Pyelonephritis - Symptoms and Treatment

Pyelonephritis is an inflammation of the kidneys that occurs in an acute or chronic form. The disease is quite widespread and very dangerous to health. Symptoms of pyelonephritis include pain in the lumbar region, fever, severe general condition and chills. Occurs most often after hypothermia.

It can be primary, that is, it develops in healthy kidneys, or secondary, when the disease occurs against the background of already existing kidney diseases (glomerulonephritis, urolithiasis, etc.). Also distinguish acute and chronic pyelonephritis. Symptoms and treatment will directly depend on the form of the disease.

This is the most common kidney disease in all age groups. Most often, they are sick of young and middle-aged women - 6 times more often than men. In children after respiratory diseases (bronchitis, pneumonia) it takes the second place.

Causes of pyelonephritis

Why does pyelonephritis develop, and what is it? The main cause of pyelonephritis is infection. Under the infection refers to bacteria such as E. coli, Proteus, Klebsiella, Staphylococcus and others. However, when these microbes enter the urinary system, the disease does not always develop.

In order for pyelonephritis to appear, you also need contributing factors. These include:

  1. Disruption of normal urine flow (urinary reflux from the bladder to the kidney, “neurogenic bladder”, prostate adenoma);
  2. Impaired kidney blood supply (plaque deposition in the vessels, vasculitis, vasospasm in hypertension, diabetic angiopathy, local cooling);
  3. Inhibition of immunity (treatment with steroid hormones (prednisone), cytotoxic drugs, immunodeficiency as a result of diabetes mellitus);
  4. Contamination of the urethra (lack of personal hygiene, with incontinence of feces, urine, during sexual intercourse);
  5. Other factors (reduction of mucus secretion in the urinary system, weakening of local immunity, impaired blood supply to the mucous membranes, urolithiasis, oncology, other diseases of this system and any chronic diseases in general, reduced fluid intake, abnormal kidney anatomy).

Once in the kidney, the microbes colonize the cup-pelvis-plating system, then the tubules, and of them the interstitial tissue, causing inflammation in all these structures. Therefore, it is not necessary to postpone the question of how to treat pyelonephritis, otherwise serious complications are possible.

Symptoms of pyelonephritis

In acute pyelonephritis, the symptoms are pronounced - it begins with chills, while measuring the body temperature, the thermometer shows over 38 degrees. After a little time, a aching pain appears in the lower back, the lower back “pulls”, and the pain is quite intense.

The patient is worried about the frequent urge to urinate, which are very painful and indicate adherence of urethritis and cystitis. Symptoms of pyelonephritis may have common or local manifestations. Common signs are:

  • High intermittent fever;
  • Severe chills;
  • Sweating, dehydration and thirst;
  • Intoxication of the body occurs, resulting in a headache, increased fatigue;
  • Dyspeptic symptoms (nausea, no appetite, stomach ache, diarrhea appears).

Local signs of pyelonephritis:

  1. In the lumbar region of pain, on the affected side. The nature of the pain is dull, but constant, aggravated by palpation or movement;
  2. The muscles of the abdominal wall can be tense, especially on the affected side.

Sometimes the disease begins with acute cystitis - frequent and painful urination, pain in the bladder, terminal hematuria (the appearance of blood at the end of urination). In addition, there may be general weakness, weakness, muscle and headache, lack of appetite, nausea, vomiting.

At occurrence of the listed symptoms of pyelonephritis should consult a doctor as soon as possible. In the absence of competent therapy, the disease can turn into a chronic form, which is much more difficult to cure.

Complications

  • acute or chronic renal failure;
  • various suppurative diseases of the kidneys (kidney carbuncle, kidney abscess, etc.);
  • sepsis.

Pyelonephritis treatment

In case of primary acute pyelonephritis, in most cases the treatment is conservative, the patient should be hospitalized in the hospital.

The main therapeutic measure is the effect on the pathogen of the disease with antibiotics and chemical antibacterial drugs in accordance with the data of the antibiogram, detoxification and immunity enhancing therapy in the presence of immunodeficiency.

In acute pyelonephritis, treatment should begin with the most effective antibiotics and chemical antibacterial preparations to which the urine microflora is sensitive, so that the inflammatory process in the kidney can be eliminated as soon as possible, preventing it from turning into a purulent-destructive form. In case of secondary acute pyelonephritis, treatment should begin with the restoration of urine massage from the kidney, which is fundamental.

Treatment of the chronic form is fundamentally the same as acute, but longer and more laborious. In chronic pyelonephritis treatment should include the following main measures:

  1. Elimination of the reasons that caused the violation of the passage of urine or kidney blood, especially venous;
  2. Purpose of antibacterial or chemical preparations taking into account data of the antibiogram;
  3. Increase the body's immune reactivity.

Recovery of urine outflow is achieved primarily by the use of one or another type of surgical intervention (removal of prostate gland adenoma, stones from the kidneys and urinary tract, nephropexy with nephroptosis, urethra plastic or pelvic-ureteral segment, etc.). It is not uncommon for these surgical interventions that it is relatively easy to get a stable remission of the disease without long-term antibacterial treatment. Without a sufficiently restored urine massage, the use of antibacterial drugs usually does not give long-lasting remission of the disease.

Antibiotics and chemical antibacterial drugs should be prescribed taking into account the sensitivity of the patient's microflora to antibacterial drugs. In addition, antibiograms prescribe antibacterial drugs with a broad spectrum of action. Treatment for chronic pyelonephritis is systematic and prolonged (at least 1 year). The initial continuous course of antibacterial treatment is 6-8 weeks, since during this time it is necessary to achieve the suppression of the infectious agent in the kidney and the resolution of the purulent inflammatory process in it without complications in order to prevent the formation of scar connective tissue. In the presence of chronic renal failure, the administration of nephrotoxic antibacterial drugs should be carried out under the constant control of their pharmacokinetics (blood concentration and urine). With a decrease in the indices of humoral and cellular immunity, various drugs are used to increase immunity.

After the patient has reached the stage of remission of the disease, antibacterial treatment should be continued in intermittent courses. Terms of interruptions in antibacterial treatment are established depending on the degree of kidney damage and the time of onset of the first signs of exacerbation of the disease, i.e. the appearance of symptoms of the latent phase of the inflammatory process.

Antibiotics

Medicines are selected individually, taking into account the sensitivity of microflora to them. The most commonly prescribed antibiotics for pyelonephritis are:

  • penicillins with clavulanic acid;
  • cephalosporins 2 and 3 generations;
  • fluoroquinolones.

Aminoglycosides are undesirable because of their nephrotoxic action.

How to treat pyelonephritis folk remedies

Home treatment of pyelonephritis with folk remedies must be accompanied by bed rest and a healthy diet consisting mainly of plant foods in raw, boiled or steam form.

  1. In the period of exacerbation helps such a collection. Mix equally taken white birch leaves, herb of St. John's wort and knotweed, calendula flowers, fruits of fennel (pharmaceutical fennel dill). Pour in a thermos 300 ml of boiling water 1 tbsp. l collection, insist 1-1.5 hours, drain. Drink the infusion in the form of heat in 3-4 reception 20 minutes before meals. The course is 3-5 weeks.
  2. Outside the exacerbation of the disease, use another collection: coarse herb - 3 parts; the grass of the ash tree (deaf nettle) and the grass (straw) of the seed oats, the leaves of medicinal sage and wintergreen leaves, rosehips and licorice roots - in 2 parts. Take 2 tbsp. l collection, pour in a thermos 0.5 liters of boiling water, insist 2 hours and strain. Drink a third of a glass 4 times a day 15-20 minutes before meals. The course is 4-5 weeks, then a break for 7-10 days and repeat. Total - up to 5 courses (until stable results are obtained).

Diet

When inflammation of the kidneys is important to observe bed rest and a strict diet. Use plenty of fluids to stop dehydration, which is especially important for pregnant women and people over 65 years of age.

In inflammatory processes in the kidneys allowed: lean meat and fish, stale bread, vegetarian soups, vegetables, cereals, soft-boiled eggs, dairy products, sunflower oil. In small quantities, you can use onions, garlic, dill and parsley (dried), horseradish, fruits and berries, fruit and vegetable juices. Forbidden: meat and fish broth, smoked meat. You also need to reduce the consumption of spices and sweets.

Watch the video: Mayo Clinic Minute: Treating Urinary Tract Infections (January 2020).

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