Chronic pyelonephritis of the kidneys symptoms. How to recognize the chronic course of pyelonephritis? Medical treatment of pyelonephritis

Chronic pyelonephritis is a disease that has an infectious and inflammatory nature in which the calyxes, pelvises and tubules of the kidneys are involved in the pathological process, followed by damage to their glomeruli and blood vessels.

According to available statistics, chronic pyelonephritis among all diseases of the genitourinary organs with an inflammatory nonspecific nature is diagnosed in 60-65% of cases. Moreover, in 20-30% of cases it is a consequence of acute pyelonephritis.

Most often, the development of chronic pyelonephritis affects women and girls, which is due to the peculiarities of the structure of their urethra. As a result, it is much easier for pathogens to enter the bladder and kidneys. Two kidneys are mainly involved in the pathological process of a chronic nature, which is the difference between chronic pyelonephritis and acute. In this case, the organs may not be affected in the same way. The acute course of the disease is characterized by a sharp increase in symptoms, the rapid development of the disease. While chronic pyelonephritis can often occur latently, making itself felt only during periods of exacerbation, which are then replaced by remission.

If a complete recovery from acute pyelonephritis does not occur within three months, then it makes sense to talk about chronic pyelonephritis. Therefore, the chronic form of the disease, according to some reports, is somewhat more common than the acute form.

Symptoms of chronic pyelonephritis Causes of chronic pyelonephritis Stages of chronic pyelonephritis Complications and consequences of chronic pyelonephritis Diagnosis of chronic pyelonephritis Treatment of chronic pyelonephritis Nutrition for chronic pyelonephritis Prevention of chronic pyelonephritis

Symptoms of chronic pyelonephritis

The course of the disease and symptoms of chronic pyelonephritis largely depend on the localization of inflammation, on the degree of involvement of one or two kidneys in the pathological process, on the presence of urinary tract obstruction, and on the presence of concomitant infections.

For many years, the disease can proceed sluggishly, with involvement of the interstitial tissue of the kidney in inflammation. Symptoms are most pronounced during an exacerbation of the disease and may be almost invisible to a person during remission of pyelonephritis.

Primary pyelonephritis gives a more pronounced clinical picture than secondary. The following symptoms may indicate an exacerbation of chronic pyelonephritis:

An increase in body temperature to high values, sometimes up to 39 degrees.

The appearance of pain in the lumbar region, both on one and on both sides.

The occurrence of dysuric phenomena.

Deterioration of the general well-being of the patient.

Lack of appetite.

The occurrence of headaches.

Abdominal pain, vomiting and nausea occur more often in childhood than in adult patients.

The appearance of the patient changes somewhat. He can notice these changes on his own, or the doctor will pay attention to them during the examination. The face becomes somewhat puffy, there may be swelling of the eyelids (see also: Why do the eyelids swell?). The skin is pale, bags under the eyes are not uncommon, they are especially noticeable after sleep.

During the remission period, it is much more difficult to diagnose the disease. This is especially true of primary chronic pyelonephritis, which is characterized by a latent course.

Possible symptoms of this course of the disease are as follows:

Pain in the lumbar region is rare. They are small and not permanent. The nature of the pain is pulling or aching.

Dysuric phenomena are most often absent, and if they occur, they are very weak and proceed almost imperceptibly for the patient himself.

Body temperature, as a rule, remains normal, although in the evening it may slightly increase to 37.1 degrees.

If the disease is not diagnosed and treated for a long time, then people begin to notice increased fatigue, loss of appetite and associated weight loss, drowsiness, lethargy, and sometimes unexplained headaches. (read also: Causes, signs and symptoms of headache, consequences)

As the disease progresses, dysuric phenomena increase, the skin begins to peel off, becomes dry, its color changes to grayish-yellow.

The tongue of patients with long-term chronic pyelonephritis is coated with a dark coating, the lips and oral mucosa are dry.

In such patients arterial hypertension often joins with a pronounced increase in diastolic pressure. Nosebleeds are possible.

The advanced stages of chronic pyelonephritis are characterized by pain in the bones, polyuria with the release of up to 3 liters of urine per day, severe thirst.

Causes of chronic pyelonephritis

The cause of chronic pyelonephritis etiologically can be only one - it is damage to the kidneys of the microbial flora. However, in order for it to enter the organ and begin to actively multiply, provocative factors are needed. Most often, inflammation leads to infection with para-Escherichia or Escherichia coli, enterococci, Proteus, Pseudomonas aeruginosa, streptococci, as well as associations of microbes. Of particular importance in the development of the chronic form of the disease are L-forms of bacteria that multiply and exhibit pathogenic activity due to insufficient antimicrobial therapy, or when the acidity of urine changes. Such microorganisms are particularly resistant to drugs, are difficult to identify, can simply exist in the interstitial tissue of the kidneys for a long period of time and be active under the influence of favorable factors for them.

Most often, the development of chronic pyelonephritis is preceded by acute inflammation of the kidneys.

Additional stimulating reasons for the chronicization of the process are:

Timely unidentified and untreated causes leading to a violation of the outflow of urine. It can be urolithiasis, urinary tract strictures, prostate adenoma, nephroptosis, vesicoureteral reflux.

Violation of the terms of treatment of acute pyelonephritis, or incorrectly selected therapy. Lack of systemic dispensary control for a patient who has suffered acute inflammation.

The formation of L-bacteria and protoplasts, which can exist for a long time in the kidney tissue.

Decreased immune forces of the body. immunodeficiency states.

In childhood, the disease often develops after acute respiratory viral infections, scarlet fever, tonsillitis, pneumonia, measles, etc.

Having a chronic illness. Diabetes mellitus, obesity, tonsillitis, gastrointestinal diseases.

In women at a young age, a regular sexual life, its onset, the period of pregnancy and childbirth can become an incentive for the development of a chronic form of the disease.

A possible cause of the development of the disease is unidentified congenital malformations: bladder diverticula, ureterocele, which disrupt normal urodynamics.

Recent studies point to a significant role in the development of the disease of secondary sensitization of the body, as well as the development of autoimmune reactions.

Sometimes hypothermia of the body becomes the impetus for the development of the chronic form of the disease.

Stages of chronic pyelonephritis

There are four stages of chronic pyelonephritis:

At the first stage of the development of the disease, the glomeruli of the kidneys are intact, that is, they are not involved in the pathological process, the atrophy of the collecting ducts is uniform.

At the second stage of the development of the disease, some glomeruli hyalinize and become empty, the vessels undergo obliteration and narrow significantly. Growing cicatricial-sclerotic changes in the tubules and interstitial tissue.

At the third stage of the development of the disease, the death of most of the glomeruli occurs, the tubules strongly atrophy, the interstitial and connective tissue continues to grow.

At the fourth stage of development of chronic pyelonephritis, most of the glomeruli die, the kidney becomes smaller in size, its tissues are replaced by scar tissue. The organ looks like a small wrinkled substrate with a bumpy surface.

Complications and consequences of chronic pyelonephritis

Possible consequences of chronic pyelonephritis may be secondary wrinkling of the kidney, or pyonephrosis. Pyonephrosis is a disease that develops at the final stage of purulent pyelonephritis. In childhood, such an outcome of the disease is extremely rare, it is more typical for people aged 30 to 50 years.

Complications of chronic pyelonephritis can be as follows:

Acute renal failure. This condition, which can be reversed, comes on suddenly, is characterized by a pronounced impairment or complete cessation of the functioning of the kidney.

Chronic renal failure. This condition is a gradual extinction of the work of the body against the background of pyelonephritis, caused by the death of nephrons.

Paranephritis. This complication is a process of purulent inflammation of the located perirenal tissue.

Necrotic papillitis. This is a serious complication that most often occurs in inpatient urological patients, predominantly in women. Accompanied by renal colic, hematuria, pyuria and other serious body disorders (fever, arterial hypertension). May end in kidney failure. (read also: Causes and symptoms of kidney failure)

Urosepsis. One of the most severe complications of the disease in which the infection from the kidney spreads throughout the body. This condition carries a direct threat to the life of the patient and often ends in death.

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Diagnosis of chronic pyelonephritis

Diagnosis of chronic pyelonephritis should be comprehensive. To make a diagnosis, the results of laboratory and instrumental studies will be required.

Doctors refer patients for the following laboratory tests:

UAC. The chronic course of the disease will be indicated by anemia, an increase in the number of leukocytes, a shift in the blood formula to the left, as well as an increased erythrocyte sedimentation rate.

OAM. According to the results of the analysis, an alkaline environment will be revealed. Urine is cloudy, its density is reduced. The presence of cylinders is possible, bacteriuria is sometimes determined, the number of leukocytes is increased.

The Nechiporenko test will reveal the predominance of leukocytes over erythrocytes, in addition, active leukocytes will be detected in the urine.

Performing a prednisolone and pyrogenal test, when prednisolone is administered to the test subject and several portions of urine are collected at certain intervals.

The Zimnitsky test will reveal a decrease in density in various portions of urine that are collected throughout the day.

The LHC will detect an increased amount of sialic acids, seromucoid, fibrin, urea.

In addition, to confirm the diagnosis and study the state of the organ, it is necessary to perform some instrumental examinations, the choice of which remains with the doctor:

Performing an overview x-ray examination of the kidney area. In the chronic course of the disease, the kidneys will be reduced in size (either, both, or one).

Performing chromocytoscopy. If there is chronic pyelonephritis, then the doctor will note a violation of the excretory function of the kidneys - one or two-sided.

Performing excretory or retrograde pyelography will allow you to detect existing deformities and pathological changes in the calyces and pelvis of the organs.

Ultrasound of the kidneys allows you to detect the asymmetry of organs, their deformation, heterogeneity.

Radioisotope scanning also reveals asymmetry of the kidneys and their diffuse changes.

Detailed structural changes in the organ can be detected by such highly informative studies as CT and MRI.

Renal biopsy and biopsy examination are performed in clinically unclear cases of the disease.

It is important to exclude diseases such as renal amyloidosis, chronic glomerulonephritis, hypertension, diabetic glomerulosclerosis, which can give a similar clinical picture.

Treatment of chronic pyelonephritis

Treatment of chronic pyelonephritis cannot be complete without an individual approach to the patient and without comprehensive measures aimed at his recovery. It includes following a diet and drinking regimen, taking medications, as well as eliminating causes that may interfere with the normal flow of urine.

In the stage of exacerbation of chronic pyelonephritis, the patient should be placed for treatment and observation in a hospital. With primary pyelonephritis, patients are assigned to a therapeutic or specialized nephrological department, and with a secondary one, to a urological department.

The duration of bed rest directly depends on the severity of the course of the disease and on the effectiveness of the treatment. Diet is an indispensable aspect of the complex treatment of chronic pyelonephritis.

Edema, as a rule, does not occur in such patients, so their drinking regimen should not be limited. Priority drinks are ordinary water, fortified drinks, cranberry juice, juices, compotes, jelly. The volume of fluid entering the body during the day can be equal to 2000 ml. A decrease in its amount is possible according to the doctor's indications, in the presence of arterial hypertension, in case of violations of the passage of urine. In this case, salt intake is limited, up to its complete elimination.

The decisive moment in the treatment of chronic pyelonephritis is the appointment of antibiotics. They are prescribed as early as possible and for a long time after the sensitivity of bacterial agents to specific drugs that have been sown from the urine has been established. The effect will not be achieved if antibiotics are prescribed too late, for a short time, or if there are any obstacles to the normal passage of urine.

If the disease is diagnosed at a late stage, then even high doses of antimicrobials are often not effective enough. In addition, against the background of existing disorders in the functioning of the kidneys, there is a risk of developing severe side effects even from the most effective drugs. The likelihood of developing resistance also increases many times over.

For the treatment of chronic pyelonephritis, the following drugs are used:

Semi-synthetic penicillins - Oxacillin, Ampicillin, Amoxiclav, Sultamicillin.

Cephalosporins - Kefzol, Ceporin, Ceftriaxone, Cefepime, Cefixime, Cefotaxime, etc.

Nalidixic acid - Negram, Nevigramone.

Aminoglycosides are used in severe cases of the disease - Kanamycin, Gentamicin, Colimycin, Tobramycin, Amikacin.

Fluoroquinolones: Levofloxacin, Ofloxacin, Ciprinol, Moxifloxacin, etc.

Nitrofurans - Furazolidone, Furadonin.

Sulfonamides - Urosulfan, Etazol, etc.

Antioxidant therapy comes down to taking Tocopherol, Ascorbic acid, Retinol, Selenium, etc.

Before choosing one or another antibacterial drug, the doctor should familiarize himself with the acidity of the urine of patients, as it affects the effectiveness of drugs.

Antibiotics during an exacerbation of the disease are prescribed for up to 8 weeks. The specific duration of therapy will be determined by the results of the laboratory tests performed. If the patient's condition is severe, then combinations of antibacterial agents are prescribed to him, they are administered parenterally or intravenously and in large doses. One of the most effective modern uroseptics is the drug 5-NOC.

Self-medication is strictly prohibited, although there are many drugs for the treatment of pyelonephritis. This disease is exclusively in the competence of specialists.

The success of the treatment can be judged by the following criteria:

Absence of dysuric phenomena;

Normalization of blood and urine parameters;

Normalization of body temperature;

The disappearance of leukocyturia, bacteriuria, proteinuria.

However, despite the successful treatment of chronic pyelonephritis, a relapse of the disease is possible, which will occur with a probability of 60% to 80%. Therefore, doctors conduct many months of anti-relapse therapy, which is quite justified in the chronic process of inflammation of the kidneys.

If allergic reactions occur during treatment, then it is necessary to perform antihistamine therapy, which comes down to taking drugs such as: Tavegil, pipolfen, Suprastin, Diazolin, etc.

When anemia is detected by blood tests, patients are prescribed iron supplements, taking vitamin B12, and folic acid.

In addition, patients are shown sanatorium treatment in balneo-drinking sanatoriums.

On the subject: Effective treatment of pyelonephritis with folk remedies

Nutrition for chronic pyelonephritis

Proper nutrition in chronic pyelonephritis is a prerequisite for complete treatment. It provides for the exclusion from the diet of spicy dishes, all rich broths, various seasonings to enhance the taste, as well as strong coffee and alcohol.

The calorie content of food should not be underestimated; an adult needs to consume up to 2500 kcal per day. The diet should be balanced in terms of the amount of proteins, fats and carbohydrates and have the maximum set of vitamins.

Optimal for chronic pyelonephritis is considered a vegetable-milk diet with the addition of meat and fish dishes.

It is necessary to include a variety of vegetables in the daily diet: potatoes, zucchini, beets, cabbage, as well as various fruits. Eggs, dairy products and milk itself must be present on the table.

With iron deficiency, you need to eat more apples, strawberries, pomegranates. At any stage of chronic pyelonephritis, the diet should be enriched with watermelons, melons, cucumbers, pumpkin. These products have a diuretic effect and allow you to quickly cope with the disease.

Read more: what foods are allowed and prohibited in chronic pyelonephritis

Prevention of chronic pyelonephritis

Prevention of patients with pyelonephritis is reduced to the timely and thorough treatment of patients at the stage of acute pyelonephritis. Such patients should be registered in the dispensary.

There are recommendations for the employment of patients with chronic pyelonephritis: patients are not recommended to work in enterprises that require hard physical labor, contributing to being in constant nervous tension. It is important to avoid hypothermia in the workplace and outside it, you should avoid working on your feet and at night, work in hot shops is excluded.

You should follow a diet with salt restriction as recommended by doctors.

The success of preventive measures in secondary pyelonephritis depends on the complete elimination of the cause that led to the development of the disease. It is important to remove any obstacles to the normal outflow of urine without fail.

It is important to identify and treat hidden foci of infection and intercurrent diseases.

After discharge from the hospital, patients must be registered with the dispensary for a period of at least one year. If after this time bacteriuria, leukocyturia and proteinuria are not detected, then the patient is removed from the register. If signs of the disease persist, then the follow-up period for such patients should be extended to three years.

If primary pyelonephritis is detected in patients, then the treatment is long-term, with periodic placement in a hospital.

No less important is the correction of immunity and maintaining it in good condition. For this, it is necessary to maintain a healthy lifestyle, a long stay in the fresh air, dosed physical activity according to the doctor's indications.

Staying in sanatorium-resort institutions of a specialized profile allows you to reduce the number of exacerbations of the disease.

Special attention deserves the prevention of the disease in pregnant women and children, as well as in patients with weakened immune systems.

With a latent course of the disease, patients do not lose their ability to work for a long time. Other forms of pyelonephritis can have a significant impact on a person's performance, as there is a threat of rapid complications.

Causes Symptoms Diagnosis Course of the disease Treatment Prevention

Chronic pyelonephritis is a chronic non-specific inflammation of the interstitial tissue of the kidney, leading to damage to the mucous membrane of the pelvis, renal vessels and parenchyma.

Chronic pyelonephritis, as a rule, becomes a consequence of an acute one. In some cases, patients do not remember the attacks of acute pyelonephritis, since it can proceed latently, i.e. asymptomatic. An acute process can turn into a chronic one due to a number of reasons:

violation of the outflow of urine due to the presence of stones or narrowing of the urinary tract; vesicoureteral or ureteropelvic reflux of urine; inflammatory diseases of closely located organs (urethritis, cystitis, prostatitis, appendicitis, enterocolitis); general diseases (immune deficiency, diabetes, obesity); chronic intoxication (smoking, alcohol abuse, occupational hazards); untimely or inadequate therapy of acute pyelonephritis.

Chronic pyelonephritis is usually bilateral, but the degree of kidney damage varies. More often the disease affects women.

Etiology

The cause of pyelonephritis are bacteria:

coli, staphylococcus, streptococcus, proteus, Pseudomonas aeruginosa, enterococcus, microbial associations.

In the occurrence of chronic pyelonephritis, L-forms of bacteria play a certain role, which can persist in the body for a long time and enter the kidneys with blood.

pathological anatomy

In chronic pyelonephritis, the kidneys decrease in size, their surface becomes bumpy. In the interstitium, leukocyte infiltration is observed with damage to the tubules of the kidneys. In the later stages of the disease, the kidneys shrivel, during the same period interstitial necrosis occurs. Morphological changes develop in the direction from the pelvis to the cortex.

Type of kidney in chronic pyelonephritis

Clinic

With chronic pyelonephritis, the symptoms are quite diverse. The inflammatory process in the kidneys may resemble other diseases along the course.

Forms of chronic pyelonephritis:

latent, anemic, hypertonic, azotemichesky, recurrent.

The latent form of the disease is characterized by minor clinical manifestations. The patient may be disturbed by general weakness, fatigue, headache, sometimes the temperature may rise slightly. As a rule, lower back pain, edema and dysuria are absent, although some have a positive Pasternatsky symptom (pain when tapping in the lumbar region).

In the general analysis of urine, a slight proteinuria is detected, leukocytes and bacteria can be excreted in the urine periodically. With a latent course, the concentration ability of the kidneys is usually impaired, therefore, a decrease in urine density and polyuria are characteristic. Sometimes you can find moderate anemia and a slight increase in blood pressure.

The anemic form of pyelonephritis is characterized by a predominance of anemic symptoms in the clinic: shortness of breath, weakness, fatigue, pallor, pain in the heart. Urine changes are scanty and inconsistent.

In the hypertensive form, arterial hypertension predominates in the clinic. There are headache, dizziness, sleep disturbance, stabbing pains in the projection of the heart, frequent hypertensive crises, shortness of breath. Changes in the urine are not very pronounced and are not permanent. Hypertension in pyelonephritis is often malignant.

Azotemic form is considered chronic pyelonephritis, which began to manifest itself only at the stage of chronic renal failure. The further development of latent pyelonephritis, which was not diagnosed in a timely manner, can be attributed to the azothemic form.

The recurrent form of pyelonephritis is characterized by a change in periods of exacerbation and remission. The patient may be disturbed by discomfort in the lower back, chills, fever. Dysuric phenomena appear (frequent urination, sometimes painful).

Exacerbation of chronic pyelonephritis clinically resembles a picture of acute inflammation. As the process progresses, the leading syndrome becomes hypertensive, which is manifested by headache, dizziness, visual impairment, pain in the heart. Sometimes, as a result of long-term pyelonephritis, an anemic syndrome develops. The outcome of the disease is chronic renal failure.

Changes in urinalysis during an exacerbation are as follows:

proteinuria (up to 1-2 g of protein can be excreted per day), leukocyturia, cylindruria, microhematuria, bacteriuria.

In the blood test - anemia, an increase in the content of leukocytes, an increase in ESR.

Diagnosis and differential diagnosis

Clinical diagnosis of chronic pyelonephritis has some difficulties due to the variety of clinical manifestations and, in many cases, the latent course of the disease. The diagnosis is usually made taking into account the history, characteristic clinical picture and the results of laboratory and instrumental studies. The following diagnostic methods are usually used:

urinalysis (leukocyturia, sometimes erythrocyturia, proteinuria, decrease in urine density); complete blood count (anemia, neutrophilic leukocytosis, increased ESR); study of urinary sediment (Addis-Kakovsky test); quantitative determination of cells according to Shtenheimer-Malbin; bacteriological examination of urine; biochemical blood test with the determination of the level of residual nitrogen, creatinine and urea; determination of the content of electrolytes in the blood and urine; X-ray examination of the kidneys (change in the size of the kidneys, deformation of the cups and pelvis, violation of the tone of the urinary tract); radioisotope renography (the functional state of the left and right kidneys is determined separately); kidney biopsy (process activity, inflammatory infiltration, degree of damage to the kidney tissue).

Kidney biopsy

To diagnose the disease, retrograde and intravenous pyelography, scannography and renography are used. To identify unilateral chronic pyelonephritis, ureteral catheterization is performed and the presence of protein, blood cells in the urinary sediment is determined.

It should be said that even with an asymptomatic, latent course of pyelonephritis, a detailed questioning of complaints and anamnesis often reveals signs of the development of the disease. For example, patients may be disturbed by "causeless" chills that periodically occur over many months or even years.

Another important symptom is nocturia (more urine is excreted at night than during the daytime), especially if it is not associated with an increase in fluid intake and has been bothering you for a long time. Nocturia indicates a violation of the concentration ability of the kidneys.

Tip: if you find these symptoms in yourself, you should not leave them unattended. It is necessary to consult a doctor in order not to miss the development of chronic pyelonephritis and start treatment in a timely manner.

Chronic pyelonephritis of the kidneys should be differentiated from the following diseases:

kidney amyloidosis, chronic glomerulonephritis, kidney damage in hypertension, diabetic glomerulosclerosis.

Renal amyloidosis characterized by the presence in the body of chronic foci of infection, the scarcity of urinary sediment, the absence of bacteria in the urine and radiological signs characteristic of pyelonephritis.

Chronic glomerulonephritis differs in the predominance of erythrocytes in the urinary sediment, the absence of "active" leukocytes and bacteria.

Hypertonic disease more common in the elderly, occurs with hypertensive crises and severe sclerotic changes in the brain, coronary vessels and aorta. Also, patients do not have changes in urine and blood characteristic of pyelonephritis.

For diabetic glomerulosclerosis characterized by a history of diabetes mellitus and the presence of other manifestations of angiopathy (trophic ulcers on the legs, retinopathy, etc.). In the most difficult cases, a histological examination of kidney biopsies is performed.

The course of chronic pyelonephritis

Chr. pyelonephritis, as a rule, proceeds for a long time (15 years or more) and eventually leads to wrinkling of the kidneys. This disease is characterized by uneven wrinkling and the formation of rough scars on the surface of the kidneys. In cases where the process is one-sided, compensatory hypertrophy of a healthy kidney and its hyperfunction are observed.

With the defeat of both kidneys in the final stage of pyelonephritis, chronic renal failure appears. First, the concentration function of the kidneys decreases and polyuria occurs, and then the filtration capacity is also disturbed. This leads to a delay in the body of nitrogenous slags and uremia.

In chronic pyelonephritis, uremia develops slowly, as a result of treatment it is well amenable to reverse development.

Forecast

For latent flowing chronic pyelonephritis is characterized by long-term preservation of the ability to work of patients. This cannot be said about the hypertensive form, which occurs with high arterial hypertension, with its malignant course, patients lose their ability to work. A serious prognosis also occurs with the azotemia form of the disease. Recently, the prognosis has improved significantly due to the introduction of modern methods of treating pyelonephritis.

Treatment

Treatment of chronic pyelonephritis includes a sparing regimen, diet and drug therapy. Patients should avoid hypothermia and colds. Any infectious diseases that occur against the background of pyelonephritis require adequate therapy and monitoring of urine tests.

Diet

In all forms and stages of the disease, an important place in therapy is the observance of a certain diet. It is necessary to exclude spicy dishes and spices, coffee, alcoholic drinks, meat and fish broths from the diet. At the same time, food should be fortified and high in calories. You can eat almost all fruits and vegetables, especially those containing a lot of potassium, as well as eggs, boiled lean meat and fish, milk and dairy products.

Diet for pyelonephritis

In addition, it is necessary to drink a sufficient amount of fluid (about 1.5 - 2 liters per day) to prevent excessive concentration of urine and to flush the urinary tract. It is very useful to drink cranberry juice, which contains natural antibacterial substances. During the period of exacerbation of the disease, fluid intake, on the contrary, should be reduced, since the outflow of urine is disturbed. Also, during an exacerbation and with a hypertensive form of pyelonephritis, it is necessary to limit table salt to 2-4 g per day.

In the anemic form of the disease, foods containing a lot of iron and cobalt (strawberries, strawberries, pomegranates, apples) are included in food. Also, in almost all forms of pyelonephritis, it is recommended to use grapes, watermelon, melons, which have a diuretic effect.

Medical treatment

It should be noted that drug therapy can be effective only if an unhindered outflow of urine is ensured. Of the drugs, antibacterial agents are usually used (antibiotics, sulfonamides, uroseptics). Antimicrobial treatment is prescribed taking into account the sensitivity of the microorganisms that caused inflammation. In the case of chronic pyelonephritis, treatment is long-term; a combination of antibacterial drugs with different mechanisms of action is usually used. Antibacterial treatment should be continued until the complete elimination of leukocyturia and urine sterilization.

When the exacerbation subsides, anti-relapse treatment is carried out, which consists in long-term, many months of use of minimal doses of antimicrobial agents with a periodic change of drugs. Along with drug treatment, phytotherapy is important. A good effect is observed when using decoctions and infusions of various plants that have a diuretic, anti-inflammatory and antibacterial effect. Usually they use juniper berries, horsetail grass, bearberry leaf, kidney tea.

Important: herbal medicine cannot replace medical treatment. Decoctions and infusions can improve the effect of antibacterial or diuretic drugs. Their use must be agreed with the doctor.

Vitamin therapy is of no small importance. During antibiotic treatment, the appointment of antihistamines and anti-inflammatory drugs is justified. In the hypertensive form of pyelonephritis, antihypertensive and antispasmodic drugs are widely used. Anemia resulting from the disease is difficult to treat. To eliminate it, iron preparations and vitamins are prescribed.

In some cases, resort to nephrectomy. The operation is indicated for advanced chronic unilateral pyelonephritis, which is not amenable to therapy, as well as for wrinkling of one kidney, complicated by severe arterial hypertension. For the treatment of developing uremia, an appropriate diet with protein and salt restriction is prescribed. Peritoneal dialysis or hemodialysis is performed. If kidney function is significantly reduced, then the issue of transferring the patient to chronic hemodialysis is decided.

Prevention

The main direction of prevention of chronic pyelonephritis is the elimination of possible causes:

timely diagnosis and active treatment of acute infections of the genitourinary tract (urethritis, cystitis, acute pyelonephritis, adnexitis); rehabilitation of chronic infectious foci (chronic appendicitis, tonsillitis); elimination of local changes in the urinary tract that can disrupt urodynamics (treatment of urolithiasis, elimination of strictures and kinks of the ureters); normalization of the immune status to improve the anti-infective defense of the body.

Almost every third elderly person has changes characteristic of chronic pyelonephritis. At the same time, the disease is diagnosed much more often in women, starting from childhood and adolescence, and ending with the menopause period.

It should be understood that chronic pyelonephritis rarely gives severe symptoms characteristic of kidney disease. Therefore, the diagnosis is difficult, but the consequences are quite serious.

Chronic pyelonephritis: what is it?

Pyelonephritis means inflammation of the renal pelvis. And, if acute inflammation cannot be overlooked - a high temperature rises, severe back pain occurs, pronounced changes in the urine are recorded - then chronic pyelonephritis most often develops gradually.

In this case, structural changes occur in the renal tubules and pelvis, which are aggravated over time. Only in a third of cases, chronic pyelonephritis is due to improperly treated acute inflammation. The diagnosis of chronic pyelonephritis is made when there are characteristic changes in the urine and symptoms for more than 3 months.

The cause of inflammation is a nonspecific pathogenic microflora: proteus, staphylococci and streptococci, E. coli, etc. Often several types of microbes are sown at once. Pathogenic microflora has a unique chance of survival: it has developed resistance to antibiotics, is difficult to identify under microscopic examination, can go unnoticed for a long time and is activated only after a provoking effect.

The factors that activate the inflammatory process in the kidneys in women include:

• Congenital pathology - bladder diverticula, vesicoureteral reflux, urethrocele;
• Acquired diseases of the urinary system - cystitis / urethritis, nephrolithiasis, nephroptosis and, in fact, untreated acute pyelonephritis;
• Gynecological pathology - non-specific vulvovaginitis (thrush, bacterial vaginosis, reproduction in the vagina of Escherichia coli, etc.), sexual infections (gonorrhea, trichomoniasis);
• Intimate sphere of a woman - the beginning of sexual contacts, active sex life, pregnancy and childbirth;
• Concomitant diseases - diabetes mellitus, chronic pathology of the gastrointestinal tract, obesity;
• Immunodeficiency - frequent diseases of angina, influenza, bronchitis, otitis media, sinusitis, not excluding HIV;
• Elementary hypothermia - habit of washing feet in cold water, inappropriate clothing in cold weather, etc.

Important! Recent studies have shown the dependence of the development of chronic pyelonephritis with an inadequate immune response. Sensitization to one's own tissues activates an autoimmune attack on one's own kidney cells.

Stages of chronic pyelonephritis

With chronic inflammation, a gradual degeneration of the renal tissues occurs. Depending on the nature of structural changes, four stages of chronic pyelonephritis are distinguished:

1. I - atrophy of the tubular mucosa and the formation of infiltrates in the interstitial tissue of the kidneys;
2. II - sclerotic foci form in the tubules and interstitial tissue, and the renal glomeruli become empty;
3. III - large-scale atrophic and sclerotic changes, large foci of connective tissue are formed, renal glomeruli practically do not function;
4. IV - the death of most of the glomeruli, almost all of the renal tissue is replaced by connective tissue.

The larger the irreversible changes, the more severe the symptoms of kidney failure.

Chronic pyelonephritis is characterized by an undulating course. Periods of deterioration are replaced by remission and give the patient a false sense of complete recovery. However, most often chronic inflammation proceeds erased, without bright exacerbations.

Symptoms of chronic pyelonephritis in women with a latent course of the disease are lethargy, headache, fatigue, loss of appetite, periodic temperature rises to 37.2-37.5ºС. In comparison with acute inflammation, in chronic pyelonephritis the pain is not very pronounced - a weak symptom of Pasternatsky (pain when tapping in the lumbar region).

Changes in the urine are also not informative: a small amount of protein and leukocytes is often associated with cystitis or eating salty foods. The same explains the periodic increase in the number of urination, a slight increase in pressure and anemia. The appearance of the patient also changes: dark circles under the eyes clearly appear on the pale skin of the face (especially in the morning), the face is puffy, hands and feet often swell.

Exacerbation of the chronic form

With recurrent pyelonephritis against the background of poor symptoms - malaise, slight hyperthermia, mild back pain, increased urination (especially at night) - suddenly, after a provocative effect, a picture of acute pyelonephritis develops. High temperature up to 40.0-42ºС, severe intoxication, severe lumbar pain of a pulling or pulsating nature are accompanied by vivid changes in the urine - proteinuria (protein in the urine), leukocyturia, bacteriuria and rarely hematuria.

Progressive replacement of the renal tissue with connective tissue leads to a decrease in kidney function, up to the development of renal failure. Toxins and decay products enter the bloodstream and poison the entire body.

In this case, the further development of chronic pyelonephritis can proceed according to the following scenarios:

• Urinary syndrome - signs of urination disorders come to the fore in the symptomatic picture. Frequent nightly trips to the toilet are associated with the inability of the kidneys to concentrate urine. Sometimes when emptying the bladder, pain occurs. The patient complains of heaviness and frequent pain in the lower back, swelling.
• The hypertensive form of the disease - severe arterial hypertension is difficult to respond to traditional therapy with antihypertensive drugs. Often patients complain of shortness of breath, heart pain, dizziness and insomnia, hypertensive crises are not uncommon.
• Anemic syndrome - a violation of the functionality of the kidneys leads to the rapid destruction of red blood cells in the blood. With hypochromic anemia due to kidney damage, blood pressure does not reach high levels, urination is scanty or periodically increases.
• Azotemic variant of the course - the absence of painful symptoms leads to the fact that the disease is diagnosed only with the development of chronic renal failure. Laboratory tests that detect signs of uremia help confirm the diagnosis.

Differences between chronic pyelonephritis and acute inflammation

Acute and chronic pyelonephritis differ at all levels, from the nature of structural changes to the symptoms and treatment of women. In order to accurately diagnose the disease, it is necessary to know the signs characteristic of chronic pyelonephritis:

1. Both kidneys are more often affected;
2. Chronic inflammation leads to irreversible changes in the kidney tissue;
3. The beginning is gradual, extended in time;
4. The asymptomatic course can last for years;
5. The absence of pronounced symptoms, in the foreground - intoxication of the body (headache, weakness, etc.);
6. In the period of remission or in the latent course, the urinalysis changed slightly: the protein in the general analysis is not more than 1 g / l, the Zimnitsky test reveals a decrease in beats. Weight less than 1018;
7. Hypotensive and antianemic drugs are not very effective;
8. Taking traditional antibiotics only reduces inflammation;
9. The gradual decline in renal function leads to renal failure.

Often, chronic pyelonephritis is diagnosed only with instrumental examination. When visualizing (ultrasound, pyelography, CT) of the kidney, the doctor discovers a diverse picture: active and fading foci of inflammation, connective tissue inclusions, deformity of the renal pelvis. In the initial stages, the kidney is enlarged and looks lumpy due to infiltration.

In the future, the affected organ shrinks, large inclusions of connective tissue protrude above its surface. In acute pyelonephritis, instrumental diagnostics will show the same type of inflammation.

Possible complications: what is the danger of chronic pyelonephritis?

The absence of pronounced symptoms in chronic pyelonephritis is the reason for the late visit of women to the doctor. Antibiotics that are effective in the treatment of acute pyelonephritis will only slightly reduce inflammation in the chronic form of the disease. This is due to the high resistance of microflora to conventional antibacterial agents. Without adequate therapy, the chronic form of pyelonephritis leads to the development of chronic renal failure: a little slower with a latent course and faster with frequent exacerbations.

Possible consequences:

• pyonephrosis - purulent fusion of renal tissue;
• paranephritis - a purulent process extends to the perirenal tissue;
• necrotic papillitis - necrosis of the renal papillae - a severe condition accompanied by renal colic;
• wrinkling of the kidney, "wandering" kidney;
• acute renal failure;
• stroke by hemorrhagic or ischemic type;
• progressive heart failure;
• urosepsis.

All these conditions pose a serious threat to a woman's life. It is possible to prevent their development only with complex therapy.

Illness during pregnancy

The double load on the kidneys of a pregnant woman leads to inflammation. At the same time, the impact of impaired renal function in a future mother can lead to miscarriage, fading of pregnancy, the formation of developmental anomalies in the fetus, premature birth and stillbirth. Doctors distinguish three degrees of risk associated with pyelonephritis:

• I - pyelonephritis first appeared during pregnancy, the course of the disease without complications;
• II - chronic pyelonephritis was diagnosed before pregnancy;
• III - chronic pyelonephritis, occurring with anemia, hypertension.

An exacerbation of the disease can occur 2-3 times during the gestation period. At the same time, every time a woman is hospitalized without fail. I-II degree of risk allows you to carry a pregnancy. A pregnant woman’s card is labeled “chronic pyelonephritis”, a woman more often than the usual schedule (depending on the duration of pregnancy) takes tests and undergoes ultrasound. Even with the slightest deviation, the expectant mother is registered for inpatient treatment.

III degree of risk - a direct indication for termination of pregnancy.

Struck photo, photo

Only an integrated approach to the treatment of chronic pyelonephritis will prevent the progression of the pathological process and avoid renal failure. How to treat chronic pyelonephritis:

• Gentle regimen and diet

First of all, provoking moments (colds, hypothermia) should be avoided. Food must be complete. Coffee, alcohol, carbonated drinks, spicy and salty dishes, fish / meat broths, marinades (contain vinegar) are excluded. The diet is based on vegetables, dairy products and boiled meat / fish dishes.

Not recommended citrus fruits: Vit. C irritates the kidneys. During exacerbations and pronounced changes in the analyzes, salt is completely excluded. In the absence of hypertension and edema, it is recommended to drink up to 3 liters of water in order to reduce intoxication.

• Antibiotic therapy

To select an effective drug, it is necessary to do a urine culture (it is better during an exacerbation, the pathogen may not be detected during remission) and conduct antibiotic sensitivity tests. Taking into account the results of the analysis, the most effective drugs are prescribed: Ciprofloxacin, Levofloxacin, Cefepime, Cefotaxime, Amoxicillin, Nefigramon, Urosulfan. Nitroxoline (5-NOC) is well tolerated, but not very effective, often prescribed for pregnant women.

Furadonin, furazolidone, Furamag have a pronounced toxic effect and are poorly tolerated. Palin, effective in renal inflammation, is contraindicated in pregnancy. Treatment of chronic pyelonephritis lasts at least 1 year. Antibacterial courses continue for 6-8 weeks. and are periodically repeated.

• Symptomatic therapy

In hypertensive syndrome, antihypertensive drugs are prescribed (enalapril and other ACE inhibitors, as well as combined drugs with hypothiazide), and antispasmodics that enhance their effect (No-shpa). If anemia is detected, Ferroplex, Ferrovit forte and other iron-containing tablets are prescribed.

It is also necessary to compensate for the lack of folic acid, vit. A and E, B12. Vit. C is allowed to be taken outside the exacerbation period.

To improve blood circulation in the kidneys, the nephrologist prescribes antiplatelet agents (Kurantil, Parsadil, Trental). With severe symptoms of intoxication, intravenous infusions of Regidron, Glucosolan are prescribed. In the presence of edema, diuretics are prescribed at the same time (Lasix, Veroshpiron). Uremia and severe renal failure require hemodialysis. With complete kidney failure, a nephrectomy is performed.

• Physiotherapy

Drug treatment of a sluggish current chronic process in the kidneys is enhanced by physiotherapeutic procedures. Electrophoresis, UHF, modulated (SMT-therapy) and galvanic currents are especially effective. Outside the period of exacerbation, sanatorium treatment is recommended. Sodium chloride baths, mineral water and other physiotherapy significantly improve the condition of patients.

With a latent course of chronic pyelonephritis and complex treatment of the disease, women do not lose their quality of life. Frequent exacerbations leading to kidney failure lead to disability and pose a serious threat to life.

Chronic pyelonephritis is an infectious and inflammatory disease that affects the calyces, pelvis and tubules of the kidneys. It is a consequence of the acute form of the disease. Treatment of chronic pyelonephritis is aimed at eliminating the cause of the disease and symptomatic relief of the patient's condition.

Therapy provides for several directions of treatment, which as a result will lead to remission and the absence of an early relapse. This is the destruction of infectious agents, the normalization of urination, the increase in the patient's immunity, the elimination of chronic foci of infections.

In the treatment, natural defense mechanisms are also important, which make themselves felt from the first stages of the disease.

• Increased diuresis. This is a mechanical washing of the urinary tract, which helps to remove pathogenic bacteria. In this regard, it is recommended to drink plenty of water.
• Increases in urine acidity. This is a natural defense against the spread and development of bacteria, since in an acidic environment their growth and reproduction is inhibited.

If these mechanisms fail, then the infection intensifies. Treatment is aimed at maintaining such processes, and not at their violation.

To date, it is quite difficult to cure chronic pyelonephritis completely, because it is impossible to completely suppress the infection in the kidney.

Approach to therapy

In order for the treatment of chronic pyelonephritis to be successful, experts advise to correctly draw up a patient regimen. It depends on the degree of the disease, the phase that is currently taking place, the symptoms, the degree of intoxication. In some cases, hospitalization is necessary:

• Uncorrected hypertension.
• Diuresis disorder.
• The need for functional diagnostics of the urinary organs.
• An obvious acute form of the disease.

At any stage of the development of the disease, strong physical exertion and hypothermia are excluded. If the patient's condition is assessed as stable and there are no sharp jumps in blood pressure, the kidneys are functioning normally, then no restrictions are imposed.

In the severe phase of exacerbation, bed rest is recommended. With an uncontrolled increase in blood pressure and limit the patient's motor activity. By the time the exacerbation subsides, the symptoms of intoxication disappear, the pressure returns to normal, and the regimen is relaxed.

The patient's diet plays an important role. Its volume and content depend on the presence or absence of BP jumps. For patients without edema and severe hypertension, a diet is chosen that differs little from the daily one. It includes products containing fiber, vitamin complexes, such as combinations of vitamins of group B, potassium, vitamin C. The presence of dairy and meat products, fruits is mandatory. The restriction applies only to condiments and spicy dishes.

The anti-inflammatory effect is provided by increased diuresis. It is recommended to drink up to 3 liters of liquid per day, which includes juices, fruit drinks, decoctions, mineral water. Preference is given to juices that have an antiseptic effect. Restrictions are imposed only when urinary function is impaired or sharp increases in blood pressure are observed. The consumption of juices in the phase of exacerbation of chronic pyelonephritis is severely limited. Natural diuretics are also recommended.

Treatment

Before treating chronic pyelonephritis, it is important to understand what the treatment of this disease is.

Therapy of chronic pyelonephritis is a set of measures aimed at normalizing the rate of passage of urine through the urethra, antibacterial treatment and normalizing blood circulation in the kidney.

With difficult diuresis, surgery may be indicated to normalize the passage of urine. This may be removal, prostate surgery, etc. If the causes of such a violation are not eliminated, then it will not be possible to cure the exacerbation and achieve a stable and long-term remission.

Antibacterial drugs for chronic pyelonephritis is the most important stage at all stages and variants of the disease. When choosing a medicine, all previous therapies, the type of bacteria and its sensitivity to antibiotics are taken into account. The effectiveness of drugs in acidic urine also plays an important role.

Antimicrobial drugs to which the pathogens of chronic pyelonephritis are sensitive are called uroantiseptics.

Therapy is carried out from the initial acute stage and is guided by the following rules:

1. The bacterial microflora is sensitive to the drug of choice.
2. Dosing is carried out taking into account the functional state of the kidneys.
3. Nephrotoxicity is taken into account.
4. If there is no effect for several days, then the medication is replaced.
5. With a strong severity of the infectious process and symptoms of intoxication, combined therapy with uroantiseptic agents is prescribed.

Antibiotics for chronic pyelonephritis

With pyelonephritis, groups of drugs are used:

Penicillins

• Benzylpenicillin.
• Oxacillin.
• Ampicillin.
• Amoxicillin.
• Amoxicillin + clavulanic acid.

Broad-spectrum antibiotics, excellent for an unknown etiology of the disease. These drugs are effective against gram-negative bacteria, most of the gram-positive pathogens. But staphylococcus, which produces penicillinase (enzyme), neutralizes their action. To eliminate such opposition, combinations of penicillins with beta-lactamase inhibitors are used. For example, Augmentin.

Cephalosporins

• Cefuroxime.
• Cefotaxime.
• Ceftazidime.
• Ceftriaxone.
• Cefazolin.

Broad-spectrum antibiotics that are very effective. Unfortunately, when enterococci are affected, such drugs have almost no therapeutic effect.

Aminoglycosides

• Gentamicin.
• Amikacin.

Strong bactericidal drugs with a wide spectrum of action. When prescribing, their nephrotoxicity is taken into account.

Lincosamines

• Lincomycin.
• Clindamycin.

Strong bacteriostatic antibiotics that are effective against streptococci, staphylococci, but gram-negative bacteria and enterococci are not treated.

Gram-negative strains, Pseudomonas aeruginosa, chlamydia do not show sensitivity to them, therefore, antibiotics are prescribed less frequently.

Quinolone derivatives

There are 2 generations.

1 generation:

• Nalidixic acid.
• Oxolinic acid.
• pipemidic acid.

2 generation:

• Ciprofloxacin.
• Norfloxacin.
• Ofloxacin.
• Pefloxacin.

Nalidixic acid is ineffective against gram-positive microorganisms, Pseudomonas aeruginosa. Pipemidic acid is suitable for the treatment of Staphylococcus aureus. Renal failure and impaired renal function are complete contraindications to the use of this group.

Antibiotics fluoroquinolones are effective against various types of bacteria, but are not very effective against enterococci and chlamydia. Often, ciprofloxacin becomes the drug of choice, as it surpasses many other antibacterial drugs in terms of the strength of its antimicrobial action.

Nitrofurans

This is a group of broad spectrum agents. These drugs fight gram-positive and gram-negative infections, but are not effective against anaerobic strains.

Furadonin is concentrated in the urine in high quantities, in the blood the indicators are much lower. It copes well with the chronic form of the disease, and is ineffective in the acute course.

Furagin is concentrated in the urine in smaller amounts than furadonin.

This group of drugs can be perfectly combined with antibiotics.

Individual drugs:

• Levomycetin

Bacteriostatic antimicrobial drug of choice for lesions of gram-positive, gram-negative, aerobes, anaerobes, chlamydia and mycoplasmas. Pseudomonas aeruginosa shows resistance to its action.

• Fosfomycin

A broad-spectrum drug that is excreted in the urine unchanged. This indicates its high effectiveness in the treatment of this disease.

Nitroxoline has a high concentration in the urine, which provides a strong therapeutic efficacy.

Urine pH influences the choice of drug for treatment. An acidic reaction enhances the effectiveness of penicillins, tetracyclines. The alkaline reaction enhances the properties of erythromycin, lincomycin, aminoglycosides. There are also environmentally independent antibiotics. For example, chloramphenicol.

Medicines are dosed taking into account the phase of pyelonephritis and are used for long courses, which eliminates the action of the pathogen in the kidney and urinary tract. Kus therapy may be extended depending on the tests and the general condition of the patient.

Folk remedies

How to cure chronic pyelonephritis with folk remedies? Phytotherapy is effective for preventing relapses and maintaining a normal state during remission, as well as in combination with the main treatment in the acute phase.

• To achieve an anti-inflammatory effect, they make a choice in favor of fees, where there are birch leaves, willow bark, elderberry.
• Anesthetic, decongestant, antiseptic effect is achieved by collections containing raspberry, birch, fireweed, burdock, chamomile, elderberry, lingonberry and bearberry.
• To enhance diuresis, horsetail, nettle, ammi tooth, goldenrod are suitable.

Cooking method: boil 2 tablespoons of raw materials in a liter of water for 20 minutes. Drink a quarter cup up to 4 times.

Conclusion

The answer to the question of whether chronic pyelonephritis can be cured is ambiguous. Unfortunately, at this stage in the development of medicine, it is very difficult to completely remove the infection from the body due to the presence of chronic foci. Chronic pyelonephritis in the treatment is complicated and it is not so easy to choose the right set of measures to stop the acute phase until complete remission. It all depends on the attending physician, who analyzes each case with its features individually.

With a properly formed course of treatment and subsequent procedures during the period of remission, the patient has every chance to forget about exacerbations and their painful symptoms forever.

Chronic pyelonephritis is an inflammatory disease of the pyelocaliceal structure of the kidneys, resulting from an untreated acute process. Among all renal pathology, the proportion of this disease reaches 15%. It is logical to assume that there should be fewer cases of chronic pyelonephritis than acute forms. In fact, it turns out the opposite.

Either this is due to low accessibility for medical care, or a rapid transition immediately into a chronic course (primarily chronic) is possible. The problem does not have the support of all researchers, but is actively studied.

What causes chronic inflammation of the kidneys?

In the development of long-term inflammation, infection always plays a decisive role. But the chronic process in the kidneys requires additional negative conditions:

• obstructed outflow of urine or disturbance of its movement;
• fall of the body's defenses (immunity).

Role of infection

The most common infectious agents are microorganisms living in the intestines of a healthy person. These include bacteria:

• enterococci,
• coli,
• klebsiella,
• Proteus,
• Staphylococcus aureus,
• Pseudomonas aeruginosa.

For chronic pyelonephritis in children, sources of infection from old foci with tonsillitis, dental caries, and constantly inflamed adenoids are important. In adults, chronic foci are still hidden in the genitals (adnexitis in women, prostatitis in men), paranasal sinuses, intestines, and gallbladder.

Much less likely to cause inflammation are:

• viruses (including herpes, adenoviruses, parainfluenza, enteroviruses);
• mushrooms of the genus Candida,
• mycoplasmas,
• chlamydia.

E. coli causes almost half of the cases of kidney inflammation. The microbe has especially contagious properties in the form of specific O- and K-antigens to the renal epithelium.

Intestinal bacteria cling to the villi and move throughout the urinary system, causing chronic pyelonephritis

Klebsiella also contain K-antigen, produce toxins that can damage the smooth muscles of the urinary organs, cause paralysis and impaired urine flow.

Proteus works by changing the acidity of the urine. It can break down urea to ammonia, thereby increasing alkalization and damage to the epithelium. Usually accompanies malformations of the urinary organs, general dysbacteriosis.

Pseudomonas aeruginosa has a capsular form that phagocytes cannot destroy.

Staphylococci also inhibit the local defense reaction and accumulate in the urine. Such microorganisms are called uropathogenic, since they have specific properties of damage and survival, are able to resist phagocytosis, the action of interferon, compliment, lysozyme.

Significance of Impaired Urinary Progression

Microorganisms enter the kidney:

• through blood vessels (hematogenous route) from distant foci;
• along the lymphatic vessels from neighboring organs and lymph nodes (lymphogenic), most often from the intestines and genitals;
• against the flow of urine along the epithelium of the urinary tract from the urethra, bladder, ureters (urinogenic).

The most favorable conditions for the reproduction of bacteria are created during dysbacteriosis. Pathogenic microorganisms begin to multiply actively.

Getting into the blood and lymph, they are unevenly entered into one kidney or both, so the process can be one-sided or two-sided.

The easiest way to get an infection into the kidneys is urinogenic

Partial paralysis of the smooth muscles of the urinary tract leads to stagnation of urine and increased pressure in the renal pelvis and ureters. This phenomenon forms the mechanism of reflux or reflux of urine against its usual direction.

There are 3 types of reflux:

• pelvic-renal,
• ureteropelvic,
• vesicoureteral.

The latter is of greatest importance in kidney infection. Thanks to him, the infection enters from the lower tract into the pelvis, calyx and interstitial tissue. The diagnosis of pyelonephritis associated with reflux is important in the correct organization of the patient's treatment.

Urologists consider reflux not only as a mechanism for the development of pyelonephritis, but also as an independent disease.

Chronic pyelonephritis in children occurs due to hereditary changes in metabolism, renal tissue (tubulopathy), underdevelopment of the necessary renal structures.

Why does an acute process become chronic?

The causes of chronic pyelonephritis can be considered:

• untimely diagnosis and treatment of diseases that violate the outflow of urine (urolithiasis, nephroptosis, vesicoureteral reflux, congenital anomalies of narrowing of the urinary tract, prostate adenoma);
• poor-quality treatment of an acute form of pyelonephritis, non-compliance by the patient with the clinical recommendations of a doctor, disruption of dispensary observation of a child or adult;
• the ability of some pathogens to form L-forms, which can be in the kidney tissue for a long time in an inactive state, but cause an exacerbation with a decrease in protective forces or immunodeficiency states;
• the presence of concomitant chronic diseases that undermine the body's immunity, or are constant foci of infection (obesity, diabetes, sinusitis, tonsillitis, diseases of the gallbladder, intestines, pancreas).

There is no standard risk group for chronic pyelonephritis, but practitioners believe that the infection is most dangerous for:

• children under three years of age, predominantly bottle-fed;
• girls during the onset of sexual activity;
• pregnant women;
• people in old age.

These patients are most indicated for the prevention of chronic pyelonephritis.

The mechanism of the development of the disease

Inflammation begins in the pelvis, then moves to the cups and interstitial tissue with renal tubules. First, the distal sections are infiltrated, swell and undergo atrophy, then the proximal ones are affected. The renal parenchyma is replaced by scar tissue.

Changes in the glomeruli are formed only at a late severe stage of the course of the disease. First, endarteritis develops in the vessels with the growth of the middle layer. Then the arterioles are sclerosed. The filtration function of the kidneys is impaired. Renal blood flow drops, as a result, blood pressure rises.

Characteristic anatomical and morphological changes

With inflammation in one kidney, it differs from a healthy one in a much smaller size due to multiple scars and adhesions. The mass of the affected organ reaches 40-60 g. The surface is covered with large dense bumps. The fibrous capsule is thickened.

Calyces and pelvis in chronic pyelonephritis do not have enlarged cavities with thickened walls and sclerotic mucosa

Foci of healthy tissue are visible, the zone of infiltration and scarring surrounding them. Inflammation has a different prescription, determined by relapses.

The process of damage to the glomeruli and tubules is slow. The kidneys first lose the ability to concentrate urine, so a low specific gravity is determined in the analyzes. The outcome is more favorable compared to chronic glomerulonephritis, which is accompanied by damage to the glomeruli from the initial stage of the disease.

The inflammatory process goes through 3 stages of development:

• Stage I - leukocytes infiltrate the medulla, causing atrophy of the tubules, but the glomeruli are not affected.
• Stage II - cicatricial and sclerotic changes in the interstitium and tubules increase, the distal nephrons die, and the collecting ducts are compressed. Due to the expansion of the cortical sections of the tubules and overflow with protein masses, the structure begins to resemble thyroid tissue. Fibrous tissue develops around the glomeruli, which causes their desolation. Vessels are narrowed or completely closed.
• III final stage- almost all renal tissue is replaced by scar tissue, the organ looks like a wrinkled kidney.

Existing classifications

There is no single classification of chronic pyelonephritis. In different countries, urologists use their own practical recommendations. According to ICD-10, the disease code accepted for statistical registration is N11. The types and names of forms of chronic pyelonephritis are determined by the relationship with various factors.

Depending on the presence of predisposing diseases and the causes of organic kidney damage, there are:

• primary chronic form - no causes have been identified, inflammation develops in previously healthy kidneys, more often it is bilateral;
• secondary chronic pyelonephritis - the disease is a complication or a negative consequence of the existing pathology of the urinary tract, at first it has a one-sided character, then the damage to the second kidney is added.

• out-of-hospital;
• nosocomial - at the onset of the disease after two days of stay in the hospital.

This attitude is important for the organization of treatment, since nosocomial pathogens are highly resistant to antibiotics. In addition, the identification of nosocomial infection makes it possible to identify shortcomings in the organization of the nursing process of patient care.

Depending on the localization of inflammation and the coverage of the kidneys, there are:

• unilateral process;
• bilateral (observed more often).

The clinical course suggests differences in the period of exacerbation and remission:

• inflammation is considered latent (50–60% of cases of chronic pyelonephritis) in the absence of typical symptoms, but abnormalities are found in the tests, manifestations such as increased weakness, chilling, a slight increase in temperature in the evening are possible;
• active inflammation should be confirmed by symptoms of pyelonephritis and laboratory parameters;
• the stage of remission is determined by the normalization of well-being, the elimination of pathology after treatment.

In the absence of exacerbations for five years, recovery can be judged, the diagnosis of chronic pyelonephritis is removed.

Depending on the severity of the disease, pyelonephritis is distinguished:

• uncomplicated;
• complicated - includes all cases of the disease occurring against the background of other renal and non-renal pathologies that arose after urological procedures and manipulations (cystoscopy, catheterization of the bladder), particular importance is attached to the presence of immunodeficiency states (HIV, diabetes mellitus).

Chronic pyelonephritis with renal insufficiency is taken into account separately.

Practice shows that the most frequently complicated forms are determined in men.

Depending on extrarenal disorders, there are forms:

• with secondary reno-parenchymal hypertension;
• with anemia.

According to the nature of morphological changes, variants of the disease with:

• minimal damage;
• interstitial-cellular nature of inflammation:
• infiltrative course;
• sclerosing stage;
• interstitial-tubular lesion;
• interstitial-vascular variant of vascular changes;
• mixed character;
• sclerosis and shriveled kidney.

Depending on the connection with refluxes and the ways in which the infection is likely to enter the kidneys, it is customary to distinguish between:

• non-obstructive pyelonephritis- occurs against the background of previously unidentified and not eliminated reflux of urine from the underlying urinary level;
• obstructive - occurs after a previous and missed acute illness, against the background of another renal pathology, symptoms of severe concomitant diseases, while a violation of the passage of urine also occurs, but its origin is secondary.

Symptoms and clinical course

The clinical picture of chronic pyelonephritis depends on:

• stages and forms of inflammation;
• damage to one or both kidneys;
• existing obstruction to the outflow of urine;
• concomitant diseases;
• effectiveness of previous treatment.

Often chronic pyelonephritis begins in childhood with acute attacks that go unnoticed during other infectious lesions (tonsillitis, influenza, pneumonia, otitis media, enterocolitis). Similar masking diseases simultaneously affect the kidneys. Girls are more inclined towards them.

With the latent course of pyelonephritis, pain is not permanent.

If therapy is not sustained or prescribed incorrectly, the child develops chronic pyelonephritis and proceeds in waves: the active phase is replaced by remission.

With a latent course, there are no symptoms. Less pronounced signs of kidney damage in the primary disease. Patients retrospectively recall:

• intermittent mild back pain;
• rare cramps when urinating;
• sometimes a slight increase in temperature.

Each new exacerbation manifests itself as acute pyelonephritis. The most typical symptoms are:

• an increase in body temperature up to 39 degrees;
• lower back pain on one or both sides;
• cramps when urinating;
• increased urge to urinate;
• headache;
• general weakness;
• children often have vomiting, nausea, abdominal pain.

Medical examination shows:

• swelling of the eyelids, puffiness of the face;
• pallor;
• pain when tapped on the lower back.

A long period of the disease leads to the occurrence in patients:

• severe fatigue;
• reduced work capacity;
• weight loss;
• poor appetite;
• drowsiness;
• headaches;
• dry with a grayish skin tone;
• permanent swelling on the eyelids.

Arterial hypertension appears, which is persistent and differs from true hypertension by an increase in diastolic pressure.

Severe edema is not characteristic of chronic pyelonephritis. In the later stages, polyuria occurs (copious urine output).

The diagnosis is made on the basis of the study of symptoms and clinical signs in laboratory diagnostics.

Meaning are:

• in the blood test: leukocytosis, ESR acceleration, protein decrease, nitrogenous waste growth, decrease in potassium, sodium and chlorine;
• in urine: a large number of leukocytes, bacteria, low specific gravity, the appearance of protein;
• in order to study the concentration ability of the kidneys, a Zimnitsky test is performed;
• according to the test of Nechiporenko and Addis-Kakovsky, the massiveness of bacterial damage to the kidneys is judged.

Microscopic examination of the urine sediment shows large white salt crystals and rod-shaped bacteria, which can be the cause of the chronic course of pyelonephritis.

• Ultrasound, which allows to identify the size of the kidneys and their structures, the presence of additional organic lesions, anomalies;
• contrast x-ray study to study the outflow tract of urine, to identify the shadows of calculi, reflux options.

In difficult cases, they resort to a puncture biopsy of the kidneys with a detailed analysis of the histological structure.

Treatment

Treatment of chronic pyelonephritis during an exacerbation is carried out in a hospital. Refer patients based on the cause of the inflammation:

• with primary pyelonephritis - in the therapeutic department;
• at secondary - in urological.

Surgery may be needed to correct reflux and obstruction of the urinary tract.

The treatment plan is developed individually.

It must include:

• bed rest;
• dietary requirements;
• antibacterial and anti-inflammatory drugs;
• compensation for loss of protein, electrolytes;
• restoration of immunity for independent fight against infection;
• vitamin therapy.

Diet Features

Patients with chronic inflammation of the kidneys are prescribed a diet with a sufficient content of energy and plastic materials, vitamins. Most shown:

• vegetable dishes (from potatoes, cabbage, carrots, beets);
• fresh fruits and juices (apples, figs, apricots);
• milk, cottage cheese, kefir;
• eggs;
• lean meat and fish.

Fruits and vegetables contain a sufficient amount of vitamins and help to cope with the disease faster.

Contraindications apply to:

• hot spices;
• fatty foods;
• rich broths;
• strong coffee;
• alcohol.

The absence of edema allows you to drink enough juices, compotes, fruit drinks, decoctions of herbs, mineral water. The doctor will warn about fluid restriction if the patient has high blood pressure or has a difficult outflow of urine. At the same time strictly approach the use of salt.

For the purpose of diuretic effect appoint:

• watermelon,
• melon,
• pumpkin.

They wash away the infection from the urinary tract.

Of the antibacterial drugs, the most significant are:

• antibiotics after determining the sensitivity of the flora;
• a group of nitrofurans;
• sulfonamides.

Antibiotics have to be changed, combined. The total duration of anti-inflammatory treatment is up to 8 weeks.

We can talk about the effectiveness of the applied treatment if the temperature returned to normal, pain and dysuric phenomena disappeared, there is no pathology in the blood and urine tests.

With such long-term treatment, medicinal herbs have a good supporting and bacteriostatic effect. Urologists recommend preparing and taking decoctions for a long time from:

• cranberries,
• wild rose,
• horsetail,
• juniper berries,
• birch and lingonberry leaves,
• celandine stems.

Juniper berries are a natural phytoncide, contribute to the destruction of pathogenic microorganisms

With long courses of antibiotics, antifungal drugs and vitamins are required.

Renal pressure is treated with the selection of antihypertensive drugs.

Anemia shows:

• vitamin B 12,
• folic acid,
• hormonal anabolics,
• in severe cases - transfusion of erythrocyte mass.

In secondary pyelonephritis with impaired urine passage, treatment is futile without surgery to remove:

• stones (urolithiasis);
• prostate adenoma, squeezing the urethra;
• bladder tumors.

Sanatorium-and-spa treatment is most indicated taking into account natural sources of mineral waters. Before you go, you should consult your doctor.

Prevention

For the prevention of chronic pyelonephritis, it is necessary to control the cure of the acute form of the disease. In order not to miss and adequately treat patients, it is necessary:

• parents and pediatricians to monitor the urine and blood tests of the child after childhood infections, colds;
• girls and women especially carefully monitor the condition of the intestines, genital organs, check urine tests after suffering angina, flu;
• persons of any gender are required to sanitize their teeth, nasopharynx, maxillary sinuses, biliary tract, they can provoke the spread of infection to the kidneys;
• for men, it is important to undergo an examination with rectal palpation of the prostate gland; in the early stages, prostatitis and adenoma are treated with drugs.

It should always be remembered that today's girl will soon grow up and want to give birth to healthy offspring. .

People of working age may need employment. After an exacerbation, it is necessary to visit a doctor at least twice a year. At the same time, all control tests (blood, urine, according to Zimnitsky and Nechiporenko, protein fractions) should be passed, if necessary - ultrasound and X-ray examination.

Signs of kidney failure, high blood pressure require checking the fundus, monitoring the accumulation of nitrogenous substances (creatinine, residual nitrogen, urea).

Persistent hypertension is dangerous for its complications (stroke, myocardial infarction). Therefore, the patient has to constantly take antihypertensive drugs.

Attitude towards military service

Conscripts and their parents are concerned about the question: do they take young people with chronic pyelonephritis into the army. If there are indications in the medical documents about the transferred acute or chronic pyelonephritis, the conscript is sent for examination to a specialized urological department. Here, the excretory and other functions of the kidneys, the duration of bacteriuria in the urine, ultrasound and X-ray examinations are necessarily checked. If necessary, conduct a course of treatment.

Depending on the results of the discharge, the young man may be recognized by the medical commission:

• exempt from conscription;
• limited fit;
• fit for military service.

Chronic pyelonephritis differs from other diseases in its latent course, so patients do not go to the doctor for a long time. You can only prevent it by controlling your health and protecting yourself from any infection.

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 human bloodstream (this can be Escherichia 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;
• alcohol.

• dairy products;
• 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 condition of a patient with a diagnosis of "acute pyelonephritis", antispasmodics ("Drotaverin", "No-Shpa", "Spasmalgon") are prescribed. In the course of direct treatment of inflammation of the kidneys, specialists conduct a number 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 ingredients in these cephalosporins break down the cell walls of the bacteria that cause pyelonephritis (kidney disease) and kill them, restoring 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 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 therapeutic 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 infection 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!