In nephrologic practice, kidney disease -pyelonephritis - is a fairly common disease. This nonspecific disease is more infectious, spreading to the renal parenchyma, interstitium and pelvis of the organ. At the beginning and the current distinguish between chronic and acute pyelonephritis. In the pathological process, one kidney or both can be involved. Also, the disease can develop as an independent (primary) disease or proceed against the background of existing diseases of excretory organs.
Causes of the disease
The main microorganisms causingdisease, are E. coli, staphylococcus or streptococcus, protaeus. In most patients with chronic form of pyelonephritis, the flora is mixed. The infection occurs in an ascending way (on the ureters), as well as with blood. Acute pyelonephritis can occur with stasis of urine, with stones in the pelvis of the kidneys, in the presence of concomitant diseases and weakened immunity. Very often the attack of the disease is preceded by hidden nephritis.
Acute pyelonephritis is interstitial, serous and purulent. A serious complication is the formation of carbuncle and the transition to apostematous nephritis.
Clinical manifestations of the disease
The disease has a sharp, sudden onset.There is a prolongation, body temperature rises high figures (40 ° C), the patient sweats heavily, complains of pain in the area of the projection of the kidneys, thirst. Tension of the abdominal muscles from the side with which there is damage to the kidney and severe pain during palpation in the costal-vertebral corner can also be noted. Frequent violations of urination, a decrease in the volume of excreted urine, it can be with an admixture of pus or blood. Due to severe intoxication, vomiting occurs. When examining the patient, there is a positive symptom of effleurage (Pasternatsky). Renal failure may occur.
Diagnosis of the disease
The diagnosis "Acute pyelonephritis" is put onthe basis of characteristic complaints, examination and laboratory diagnosis data. The patient may indicate a recent purulent infection or the presence of chronic inflammatory diseases in the body. Acute pyelonephritis can provoke hypothermia, in women chronic diseases of the genital organs, in men the presence of prostatic hyperplasia with a violation of the outflow of urine. A characteristic feature of pyelonephritis is the presence of urinary disorders, clouding of the urine or the presence of blood in it, with severe low back pain and high fever. However, it should be remembered that changing the composition of urine can be a reaction to other inflammatory diseases.
In the analysis of urine, you can see a huge number of white blood cells, an increase in erythrocytes and the presence of bacteria. In the urine, the protein rises slightly.
При ультразвуковом исследовании почек, пораженный the organ is enlarged in size, its mobility during breathing is sharply limited. Parenchyma of the kidney edematous. In rare and severe cases, an abscess or carbuncle of the kidney can be seen on sonograms that require surgical intervention.
Treatment of acute pyelonephritis
Больной с пиелонефритом подлежит госпитализации в nephrologic or therapeutic department of the hospital. Assign table number 7. It is recommended to drink a large amount of liquid, at least three liters per day. Pain relief is prescribed for analgesic drugs and antispasmodics. Obligatory drugs in the treatment is antibiotic therapy. In the initial period of the disease, antibiotics of a wide spectrum are administered, and after isolation of the pathogen, an antibacterial drug acting against this microorganism. Infusion therapy is performed to remove intoxication, disaggregants, uroseptics are prescribed. An effective auxiliary method of treatment is phytotherapy.
