Pyelonephritis

Description:

Pyelonephritis is an acute or chronic disease of kidneys with the infectious and inflammatory nature of damage, with disturbance of renal structure and function of an urinary system.

Pyelonephritis is a widespread disease and statistically makes up to 70% of cases among all diseases of an urinary system.  At pyelonephritis only one kidney is surprised. Owing to anatomic features thanks to which the easy way of the ascending infection from a bladder on urinary channels is possible women are ill more often than men.
Pyelonephritis combines pathological process in a pelvis (pyelitis) both renal cups and tissue of a kidney.
On character of a current pyelonephritis can be acute or chronic

Pyelonephritis reasons:

Pyelonephritis has an infectious etiology, and when determining the activator colibacillus, staphylococcus most often is defined, is slightly more rare – a pyocyanic stick. Development of a disease requires presence of provocative factors. It was revealed that pyelonephritis develops against the background of the accompanying pathology more often (first of all a diabetes mellitus), decrease in the immune status, and nonspecific body resistance.
Pathogenic microorganisms get into a kidney in the hematogenous way when the center is in the remote area, or in the ascending way, climbing urinary channels from a bladder. The final journey can be carried out against the background of the broken outflow of urine owing to anatomic damages. Activation of L-forms of bacteria which are in the "neutralized" state can happen under the influence of the weakened immunity. Cases are frequent and at primary immunodeficiences.
The risk group on incidence of pyelonephritis is made by women from 18 to 30 years which can ache for the first time during pregnancy and after the delivery.

Pyelonephritis symptoms:

Displays of acute pyelonephritis are similar to clinical symptomatology of an aggravation of chronic process. The disease is followed by sharp rise in temperature to febrile figures, quite often temperature curve has gektichesky character, with "peaks" through a certain period. Temperature reaction is followed by oznoba, the general weakness. Patients are adynamic, attract attention the expressed puffiness and pallor of the person. Renal hypostases are localized preferential on a face, are defined as "baggies lower eyelids", but can be found also on the lower extremities. The pain syndrome has localization in a waist, most often unilateral.  The disease can be followed by dispeptic manifestations – nausea, vomiting, a loss of appetite. At it is long the proceeding process the phenomena of a renal failure which in a final stage is followed by uraemia join clinical symptomatology.
Chronic pyelonephritis in a stage of remission has no clinical проявленй, and can be found only at additional methods of inspection.

Diagnosis:

Clinical symptoms give to the doctor the chance to suspect acute or chronic pyelonephritis at the patient. For confirmation of a disease it is necessary to pass additional methods of inspection.
In the clinical analysis a shelter inflammatory reaction – a leukocytosis decides on shift of a formula to the left, increase in SOE. Results of biochemical analysis of blood will indicate a renal failure in a look (definition of urea, residual nitrogen). The general analysis of urine finds increase in leukocytes in urine up to a pyuria. At an urine bakposeva existence of the specific activator – a bacterium or the elementary is defined on a medium. The Polimerazno-chain Reaction (PCR) allows to define perhaps the etiological agent if he is an intracellular parasite, for example, of a chlamydia.

Treatment of Pyelonephritis:

Medical tactics at pyelonephritis includes the regime moments, healthy nutrition, medicamentous therapy, physiotreatment in the period of an utikhaniye of acute process.
Food at renal pathology has to be fat-free, with a minimum of table salt, acute and smoked.
Destruction of a bacterial infection requires purpose of antibacterial therapy. According to the recommendation of Evropeystky association of urologists, as choice drug at treatment of pyelonephritis  antibacterial drugs (ftorkhonolona, cephalosporins) are. They are appointed a course up to 10 days. At the complicated pyelonephritis antibacterial therapy can be prolonged up to 3 weeks. If pyelonephritis developed against the background of pregnancy (since pyelonephritis of pregnant women) ftorkhinolona are contraindicated, it is better to appoint cephalosporins of the 3rd generation. At the accompanying diabetes mellitus the long antibiotikotepiya using low dosages is justified. Carrying out dialysis is not a contraindication for prescription of antibiotics, however in this case they are appointed after holding a procedure.
Performing treatment needs to be controlled antibiotikogrammy that is connected with the high level of distribution of resistance of a bacterial infection to drugs. Today it is defined that sensitivity of golden staphylococcus to gentamycin and ciprofloxacin makes 50%, to Oxacillinum – 67%.
At pyelonephritis the protected penicillin (Amoxiclav), cephalosporins, karbapenema and aminoglycosides are recommended for use.
Except antibacterial therapy, in treatment of pyelonephritis symptomatic therapy – purpose of non-steroidal anti-inflammatory drugs, performing infusional disintoxication therapy is applied.
Fitoterpatiya and use of physiotherapy is shown out of an exacerbation of chronic pyelonephritis.