibiotic and it ceases to act. With the timely diagnosis of the disease, when the correct treatment regimen is chosen, the disease can be defeated. But within a year after therapy, a person is shown to periodically take urine tests to detect microorganisms. If after a year there is no pathogenic microflora in the urine, the patient is considered healthy.

Is it possible to cure pyelonephritis at home and what to take for recovery? The answers to these and many other questions concern people suffering from kidney inflammation. According to experts, self-treatment of pyelonephritis in the initial stages can be very effective, but extreme caution must be exercised. After reading this article, you will get an overview of the methods of treating the disease and find out in which cases you may need to seek emergency medical help.

Causes of the disease

The first thing you need to pay attention to when starting the fight against a particular disease is the etiology. Pyelonephritis develops when a mixed infection or pathogens enter the bloodstream of a person (this can be E. coli, all kinds of cocci, etc.). Before you learn how to cure pyelonephritis, check out the list of factors associated with infection:

• chronic states of overwork/weakness/stress;
• decreased immunity;
• lack of vitamins;
• passage of urine;
• urolithiasis disease;
• kidney tumor;
• narrowing of the ureters.

How to treat pyelonephritis in adults

It is known that the treatment of pyelonephritis in mature women and men is a complex set of medicinal measures aimed at normalizing the condition of the kidneys. The disease control program includes the use of drugs and procedures aimed at eliminating foci of inflammation. Features of kidney treatment depend on the person's age, general health and the current form of the disease.

diet therapy

The first thing you should take care of is the diet, because the body receives all the nutrients along with food. When choosing a diet, the nature of the disease and the individual characteristics of the patient's body must be taken into account. If we are talking about acute pyelonephritis, the following foods should be excluded from the diet:

• snacks, canned food, smoked meats, pickles;
• hot spices / seasonings;
• coffee;
• broths with broth;
• legumes;
• cakes/creams;
• mushrooms;
• sparkling water;
• alcoholic drinks.

• dairy;
• fruits with a high content of potassium (dried apricots, apricots, raisins);
• white bread (salt-free);
• butter (in moderation);
• boiled and grated vegetables;
• cereals;
• sugar.

• herbal decoctions;
• compotes / fruit drinks / kissels / juices;
• teas (green, weak black);
• mineral soda water without gas.

In the process of treating chronic pyelonephritis, the list of products to be excluded remains unchanged. The basis of dietary nutrition includes the following products:

• lean varieties of fish / meat / poultry (minced meat or boiled meat);
• vegetarian and milk soups (fruit/vegetable);
• dairy and dairy products;
• flour products;
• chicken eggs;
• pasta (well boiled);
• cereals;
• puddings;
• raw / boiled vegetables (except radish, cauliflower, garlic and onions);
• fruits and berries of all kinds;
• gourds;
• jam, honey, sugar and some other harmless sweets.

The nuances of the diet for pyelonephritis (kidney disease) must be agreed with the attending physician, otherwise digestive disorders may occur. You will have to forget about the products recommended for exclusion from the diet until the kidneys are completely recovered, otherwise the effectiveness of therapeutic measures will decrease significantly. The sooner the patient provides a balance of substances in the body, the less chance there will be for pyelonephritis.

Medical therapy

Treatment of the acute form of pyelonephritis with drugs is aimed at quickly eliminating foci of inflammation in the kidneys and preventing the strengthening of the disease. The average course duration is 12-16 days. The general complex of therapeutic measures is based on the following principles:

• elimination of factors that cause infection in the kidneys;
• antibiotic therapy after sampling for culture;
• strengthening the immune system to prevent relapses in the future;
• pathogenic/symptomatic treatment.

To alleviate the patient's condition with a diagnosis of "acute pyelonephritis" antispasmodics ("Drotaverine", "No-Shpa", "Spasmalgon") are prescribed. In the course of direct treatment of inflammation of the kidneys, specialists conduct a series of laboratory tests and prescribe complex treatment with drugs from several pharmacological groups:

1. Antibiotics: Cefalexin, Cefaclor, Amikacin, Gentamicin. Highly effective, but at the same time low-toxic antibacterial drugs for the treatment of acute forms of pyelonephritis. Depending on the form of release, they are used orally and intravenously.
2. Non-steroidal anti-inflammatory drugs (NSAIDs): Nimesulide, Voltaren, Movalis. The acute form of pyelonephritis is often accompanied by fever. To reduce body temperature and block inflammation in the kidneys during the treatment of this disease, NPS tablets are prescribed.
3. Probiotics: Ecoflor, Trilact, Bifidum BAG. These drugs are prescribed to restore the intestinal microflora affected by the treatment of acute pyelonephritis with antibiotics. Probiotics contain beneficial microorganisms that reduce the level of intoxication and remove toxins.
4. Anticoagulants: "Dipiridamolm", "Heparin", "Troxevasin". Drugs in this category normalize blood flow in the kidneys, which significantly increases the effectiveness of treatment.

Treatment of the chronic form of pyelonephritis requires a long methodical approach. After the examination, doctors prescribe long-term treatment with drugs of the following pharmacological groups:

1. Penicillins: "Carbenicillin", "Azocillin", "Amoxicillin". They are prescribed for the treatment of chronic pyelonephritis (kidney disease) with a minimum level of nefortoxicity.
2. Fluoroquinols: "Ofloxacin", "Ciprofloxacin", "Levofloxacin". They are given in the form of injections. The powerful antibacterial effect of these drugs significantly increases the effectiveness of the fight against pyelonephritis (kidney disease).
3. Cephalosporins 2, 3 generations: "Cefaclor", "Cefalexin". Low-toxic drugs to combat inflammatory processes. The active substances in these cephalosporins break down the cell walls of the bacteria that cause pyelonephritis (kidney disease) and kill them, restoring the normal functioning of the tubular system.
4. Nitrofurans: Furagin, Furazolidone, Furadonin. Effective in the fight against chronic pyelonephritis, however, due to the high degree of toxicity, they are prescribed in the most extreme cases of kidney disease.
5. Oxyquinolines: Nitroxoline, 5-Nock. Drugs in this category are well tolerated by the body, but their effectiveness in the treatment of chronic pyelonephritis (kidney disease) has noticeably deteriorated due to a decrease in the sensitivity of bacterial microorganisms.

Surgical intervention

Surgical treatment for pyelonephritis is prescribed in the most extreme cases, when inflammatory processes that affect the internal tissues of the kidneys do not respond to antibiotics and NPS drugs. Surgery is performed to prevent neforsclerosis and pyonephrosis. Advanced stages of pyelonephritis lead to unilateral wrinkling of the kidney.

To prevent further inflammation of the organs of the urinary system, a nephrectomy is prescribed - an operation to remove the kidney (under general anesthesia, the patient's retroperitoneal space is opened and the affected organ is cut off). In rare cases, when there is destruction of one of the halves of the doubled kidney, surgeons resort to resection. This operation involves the removal of part of the kidney tissue affected by purulent inflammatory processes.

Folk remedies for treatment at home

Traditional methods of dealing with pyelonephritis (kidney disease) involve the use of medications in a hospital hospital, but is there really no way to do without doctors. Connoisseurs of home recipes say: in the early stages, effective treatment of pyelonephritis with folk remedies at home is quite possible. Write down a few grandma's recipes for yourself to be ready if there is a threat of inflammation of the kidney:

1. Propolis with butter. Melt 60-70 grams of butter, add 15 grams of propolis and mix. Use the resulting slurry of 5-7 grams with an interval of 7-8 hours.
2. . An excellent remedy for the treatment of acute and chronic forms of pyelonephritis (kidney disease). Cook 170 grams of oats in a liter of milk. You need to boil for a long time, until half of the liquid has evaporated. Cool the resulting jelly and drink it at intervals of 5-6 hours. After 2-3 weeks, kidney disease will recede.
3. Salt dressing. Pour 230 grams of salt onto a thick large towel and soak it with water. Before going to bed, tie around the waist and go to bed. Performing this procedure every night, you can remove the exacerbation of pyelonephritis (kidney disease) in less than two weeks.

Phytotherapy

Natural herbal decoctions will help to increase the effectiveness of drug treatment of inflammation of the kidneys. Natural components contribute to the normalization of the balance of substances and cleanse the body of toxins. Official medicine recognizes most of the existing methods of herbal treatment. Folk decoctions provide a whole range of beneficial effects:

• uroseptic;
• diuretic;
• detoxification;
• restorative.

Below are some of the phytotherapeutic recipes that have repeatedly demonstrated their effectiveness in the treatment of acute infectious pyelonephritis (kidney disease):

1. Meadowsweet, yarrow and budra. In a large metal container, mix these herbs in equal proportions, add a small amount of agrimony, immortelle, celery and marshmallow. Pour a liter of boiling water and let it brew for 1.5-2 hours. For effective treatment of an acute form of pyelonephritis (kidney disease), drink a decoction at intervals of 12 hours, 30-40 ml each.
2. Fireweed, chamomile, birch. An incredibly effective remedy for the treatment of chronic pyelonephritis (kidney disease). Mix the components in equal quantities and pour three cups of boiling water. The scheme of application is extremely simple: drink 50-60 ml of decoction every 8 hours, and after 2-3 weeks, kidney disease will recede forever.

Features of the treatment of the disease

The main task of the doctor prescribing drugs for the treatment of acute / chronic pyelonephritis is to correctly assess the current situation and take into account all the nuances. Most people admitted to hospital with inflammation of the kidney are treated according to the standard scheme, however, there are certain categories of people for whom treatment measures are selected taking into account additional factors.

In children

By definition, the child's body cannot normally absorb potent drugs, so doctors are especially careful about which antibiotics to treat the baby with so as not to damage the organs of the gastrointestinal tract. At the age of 12 years, it is not recommended to get involved in folk remedies, it is better to immediately contact specialists. Homemade decoctions and tinctures are not contraindicated, but if they do not help cure pyelonephritis (kidney disease) within 2-3 days, seeking medical help should not be postponed.

In pregnant women

Potent antibacterial drugs for the treatment of acute pyelonephritis during pregnancy are used only after a complete examination and only as prescribed by the attending physician. Any self-activity in such situations should be excluded. The exhausted body of a pregnant woman may not respond adequately to medications, so she always needs to be under the supervision of specialists.

Is it possible to cure chronic pyelonephritis completely

Treatment of chronic pyelonephritis is aimed at blocking inflammatory processes and normalizing the functioning of the kidney. With a successful outcome, all symptoms disappear, the state of human health returns to normal, but the disease itself remains. Under the influence of negative external / internal factors, whether it is a decrease in immunity, hypothermia, stress, or something else, the disease will manifest itself again, and then repeated treatment will be required.

Video about the symptoms and treatment of acute pyelonephritis

The video below contains recommendations from experts on how to behave when a kidney inflammation is suspected. After watching this video, you will get a lot of valuable information about the identification and treatment of acute pyelonephritis. Take the received information into service so that a dangerous infectious disease does not bring you to a hospital bed!

Pyelonephritis is a non-specific inflammatory disease of the kidneys of bacterial etiology, characterized by damage to the renal pelvis (pyelitis), calyces and parenchyma of the kidney.

In view of the structural features of the female body, pyelonephritis is 6 times more common in women than in men. The most common causative agents of the inflammatory process in the kidney are Escherichia coli (E.coli), Proteus (Proteus), enterococci (Enterococcus), Pseudomonas aeruginosa (Pseudomonas aeruginosa) and staphylococcus (Staphylococcus).

If we talk about the frequency of occurrence of this disease, it should be noted that among the adult population it is approximately 10 out of 1000 people, and among children - 10 out of 2000. Most of the cases belong to the middle age group - from 26 to 44 years. An interesting fact is that more than 70% of all patients are young women who fell ill shortly after the first sexual intercourse. Among children's diseases, inflammation of the kidneys securely holds the 2nd position immediately after various respiratory diseases (bronchitis, pneumonia, etc.).

What it is?

Pyelonephritis is a non-specific inflammatory process with a predominant lesion of the tubular system of the kidney, predominantly of bacterial etiology, characterized by damage to the renal pelvis (pyelitis), calyces and parenchyma of the kidney (mainly its interstitial tissue).

Based on puncture and excision biopsy of the renal tissue, three main variants of the course of the disease are revealed: acute, chronic and chronic with exacerbation.

Causes of pyelonephritis

In women, due to anatomical features, the ascending (urinogenic) route of infection into the pelvis and renal tissue comes first - due to, and anomalies in the structure of the urinary system, a long stay of a catheter for excretion of urine. Hematogenous (with blood flow) spread of infection is also possible, when any focus can become a potential source - transferred purulent mastitis, inflammation of the ear, and even inflammation of the dental canal (pulpitis).

The main microbe that causes pyelonephritis is Escherichia coli (up to 75% of all cases). The remaining 25% of cases are associated with the entry into the urinary tract of Klebsiella, Proteus, Staphylococcus aureus, Enterococcus, Pseudomonas aeruginosa, fungal infection, chlamydia, salmonella, etc.

Risk factors in the occurrence of pyelonephritis in women are all protracted pathological processes of any localization that occur with a decrease in the overall immunity of the body: diabetes mellitus, bone marrow diseases, neurological problems (multiple sclerosis), HIV infection, condition after chemotherapy or organ transplantation.

Interesting facts about pyelonephritis:

• In the United States of America, 1 in 7,000 people gets sick every year. 192,000 patients need and receive hospitalization every year.
• It has been established that female representatives suffer from pyelonephritis more often than men by 5 times. The acute form of the disease is diagnosed more often in women of reproductive age who have an active sex life.
• With adequate treatment, up to 95% of all patients notice a significant improvement in the first two days.
• You should not refuse to drink plenty of water because of pain during bladder emptying, as this is the only way to remove bacteria from the body. You should urinate as often as possible so that there is no such serious complication as blood poisoning, as a result of which a person may die.
• Abundant fluid intake is an essential condition for the treatment of the disease. For drinking, it is necessary to use clean water, which normalizes the balance in the body, thins the blood, promotes the speedy removal of pathogenic microorganisms and toxic products of their vital activity. The effect is achieved by increasing the number of urination as a result of heavy drinking.
• Alcoholic drinks, coffee, carbonated water - all this is prohibited in pyelonephritis. It is believed that cranberry juice can help in the fight against the disease. It is consumed in its pure form, or diluted with water.
• Pyelonephritis affects children, both girls (in 3% of cases) and boys (in 1% of cases). In childhood, the disease is dangerous for its complications. Thus, cicatricial changes in the kidney parenchyma are diagnosed in 17% of children who have been ill, hypertension in 10-20% of children.

Chronic pyelonephritis

This is an inflammatory process in the kidneys, during which scarring of the kidney parenchyma occurs.

In the case, sudden pain sensations are not observed (as in the acute course of the disease). The disease is often accompanied by arterial hypertension. The most common reason patients seek medical advice is poor laboratory results. If the patient has inflammation of both kidneys, polyuria and nocturia (nighttime urination) occur, associated with impaired urine concentration.

Chronic pyelonephritis is associated with a violation of the outflow of urine. Violation of the outflow of urine causes the occurrence of a certain amount of urine in the bladder, despite frequent urination. This condition contributes to the development of infection. If left untreated, complications can occur, such as kidney failure.

Pyelonephritis - symptoms in women

The weaker sex is more susceptible to such a disease, but only in the first two age periods, i.e. up to about 45-50 years. Everything is explained by the structure of the urethra - it is short and is located next to the intestine and genital tract.

This increases the risk of developing pyelonephritis - symptoms in women appear as follows:

• nausea or vomiting;
• poor appetite;
• weakness and high fever;
• frequent trips to the toilet;
• cloudy or bloody urine and pain when urinating;
• pain in the lower back, worse in cold weather;
• colic and pain in the lower abdomen;
• unusual discharge.

Pyelonephritis in pregnant women

Unfortunately, pregnant women are very likely to develop a dangerous infectious kidney disease. In about seven percent of cases, a woman during pregnancy becomes ill with a similar ailment.

Often, symptoms appear, starting from the second trimester. Often the symptoms are not taken seriously, which leads to complications such as sepsis, kidney failure and premature birth, anemia. Bacteriuria in pregnant women can occur without vivid symptoms if a woman gives birth to a child not for the first time. In mothers with many children, as a rule, signs of pyelonephritis appear only in the later stages.

Infectious kidney disease of an inflammatory nature is very insidious. The whole problem lies in the frequent asymptomatic course of the disease. As a result, a person does not seek medical help in a timely manner and may suffer from serious complications. There are frequent cases of death of pregnant women from pyelonephritis for this very reason.

Symptoms

The most common symptoms of acute pyelonephritis include:

1. Pain in the lumbar region on the affected side. With non-obstructive pyelonephritis, pain is usually dull, aching in nature, can be low or reach high intensity, take on a paroxysmal character (for example, with obstruction of the ureter by a stone with the development of the so-called calculous pyelonephritis).
2. Dysuric phenomena for pyelonephritis itself are not characteristic, but may occur with urethritis and cystitis, which led to the development of ascending pyelonephritis.

General symptoms are characterized by the development of intoxication syndrome:

• fever up to 38-40 ° C;
• chills;
• general weakness;
• loss of appetite;
• nausea, sometimes vomiting.

For children, the severity of the intoxication syndrome is characteristic, and the development of the so-called. abdominal syndrome (severe pain not in the lumbar region, but in the abdomen).

In elderly and senile people, an atypical clinical picture often develops, either with an erased clinic, or with severe general manifestations and the absence of local symptoms.

Possible Complications

In the absence of adequate therapy, pyelonephritis threatens with the following consequences:

• (to protect the body from intoxication, it is necessary to regularly resort to the use of an artificial kidney device);
• sepsis (in case of penetration of bacteria into the bloodstream);
• chronization of the process (painful exacerbations are periodically observed);
• severe kidney damage;
• development of urolithiasis (renal colic is periodically observed);
• death (as a result of blood poisoning - sepsis or kidney failure).

Diagnostics

1. Biochemistry of blood. Reveals an increased number of urea, creatinine, potassium. The content of an increased amount of potassium characterizes the development of renal failure.
2. Blood study. It will show the course of the inflammatory process in the body (acceleration of ESR, the presence of a large number of leukocytes).
3. Urine culture. The liquid is sown on a special nutrient medium. After a while, the growth of a certain bacterium that provoked inflammation will be indicated. Thanks to sowing, the doctor will be able to choose the right antibiotic therapy.
4. Analysis of urine. In the case of pyelonephritis, urine will be alkaline, with a pH of 6.2-6.9. In addition, the shade of the liquid is evaluated. In the presence of pyelonephritis, urine acquires a dark, sometimes even reddish color. It often contains protein.
5. Research on Nechiporenko. This method allows you to identify a significant predominance of leukocytes in the urine over erythrocytes.
6. prednisone test. The event allows you to diagnose a pathology that is characterized by a latent course. The patient is administered the drug Prednisolone intravenously in combination with sodium chloride. After 1 hour after this, the woman needs to collect urine, then after 2 and 3 hours. And after a day. Urine is sent for a detailed study. An increased number of leukocytes will indicate the course of pyelonephritis.
7. Zemnitsky's test. The method allows you to detect a reduced density of urine. With pyelonephritis, nocturnal diuresis (the amount of urine excreted) prevails over daytime.

To confirm pyelonephritis and differentiate it from other pathologies, the doctor will prescribe the following measures:

1. excretory urography. Allows you to detect the mobility of the kidney. The study characterizes the condition of the cups, the tone of the urinary tract.
2. Ultrasound procedure. To get an idea of ​​the size of the kidneys, their structure, density, the presence of calculi in them, an ultrasound is taken. In the case of a chronic process, the echogenicity (the ability to reflect ultrasound) of the parenchyma is increased, in the acute phase it is unevenly reduced.
3. Cystometry. This study allows you to identify pathologies of the bladder. The principle of examination is based on determining the volume of the urea.
4. Cystography. This is an x-ray contrast study that can detect vesicoureteral reflux or intravesical obstruction.
5. CT scan. Detailed study of the structure of the kidney. Unlike ultrasound, it allows you to determine the condition of the pelvis, vascular pedicle and perinephric tissue.

How to treat pyelonephritis?

At home, pyelonephritis in women and men is treated with antibacterial and symptomatic therapy in combination. To eliminate the symptoms of the disease, the following conditions must be met:

1. It is important to observe the drinking regimen throughout the entire period of treatment.
2. For the first few days, the patient must observe bed rest, that is, be warm in a horizontal position.
3. To reduce body temperature and eliminate pain, it is necessary to use NSAIDs, including: Diclofenac, Metamizole. In childhood, paracetamol is indicated.

Given the infectious nature of the disease, the presence of predisposing factors, the main clinical symptoms, the main therapeutic directions are as follows:

• infection control (antibacterial drugs);
• elimination of obstruction of the ureters or renal pelvis, as well as other anatomical or neurogenic obstructions that make normal outflow of urine impossible;
• decrease in the severity of intoxication syndrome (drink more fluids, bed rest, antipyretics);
• power correction.

Particular attention in the treatment is paid to the diet, with which you can have a gentle effect on inflamed kidneys, normalize metabolism, remove toxins from the body, restore diuresis, and lower blood pressure.

In the event that an exacerbation of a chronic disease, or primary acute pyelonephritis occurs against a background of high temperature, accompanied by a drop in pressure, severe pain, suppuration and a violation of the normal outflow of urine, surgical intervention will be required. The patient must be hospitalized if it is impossible to carry out drug therapy at home (vomiting after taking pills for pyelonephritis), as well as with severe intoxication. In other situations, at the discretion of the doctor, treatment can be carried out on an outpatient basis.

Antibacterial therapy

It is desirable that the antibiotic is selected on the basis of the results of bacteriological culture of urine with the determination of the sensitivity of the pathogen to various drugs. In the case of acute pyelonephritis, immediately after the seeding, a broad-spectrum antibiotic from the fluoroquinol group, for example, Tsiprolet, may be prescribed and adjusted according to the results of the seeding. Antibacterial therapy should continue for at least 2-3 weeks.

New in the treatment of pyelonephritis

1) A group of first-line antibiotics - fluoroquinolones.

• The drugs of choice are Cefixime (400 mg per day) and Levofloxacin (0.5-0.75 1 time per day) in tablets.
• Ciprofloxacin 0.5-0.75 twice daily and Norfloxacin 400 mg twice daily remain relevant only in previously untreated patients.

2) 2nd line antibiotics (alternative) - Amoxicillin with clavulanic acid (625 mg) 3 times a day. With culture-proven sensitivity, Ceftibuten 400 mg once daily can be used.

3) Pyelonephritis in pregnant women is no longer treated with amoxicillin, and, regardless of the gestational age, the following drugs are prescribed:

• Cefibuten 400 mg once a day or
• Cefixime 400 mg once a day or
• Cefatoxime 3-8 g per day in 3-4 injections intramuscularly or intravenously or
• Ceftriaxone 1-2 g per day once intramuscularly or intravenously.

4) In severe pyelonephritis requiring hospitalization, treatment in a hospital is carried out with carbopenems (Ertapenem, Miranem) intramuscularly or intravenously. After the patient has had a normal temperature for three days, therapy can be continued with oral drugs. An alternative to carbopenems are Levofloxacin and Amikacin.

Diet for pyelonephritis

In the acute stage, the diet should be as sparing as possible. It is necessary to drastically reduce salt intake (no more than 5-10 grams per day, with high blood pressure - 2-3 grams), and completely exclude spicy, spicy, smoked and canned foods, strong meat broths, spices, coffee and alcohol from the diet .

Allowed: egg white, fermented milk products, vegetarian (vegetable) dishes, boiled or steamed. As the inflammation subsides, fish and lean meat are introduced into the diet. It is recommended to consume juices, compotes, gourds, vegetables, fruits, and also drink 2-2.5 liquids daily (in the absence of edema).

During the remission period, it is allowed to gradually introduce some spices, garlic and onions into the diet in small portions. Very useful for patients suffering from chronic pyelonephritis, cranberry juice, stimulating the production of hippuric acid (an effective bacteriostatic agent). Allowed foods: fruits, vegetables, cereals, eggs, lean boiled meat and fish, low-fat dairy products.

Forecast

There are two types of exits from pyelonephritis - complete recovery or chronicity of the condition. With timely treatment, the prognosis is mostly favorable. In most cases, relief comes after 3-5 days of drug therapy. The body temperature decreases, the pain subsides, the general condition of the patient returns to normal. With a favorable course of treatment, a person leaves the hospital after 10-12 days.

In the presence of remission of pyelonephritis, antibiotics are prescribed for 6 days. When acute pyelonephritis becomes chronic and there are complications, the prognosis is poor. In this case, there is a high probability of renal failure, pyonephrosis, arterial hypertension, etc.

It is very important after the cure to follow the rules recommended by the doctor, regularly take urine tests and take preventive measures. The sooner the patient seeks help from a doctor, the higher the chances of a timely cure and the absence of complications.

Prevention

In order not to bring yourself to pyelonephritis - prevention should be carried out taking into account certain rules:

1. The use of medicinal herbs as a preventive measure.
2. If the pathological process of infectious etiology is located in any other organs, it must be sanitized, since bacteria can spread to the kidneys with the help of blood.
3. Getting rid of bad habits, since alcohol and smoking significantly reduce the immune properties of the body, which inhibits the ability to respond to the penetration of bacteria and viruses into the body.
4. The body must get enough rest and sleep, as an exhausted body is not able to fight a bacterial infection.
5. Persons who are at risk of developing the disease should regularly conduct laboratory and instrumental research methods in order to prevent pyelonephritis.

Compliance with these rules does not provide significant work, you should only carefully pay attention to your own health to carry out treatment at the early stages of the pathological process.

Pyelonephritis is a severe infectious disease that can be caused by various pathogens. Determination of a specific pathogen and selection of antibiotic therapy is the main method of treating this pathology. The cause of the development of the disease is often a violation of the passage of urine, nephrolithiasis and other abnormalities in the urinary system.

In this regard, the treatment of pyelonephritis must also necessarily include measures to eliminate the etiological factor in order to prevent further relapses of inflammatory processes in the kidneys. The applied therapeutic methods are selected taking into account the severity of the disease, the nature of the course, the presence of complications, as well as the characteristics of the patient's state of health. In the acute form of pyelonephritis or exacerbations, treatment should be carried out under the strict supervision of specialists.

Treatment of acute pyelonephritis

- this is a serous or purulent inflammation with a predominant lesion of the renal interstitial tissue. In most cases, the disease develops in only one kidney. The acute course of the disease is characterized by the sudden onset of such severe symptoms as chills, fever, high fever, weakness, etc. To avoid consequences, treatment of pyelonephritis should begin immediately and include a set of measures, including antibiotics and other drugs, diet and bed rest. If necessary, surgical intervention is also used to eliminate the cause of the disease.

Medical therapy

The main drugs used to treat pyelonephritis are antibiotics. A course of antibiotic therapy for the complete destruction of pathogenic microorganisms and the prevention of relapse or the transition of the disease to a chronic form is recommended for at least 6 weeks. In the first days, patients are usually prescribed injectable dosage forms, and then transferred to tablets. Considering that the urine culture may take several days to complete, a broad-spectrum antibiotic is first empirically selected, and then, based on the results, the drug is replaced if necessary. With pyelonephritis, depending on the specific pathogen, the following groups of antibacterial agents are used:

• penicillins;
• sulfonamides;
• cephalosporins;
• fluoroquinolones;
• pipemidic acid derivatives;
• nalidixic acid derivatives;
• nitrofuans.

Antibacterial drugs are widely used for the treatment of acute pyelonephritis.

The main requirements for antibiotics for the treatment of pyelonephritis are:

• high bactericidal activity;
• minimal nephrotoxicity;
• the maximum degree of elimination in the urine.

The criterion for the effectiveness of antibiotic therapy is considered to be a decrease in symptoms, intoxication, improvement in kidney function and the general condition of the patient 2-3 days after the start of treatment. At the end of taking antibiotics, a repeated general and bacteriological analysis of urine is performed to monitor the effectiveness of the prescribed therapy. Additionally, instrumental research methods can be used to assess the state of the urinary system: excretory urography, ultrasound, cytoscopy, etc.

Important: If symptoms of acute inflammation of the kidneys appear, the patient must pass urine for bacteriological examination. Identification of pathogenic microorganisms and determination of their sensitivity to antibiotics will allow you to choose the right treatment.

If the cause of the development of pyelonephritis was some kind of disease of the kidneys or other organs of the urinary system, then the treatment of the underlying disease is mandatory.

Diet

Proper nutrition in acute pyelonephritis helps the body cope with the infection and reduces the burden on the kidneys. In addition, drinking plenty of water is recommended. Especially useful will be cranberry and lingonberry fruit drinks or rosehip broth, which have anti-inflammatory and diuretic effects. Freshly squeezed vegetable or fruit juices are a valuable source of additional vitamins needed by the body during illness. It is allowed to drink mineral water, compotes, green and herbal teas.

In the acute form of pyelonephritis, it is necessary to adhere to the following dietary rules:

• completely exclude marinades, canned food, spices, smoked meats;
• limit the consumption of muffins and sweets;
• exclude alcohol, carbonated water, strong black tea and coffee;
• do not eat fried, fatty, spicy and peppery dishes containing pepper, horseradish, garlic;
• exclude indigestible foods (mushrooms, legumes, etc.);
• increase the amount of products that have a diuretic effect (melons, watermelons, apples, zucchini, etc.).

The basis of the diet should first be fruits and vegetables, after the removal of acute inflammation, lean boiled meat and dairy products can be introduced.

Tip: If inflammation of the kidneys is accompanied by an increase in pressure, then it is recommended to significantly reduce or completely eliminate salt intake.

Surgery

Surgical treatment of pyelonephritis is carried out with severe purulent kidney damage, which is characterized by the formation of carbuncles and apostemes, in case of failure of antibiotic therapy and other conservative methods. The purpose of surgery is to stop the further progression of the inflammatory process, prevent its spread to a healthy kidney, and eliminate obstacles to the normal outflow of urine in case of obstruction. In this case, the organ is decapsulated, drained and the abscesses are opened. With complete damage to the organ (purulent-destructive stage), an operation is performed to remove the kidney.

Treatment of chronic pyelonephritis

In about 20% of patients, acute pyelonephritis becomes chronic, the course of which is characterized by alternating periods of remission and exacerbations. With exacerbation, the same therapeutic methods are used as for acute inflammation of the kidneys. During the period of remission, the treatment of chronic pyelonephritis is carried out at home under dispensary supervision. At this time, it is necessary to follow a diet, drink decoctions of medicinal herbs and, if possible, undergo rehabilitation in a specialized sanatorium. Once every three months, such patients should visit a doctor, undergo an examination and take tests.

• avoid hypothermia;
• adhere to the correct drinking regimen;
• take measures to prevent colds and infectious diseases;
• strengthen immunity;
• follow a diet;
• empty your bladder regularly (once every 3-4 hours);
• take prophylactically short courses of antibacterial drugs (as agreed with the doctor);
• follow the rules of intimate hygiene.

Tip: If symptoms of exacerbation of chronic pyelonephritis appear, you should immediately consult a doctor.

Folk methods of treatment

With pyelonephritis, treatment with folk remedies can be used as an additional method of therapy both during exacerbations and during remission. For this purpose, medicinal herbs are used individually or as part of collections, which have anti-inflammatory, bactericidal, antiseptic and diuretic effects in the form of decoctions or infusions. The combined use of folk and traditional methods of treating pyelonephritis helps to speed up the recovery of the patient during an exacerbation of the disease. Among the folk remedies used for medicinal purposes for inflammation of the kidneys, the most effective are:

• juice from the leaves of the highlander bird;
• propolis oil;
• a decoction of a mixture of bearberry leaves, flaxseed calamus, kidney tea, licorice root, birch buds;
• decoction of oats in milk or water;
• infusion of lingonberry leaves, blue cornflower flowers, birch leaves;
• decoction of aspen bark, bearberry, Siberian elderberry leaves.

Folk remedies for pyelonephritis are used as part of complex treatment