Chronic pyelonephritis remission. How to treat chronic pyelonephritis in women and men at home? Instrumental diagnostic methods

Chronic pyelonephritis is a nonspecific inflammatory process of the bacterial type that occurs in the kidneys and involves the interstitial tissue along with the pyelocaliceal complex. That is, pyelonephritis affects the entire organ, and not just some of it separate part. Malaise manifests itself as dull nagging pain in the lower back, dysuritic symptoms, weakness. Treatment of pyelonephritis in remission is aimed at maintaining normal condition organs and preventing recurrence of attacks.

How to treat chronic pyelonephritis?

The etiology of the disease must be based on the causative agent of the disease. Most often, the initiation factor is Escherichia coli, but many other causes of the disease are possible: enterobacteriaceae, staphylococci, and after identifying the main pathogen, the correct treatment is prescribed.

Important! To cure pathology, penicillins and tetracyclines are used, but in case of kidney attack by multiple microbes, broad-spectrum antibiotics are allowed. In particular, staphylococci have long been resistant to penicillins, so the doctor will select another effective medicine.

Treatment during remission is prescribed as follows:

1. Compliance with the diet. The diet of patients with pathology not burdened by high blood pressure and renal failure differs little from the diet of the average normal healthy person. It is enough to balance the protein content, slow carbohydrates and minimize fat intake. These requirements are ideally met by a vegetable-dairy diet with some tolerance lean meat, boiled or baked fish. It is useful to include fiber-rich foods: fruits, vegetables. It is good to diversify your diet with plums, apples, apricots - products that contain potassium, vitamins C, P, B. Milk and dairy products are well absorbed and complement the diet, but from hot spices, it is better to avoid spices or try to minimize them. Daily norm kcal should not be higher than 2000-3000 for a physically working adult and 1500-2500 for a person with mental work.
2. Compliance with drinking regime also required. In the absence of contraindications, it is recommended to drink at least 3 liters of liquid. Moreover, not only water, juices and soups are taken into account here, but also liquid in vegetables and fruits. Cranberry fruit drinks are useful, herbal infusions, juice-containing berries such as watermelon, pumpkin and melon - these products are excellent for removing infections from the urinary tract.
3. Urine acidifying diet- another recommendation from nephrologists. You don’t need to keep the diet for more than 2-3 days, including bread, buns, meat and eggs in the menu. After the allotted time, the diet should be changed abruptly, introducing milk, fruits, vegetables into the diet - an alkalizing diet should also not last longer than 2-3 days. A kind of “gymnastics” for the body helps prevent the development of an environment favorable to microbes and quickly get rid of them.

1. Medicinal herbs and herbal medicines will provide great benefit. A number of plants have antiseptic properties, other herbs will help eliminate the causative agent of infection, and sufficient drinking will help flush harmful elements from the kidneys.
2. Maximize your immunity, restore protective forces the body will be helped vitamin complexes, drunk twice a year. A very good treatment for chronic pyelonephritis, remission of which also requires maintenance, is tincture of ginseng or Schisandra chinensis.

Important! Regardless of the time of year, you should follow temperature regime and avoid hypothermia.

We should not forget about alternative methods treatment. Passive kidney gymnastics is a little-known but effective method. To begin with, you should administer intravenously the diuretics indicated by the doctor (Furosemide), which causes polyuria, activates the reserve capacity of the kidneys and forces the organs to work harder. After the course, a period of complete rest begins, the organs normalize functionality and return to normal operation. What matters is what it is copious discharge helps remove infection with urine and literally “washes” the kidneys, however, the method is indicated in the absence of chronic cardiovascular and many other diseases.

Important! Passive kidney exercises promote the production of antibacterial substances in the blood serum that effectively “work” in the area of ​​inflammation in terms of scar healing, which increases the rate of healing of chronic pyelonephritis.

Chronic pyelonephritis - inflammatory disease, affecting primarily the pyelocaliceal system of the kidneys. It can develop at any age, in men and women, and can be either independent disease and complications of other diseases or developmental abnormalities.

According to statistics, up to 20% of the population suffers from this disease, but experts believe that in fact its prevalence is even higher.

What clinical symptoms are typical for chronic pyelonephritis?

• Lower back pain is often mild, aching, and usually asymmetrical. It has been noticed that pain often appears not on the affected side, but on the opposite side. There may be a feeling of discomfort, heaviness in the lower back, especially when walking or long standing. Patients complain that their lower back is cold and try to dress warmer. Severe or cramping pain is more typical for urolithiasis. With a low-lying or mobile kidney, as well as in children under 10-12 years of age, pain can be localized in the abdomen.
• Temperature rise, not higher than 38 C, usually in the evening, without visible reasons.
• , especially at night.
• Increased blood pressure. During remission, this may be the only symptom.
• Deterioration of health, fatigue and weakness, more pronounced in the morning, decreased mood, headaches.
• Slight swelling of the face, hands, more in the morning, feet and legs - towards the end of the day.

Laboratory signs of chronic pyelonephritis

• Decreased hemoglobin in a general blood test.
• Triple urine tests reveal increased amount leukocytes (normally no more than 4-6 per field of view); bacteriuria more than 50-100 thousand microbial bodies in 1 ml; red blood cells (especially with urolithiasis); sometimes - protein, but not more than 1 g/l, and there are no cylinders at all.
• In Zimnitsky's sample, the specific gravity often decreases (in no single portion does it exceed 1018).
• In a biochemical blood test total protein within normal limits, albumin may decrease slightly, and when signs appear renal failure creatinine and urea increase.

Treatment of pyelonephritis

Elimination of the pathogen. For this purpose, antibiotics and uroseptics are used. The main requirements for drugs: minimal nephrotoxicity and maximum effectiveness against the most typical pathogens infections: E.coli, Proteus, Klebsiella, staphylococcus, Pseudomonas aeruginosa, etc.

It is optimal to conduct a urine culture before starting treatment to determine sensitivity to antibiotics - then the choice will become more accurate. Most often prescribed

• penicillins (amoxicillin, carbenicillin, azlocillin) - with minimal nephrotoxicity, they have wide range actions;
• 2nd and 3rd generation cephalosporins are not inferior to the first ones in terms of effectiveness, however, the bulk of the drugs are intended for injection, therefore they are used more often in hospitals, and in outpatient practice Suprax and Cedex are most often used;
• fluoroquinolones (levofloxacin, ciprofloxacin, ofloxacin, norfloxacin) are effective against most pathogens of urinary tract infections, non-toxic, but they are prohibited for use in children, pregnant and lactating women. One of the side effects is photosensitivity, so during use it is recommended to avoid visiting the solarium or going to the beach;
• sulfonamide drugs (in particular Biseptol) were used so often in our country at the end of the 20th century to treat literally any infections that now most bacteria are insensitive to them, so it should be used if culture has confirmed the sensitivity of the microorganism;
• nitrofurans (furadonin, furamag) are still very effective for pyelonephritis. However sometimes side effects- nausea, bitterness in the mouth, even vomiting - force patients to refuse treatment with them;
• hydroxyquinolines (5-Nok, nitroxoline) - usually well tolerated, but sensitivity to these drugs, unfortunately, varies Lately also decreased.

The duration of treatment for chronic pyelonephritis is at least 14 days, and if complaints and changes in urine tests persist, it can last up to a month. It is advisable to change medications once every 10 days, repeating urine cultures and taking their results into account when choosing the next medication.

Detoxification

If not high pressure And pronounced edema, it is recommended to increase the amount of fluid you drink to 3 liters per day. You can drink water, juices, fruit drinks, and at high temperatures and symptoms of intoxication - rehydron or citroglucosolan.

Phytotherapy

These folk remedies treatments for pyelonephritis are effective as an addition to antibacterial therapy, but will not replace it, and should not be used during an exacerbation period. Herbal infusions should be taken for a long time, in monthly courses after completion antibacterial treatment or during remission, for prevention. It is optimal to do this 2-3 times a year, in the autumn-spring period. Undoubtedly, herbal medicine should be abandoned if there is a tendency to allergic reactions, especially hay fever.
Examples of fees:

• Bearberry (leaf) – 3 parts, cornflower (flowers), licorice (root) – 1 part each. Brew in a ratio of 1 tablespoon per glass of boiling water, leave for 30 minutes, drink a tablespoon 3 times a day.
• Birch leaf, corn silk, horsetail 1 part each, rose hips 2 parts. Pour a tablespoon of the mixture into 2 cups of boiling water, leave for half an hour, drink half a glass 3-4 times a day.

Drugs that improve renal blood flow:

• antiplatelet agents (trental, chimes);
• drugs that improve venous outflow (escusan, troxevasin) are prescribed in courses of 10 to 20 days.

Spa treatment

It makes sense because healing effect mineral water quickly lost during bottling. Truskavets, Zheleznovodsk, Obukhovo, Kuka, Karlovy Vary - which of these (or other) balneological resorts to choose is a matter of geographical proximity and financial capabilities.

Chronic pyelonephritis develops against the background of a long-term untreated acute form of the disease and can cause the development of renal failure and disability of the patient.

Chronic pyelonephritis is an infectious-inflammatory disease characterized by involvement in pathological process, kidney tubules and damage to the glomeruli and blood vessels in the future. According to medical statistics, chronic kidney pyelonephritis is diagnosed in 60% of cases among possible infectious diseases genitourinary system and occupies a leading place as one of the reasons for the patient’s disability.

What is this disease and who is at risk?

Representatives of the weaker sex are more often susceptible to the development of chronic pyelonephritis, which is due to the structural features of their urethra - it is short and wide in women. Pathogenic microorganisms easily penetrate through urethra into the bladder, and then into the kidneys, causing an inflammatory process in them.

The main difference between acute pyelonephritis and the chronic form is that in the second case the pathological process spreads to both kidneys, whereas acute inflammation observed predominantly on one side only (more often in right kidney). The chronic form of the disease is characterized by periods of remission and exacerbation, during which the symptoms are pronounced, as with.

If in acute pyelonephritis recovery does not occur within 3 months, then the disease gradually subsides and turns into chronic form. Further, any predisposing factor will cause an exacerbation, and each exacerbation, in turn, will cause parenchymal changes in the structure of the kidneys. Gradually, changes in the structure of the organ completely disrupt its functioning, which is a direct path to kidney failure and disability.

Symptoms of chronic pyelonephritis

Symptoms of chronic pyelonephritis directly depend on the localization of the inflammatory process in the kidneys, on the degree of spread of inflammation to the organ (one or both kidneys at once), on the presence of associated complications in the form of narrowing of the lumen of the ureters or urethra. Signs of chronic pyelonephritis may not be felt at all for many years, but meanwhile the inflammation will slowly spread to all tissues and parts of the kidney.

Symptoms appear clearly during the period of exacerbation of the disease and are characterized by the following:

• high body temperature (up to 38.5-39.0 degrees);
• dull pain in the lumbar region on one side or both sides;
• various dysuric phenomena - impaired urine outflow, feeling incomplete emptying Bladder, pain and stinging at the time of urination, decreased daily diuresis;
• severe headaches and increased blood pressure;
• nausea, general weakness;
• swelling of the limbs and face;
• vomiting and symptoms general intoxication body;
• pale skin and rapid pulse.

Important! During the period of subsidence of pronounced clinical symptoms diagnosing the disease is very difficult, since pyelonephritis passes into a latent (hidden) form of the course.

During the period of remission, intermittent symptoms may appear, to which the patient does not pay attention:

• rare pains in the lumbar region of a dull, pulling nature - they intensify after exercise, consumption of salty, spicy, alcohol;
• minor dysuric phenomena - oliguria, frequent urge, discomfort when urinating;
• body temperature rises to subfebrile levels (37.0-37.4), but at the same time general state the patient is not impaired;
• frequent headaches and swelling of the face and limbs in the morning, especially after eating pickles, large amounts of liquid, or alcohol.

If the disease is not diagnosed for a long time and is not treated in any way, then the symptoms progress.

The patient develops the following symptoms:

• itching and flaking of the skin (the skin becomes yellowish or earthy);
• secondary arterial hypertension appears;
• arise frequent bleeding from the nose.

You can learn more about how pyelonephritis manifests itself in chronic form in the video in this article - the information is for informational purposes only and cannot replace consultation with a urologist.

Why does chronic pyelonephritis develop: the main reasons

The causes of chronic pyelonephritis are directly related to kidney damage pathogenic microorganisms. In order for the infection to enter directly into the kidney structure and inflammation to develop, favorable conditions are required.

Most often, the development of acute and then chronic pyelonephritis is promoted by Escherichia coli, Pseudomonas aeruginosa, Amoeba Proteus, streptococci and staphylococci. The development of a chronic pathological process in the kidneys is facilitated by microorganisms that are resistant to antibiotics and other drugs, and this happens in situations where the patient self-medicates or voluntarily stops the course of therapy prescribed by the doctor, believing that he has already recovered.

Chronic pyelonephritis is always preceded by an acute inflammatory process, and predisposing factors to the transition of the disease to chronicity are:

1. Organ diseases urinary system which are accompanied by a violation of the outflow of urine. Such pathologies include kidney prolapse, prostate adenoma in men, urolithiasis disease, narrowing of the sphincter of the bladder, cancer formations in the ureters and bladder.
2. Untreated acute inflammatory process in the kidneys or self-medication. It is strictly forbidden to arbitrarily begin a course of therapy or stop taking antibiotics prescribed by a doctor. Persons who have suffered acute pyelonephritis, must be under dispensary observation urologist for 3 months, since this critical period when the disease can silently become chronic.
3. Immunodeficiency states - weakened persons with weak immunity are more susceptible to chronic inflammatory processes than people with a good immune response.
4. Chronic pyelonephritis often develops as a complication of previous tonsillitis, ARVI, influenza, measles pneumonia, scarlet fever.
5. The presence of chronic inflammatory processes in the body - tonsillitis, sinusitis, sinusitis, gastritis and colitis. Carious neglected teeth can also be a source of spread of bacterial flora that causes inflammatory processes in the kidneys.
6. In women, a predisposing factor to the development of acute and then chronic pyelonephritis is pregnancy. On later As the fetus grows, everything in the uterus is compressed internal organs, including the bladder. Stagnation of urine and disruption of its outflow contributes to the proliferation of bacteria in the bladder, and with weakened immunity in expectant mother the risk of infection spreading to the kidneys increases.
7. Anomalies of the development of the urinary system organs - hydronephrosis of the kidney, bladder diverticula, narrowing of the lumen of the ureters. All these conditions prevent the full outflow of urine and create the preconditions for the active proliferation of microbes.
8. Severe hypothermia of the body, especially the lumbar region.

How does chronic pyelonephritis manifest: stages of the disease

Chronic inflammatory process of the kidneys develops in stages, each of which has its own clinical symptoms:

Possible complications

Is it possible to cure chronic pyelonephritis without complications? With absence timely diagnosis and therapy, this is almost impossible. A common consequence of long-term untreated chronic inflammatory process in the kidneys is pyonephrosis.

What is pyonephrosis? This purulent lesion kidney disease, which is more typical for patients over 40 years of age, a similar complication practically does not occur in children.

Other common complications of untreated chronic pyelonephritis are:

• acute renal failure– a reversible condition characterized by a sudden disruption of the kidneys or complete shutdown of the functions of the organ;
• chronic renal failure– a condition caused by the death of kidney cells and the complete cessation of organ function (such patients are tied to renal dialysis and can only live thanks to this procedure or a donor kidney transplant);
• urosepsis- a complication that often ends fatal and characterized by the spread of infection from the affected kidneys through the bloodstream throughout the body;
• purulent inflammation perirenal fiber.

Methods for diagnosing the disease

In order to give the patient accurate diagnosis and it is necessary to differentiate chronic pyelonephritis from other urinary tract diseases comprehensive examination. It includes laboratory and instrumental diagnostic methods.

Laboratory examination of the patient

A patient with suspected chronic inflammatory process of the kidneys is prescribed:

• general blood test - chronic pyelonephritis, which has not yet been treated, is characterized by anemia, increase in ESR, shift leukocyte formula to the left, with pronounced leukocytosis;
• general urine test - if treatment for chronic pyelonephritis has not yet been carried out, then a urine test will reveal alkaline environment, low density and turbidity, which is due high content bacteria and leukocytes in the material;
• – pronounced leukocytosis, active leukocytes;
• urine sample according to Zimnitsky - this study detects a decrease in urine density in various daily portions;
• biochemical blood test - reveals an increase in urea, sialic acids and seromucoid.

Instrumental diagnostic methods

The presented diagnostic methods are chosen by the attending physician and allow you to clarify the diagnosis and severity of the pathological process:

• chromocyotoscopy - a study that allows you to determine a unilateral or bilateral inflammatory process;
• Ultrasound of the kidneys - using ultrasound, the doctor assesses the size of the kidneys, the wrinkling of the organ, the presence of gross structural changes;
• retrograde pyelography is a study that allows you to diagnose existing deformations of the renal pelvis and calyces;
• CT and MRI.

If modified areas of the kidney are detected, in some cases the patient is prescribed a biopsy to clarify the diagnosis. A tissue sample is taken from the suspicious area and sent for further detailed examination in a histological laboratory. This method is highly informative for detecting kidney cancer at an early stage.

Important! When examining a patient, one should differentiate chronic pyelonephritis from renal amyloidosis, hypertension, and diabetes mellitus, since the listed pathologies may have similar clinical symptoms.

Treatment of chronic pyelonephritis

Treatment for chronic pyelonephritis is comprehensive and includes:

• regime and strict diet;
• antibacterial therapy;
• implementation of measures aimed at normalizing the outflow of urine.

How to cure chronic pyelonephritis? First of all, you need to be prepared for the fact that the therapy will be long-term, and during periods of exacerbations the patient must be hospitalized in a hospital.

Regime and diet

During the period of exacerbation of the disease, the patient must observe strict bed rest - failure to comply with this condition increases the risk of complications and renal failure. Diet food and drinking regimen are integral aspects of effective treatment.

Important! The main mistake For patients with a chronic form of pyelonephritis, there is a sharp restriction of water in the diet, but meanwhile it is not water that needs to be limited, but the amount of salt, since it is salt that provokes swelling and disrupts the outflow of urine.

Regular water is suitable for drinking pure water, including mineral slightly alkaline without gas, jelly, fruit drinks, compotes, juices, rosehip decoction. During an exacerbation of the disease, the patient can drink up to 2 liters of liquid, not counting first courses. Reducing water in the diet is advisable only with a pronounced increase in blood pressure and complications from the cardiovascular system.

To prevent edema and fluid retention in the body, you should reduce the amount table salt, and sometimes completely eliminate it for a certain period. The patient is prescribed diet No. 7 with the exception of spicy foods, pork, animal fats, herbs, spices, vinegar, smoked meats and preserves.

Proteins are limited, as they increase the load on the kidneys. The diet is dominated by dishes plant origin, vegetable stew, fresh fruits, vegetable soups, porridge (buckwheat, oatmeal, rice).

Drug treatment

If symptoms characteristic of chronic pyelonephritis are diagnosed, treatment cannot be done without antibiotics, which, unfortunately, are not always effective, especially if the pathological process is identified at an advanced complicated stage. The urologist decides how to treat each individual patient, depending on the severity of the disease.

To treat chronic inflammatory process in the kidneys, the following groups of antibiotics are used:

1. Penicillins with clavulanic acid– Amoxicillin, Amoxiclav, Flemoxin solutab. A distinctive feature of these drugs from conventional penicillins is their ability to dissolve the protective capsule of penicillin-resistant pathogens. These drugs may be prescribed in the form of injections or tablets, depending on the severity of the disease.
2. Cephalosporins– Ceftriaxone, Loraxone, Cefixime, Ceporin. Drugs in this group can sometimes be combined with aminopenicillin antibiotics for severe course inflammatory process.
3. Aminoglycosides– Gentamicin, Amikacin. Prescribed by injection in combination with cephalosporins or penicillins for complicated pyelonephritis.
4. Drugs of the nitrofuran series– Furadonin, Furazolidone. They are uroseptics and enhance the effect of antibiotics.
5. Sulfonamides- Biseptol. These drugs are combined with antibiotics; they have a bacteriostatic effect, that is, they slow down the growth and reproduction of pathogenic microorganisms.

To maintain the patient’s immune system, it is necessary to prescribe Ascorbic acid injection and vitamins A and E, which are powerful antioxidants and fight free radicals.

Important! For chronic pyelonephritis, a course of antibiotic therapy is prescribed for up to 21 days - in the first 7 days the medications are administered by injection, and if the test results improve, the patient is transferred to tablets.

About success drug therapy can be judged by the following signs:

• the outflow of urine improves and dysuric phenomena disappear;
• urine and blood tests are normalized;
• body temperature is within normal limits;
• swelling disappears and returns to normal arterial pressure.

Ancillary drugs

• for warning allergic reactions to numerous medications the patient must be prescribed antihistamines– Suprastin, Loratadine, Diazolin;
• for the treatment of anemia, which is frequent companion chronic kidney damage, prescribe iron supplements and vitamins B12 in the form of injections;
• To normalize blood pressure, drugs from the group are prescribed antihypertensive drugs– Clonidine, Reserpine, Co-prenessa.

During the period of remission, the patient is prescribed sanatorium-resort treatment.

Disease prevention

Below are instructions for actions aimed at preventing the transition of acute pyelonephritis to the chronic form of the course:

• after acute pyelonephritis, you should be registered with a urologist for at least 3 months, and in case of a complicated course - 1 year;
• after past infection avoid physical overload and hard work for six months;
• do not overcool;
• in the first six months after pyelonephritis, be sure to follow diet No. 7, give up alcohol, coffee and spices;
• Every 4 weeks during the first year after pyelonephritis, urine and blood tests should be taken - if all indicators are within normal limits, then the patient can be removed from the dispensary register.

Important! If within a year after pyelonephritis there has been a relapse of the disease at least once, then the dispensary registration is extended for 3 years with regular monitoring of tests and the patient’s condition.

To strengthen the body’s immune forces, you should sanitize all foci of chronic infection, including carious teeth, eat well, rest more, and engage in moderate physical activity.

They can be acute or chronic. Acute pyelonephritis is a disease that suddenly arose against the background healthy condition kidneys

Read about treatments for pyelonephritis, including antibiotics, physical therapy, and other ways to improve kidney function.

Primary, bilateral, segmental and other pyelonephritis

Pyelonephritis that is not associated with a previous disease of the urinary system is called primary. Accordingly, secondary pyelonephritis occurs against the background of damage to the urinary tract, for example, cystitis or urethritis.

If the disease occurs in both kidneys at once, then pyelonephritis is called bilateral. If in one kidney, then the disease is one-sided; Right- or left-sided pyelonephritis is usually indicated.

Pyelonephritis is considered segmental if the area or segment of the organ is affected, and if complete defeat Kidney pyelonephritis is called total.

Chronic pyelonephritis

The diagnosis of chronic pyelonephritis is established after three months of acute pyelonephritis without recovery or after several acute pyelonephritis that ended in recovery.

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Remission and exacerbation of chronic pyelonephritis

Chronic pyelonephritis can be in the acute phase or in the remission phase. An exacerbation is a period of activation of the inflammatory process, when there are any manifestations of the disease (pain, fever, changes in urine tests, etc.). Remission is a period of subsidence of the disease, during which there are no clinical manifestations, And normal results urine tests.

In the acute phase, the activity of the inflammatory process may vary. An active inflammatory process is indicated if urine tests show a large number of leukocytes, bacteria, active leukocytes, Sternheimer-Malbin cells are found; In the general blood test, ESR (erythrocyte sedimentation rate) is increased. The phase of the latent (hidden) inflammatory process is indicated by a slight increase in the number of leukocytes in the urine test and the absence of Sternheimer-Malbin cells; in analysis blood ESR- at the upper limit of normal.

Clinical forms of chronic pyelonephritis

There are several clinical forms chronic pyelonephritis: latent, recurrent, hypertensive, anemic, septic, hematuric and nephrotic. The division into forms is due to the fact that the symptoms of the disease are often varying degrees severity, and sometimes the forms of pyelonephritis are very similar to other diseases.

The latent form is characterized by a small number of symptoms or their weak severity. Weakness, fatigue, slight chills- these are the signs of the disease that the patient complains about. Sometimes nocturia (urination) is a concern more at night than during the day), unexpressed pain in the lower back, which can be mistaken for osteochondrosis. This often makes it difficult to make a correct diagnosis.

The relapsing form is an alternation of periods of exacerbations and remissions. In the acute phase there is usually a classic clinical picture chronic pyelonephritis. Sometimes the symptoms are so pronounced that they can be mistaken for acute pyelonephritis; progression of chronic renal failure (CRF) is possible. After a course of treatment, the manifestations of the disease gradually subside, tests become normal - the remission phase begins.

In the hypertensive form of chronic pyelonephritis, the symptom comes to the fore arterial hypertension(high blood pressure). Changes in urine may be slight and inconsistent.

The anemic form of the disease is diagnosed if the patient's symptoms are dominated by anemia, caused by intoxication and impaired synthesis of erythropoietin, which controls the maturation of red blood cells. Severe anemia often occurs with the development of chronic renal failure. Deviations in urine tests are small, sometimes they may be normal.

With severe exacerbation of chronic pyelonephritis, a septic form of the disease may develop. She is accompanied high temperature bodies, stunning chills, serious condition sick. There are a very large number of leukocytes in the urine, and bacteria are often found in the blood.

The hematuric form of chronic pyelonephritis is quite rare. Here the content of a large number of red blood cells in the urine (macrohematuria) comes to the fore. There can be many causes of hematuria, so a thorough examination of the patient is necessary to exclude others. possible diseases(for example, tuberculosis or malignant tumor kidneys). Only after other diseases are not confirmed can a diagnosis of the hematuric form of chronic pyelonephritis be made.

The nephrotic form of the disease is also rare. A urine test reveals a large amount of protein, a blood test shows a decreased level of albumin (a type of protein) and an increased level of lipids (fats), and the patient may also experience swelling.

Chronic pyelonephritis is quite common. With this pathology, nonspecific inflammatory processes occur, caused by various bacteria. As a result they suffer pelvis, calyces and renal parenchyma. Most often, inflammation occurs due to the activity of E. coli or staphylococci. From this article you will learn answers to questions about what chronic pyelonephritis is, how, and what are the signs of chronic pyelonephritis.

Symptoms of the disease

Very often, patients have an asymptomatic course of the disease. Inflammation may not make itself felt long years, slowly affecting the kidneys before symptoms of chronic pyelonephritis begin to appear. Chronic pyelonephritis of the kidneys manifests itself with symptoms only during the period of exacerbation.

If you have been diagnosed with chronic pyelonephritis, then the symptoms and treatment largely depend on how the disease manifests itself and where exactly the disease is localized, as well as on the presence of other infectious pathogens.

During the period of exacerbation of chronic pyelonephritis, a picture is observed general inflammation. Patients notice elevated temperature body, reaching up to 39 degrees. Appear painful sensations in the lumbar region, and the localization of pain depends on which kidney is affected by the disease (often both suffer from chronic pyelonephritis, which causes pain on both sides of the lumbar region).

When pyelonephritis appears, patients often complain of bad feeling, loss of appetite and headache. The presence of pyelonephritis can also be determined by appearance patient: the face becomes slightly swollen, the eyelids may swell, the skin becomes pale and bags under the eyes are often observed.

When remission occurs (a period of illness during which there is a significant weakening of symptoms or their complete disappearance), it is quite difficult to determine the presence of chronic pyelonephritis in a patient based on symptoms. Unlike the period of exacerbation, when the kidneys are affected, chronic pyelonephritis during the “lull” may not bother the patient at all, but in some cases there are following symptoms: rare and minor pain sensations (pulling or It's a dull pain) in the lumbar region, a slight increase in body temperature (especially before bedtime), dry mouth and dark coating on the tongue, pale and dry skin, high blood pressure. If sick for a long time suffers from chronic pyelonephritis and does not consult a doctor, he is often bothered by excessive fatigue, loss of appetite and subsequent weight loss, and causeless headaches. In some cases there is periodic nose bleed. For advanced stages The disease is characterized by bone pain, frequent urination and excessive thirst.

If you experience one or more of the above symptoms, you should immediately seek help from a highly qualified specialist in order to begin treatment on time and prevent subsequent complications.

Causes of the disease

They lie in the pathogens that penetrate into excretory system humans, – various microorganisms ( coli, staphylococci, streptococci, enterococci and other microorganisms). After the pathogens enter the body for one reason or another, they begin the reproduction stage. Often, before the disease begins, acute inflammation of the kidneys occurs.

The causes of chronic pyelonephritis can also be various undiagnosed kidney diseases. In children, the disease often appears after infections such as influenza, sore throat, and measles. This disease Young girls who started regular sexual activity early are susceptible. Patients suffering from diabetes, obesity and diseases gastrointestinal tract, are also included in the risk group.

A special factor contributing to the onset of the disease is weakened the immune system, which can occur due to hypothermia of the body, especially from hypothermia in the kidney area.

Stages of the disease

For a disease such as chronic pyelonephritis, the stages are as follows:

Stage 1 – atrophy of the collecting ducts of the kidneys. The branches of the segmental arteries decrease in number.

Stage 2 – significant vasoconstriction occurs, some glomeruli become empty.

Stage 3 is characterized by severe tubular atrophy, many renal glomeruli are dying.

Stage 4 is characterized by intense damage to the glomeruli, a decrease in size and drying out of the kidney.

List of consequences of the disease

The development of pyonephrosis is a consequence of chronic pyelonephritis. Complications after suffering pyelonephritis occur mainly in people after thirty years of age. The consequence may be the presence of acute renal failure, expressed by disturbances in the functioning of the kidneys, and sometimes even total loss functional capacity of the organ, the presence of paranephritis (purulent inflammation), the presence of necrotizing papillitis (most often this complication, during which renal colic, hematuria and other serious disorders, women are susceptible to), the presence of urosepsis (is perhaps the most serious complication, during which a kidney infection affects the entire body, which almost always ends in death).

Diagnostics

Diagnosing the disease is quite difficult. This is due to the fact that its manifestations can be varied, and it can often occur in latent form. To make a diagnosis of chronic pyelonephritis, a specialist relies on the patient’s complaints and additional instrumental and laboratory tests. Diagnostics must be comprehensive.

In a row laboratory research includes: general tests urine and blood, prednisolone and pyrogenal tests (during the test the patient is injected with a drug, and after a while a series of urine samples are taken for analysis), the Sternheimer-Malbin test to determine the quantitative content of cells, bacteriological research urine and biochemical analysis blood, test for the content of electrolytes in the blood and urine.

A number of instrumental studies include: X-ray, thanks to which you can determine the size of the kidneys (with chronic pyelonephritis, the kidneys decrease); carrying out radioisotope renography, through which the functional abilities of each kidney are determined separately; performing a kidney biopsy, which allows you to determine the extent to which the kidneys are affected; chromocystoscopy, which allows you to determine how correctly the excretory function of the kidneys works; carrying out ultrasound examination kidney

It should also be noted that for precise setting A diagnosis is often enough for the doctor to ask the patient in detail about his complaints.

Wherein special meaning when making a diagnosis, amyloidosis is excluded, chronic glomerulonephritis, hypertension, diabetic glomerulosclerosis, since these diseases are similar to chronic pyelonephritis in the general clinical picture.

Treatment of the disease

Is it possible to cure chronic pyelonephritis? Chronic pyelonephritis - what is it? Your doctor can answer these questions for you. If you have discovered chronic pyelonephritis, treatment is available at different methods. The process of treating the disease involves individual approach to every patient. Main methods of treatment – special diet nutrition and drug therapy. In case of exacerbation, the patient is recommended hospital treatment under the supervision of a doctor. The patient is prescribed a rest regimen in combination with compliance proper diet nutrition and reception special drugs. Duration bed rest providing treatment for chronic pyelonephritis is determined based on the degree of the disease, as well as the quality of treatment.

Nutrition plays an important role. Moreover, diet is prerequisite treatment.

It is necessary to draw up proper diet diet, excluding the consumption of foods such as rich broths, fatty and spicy food, various seasonings, as well as coffee and alcohol.

Foods that are irritating are prohibited urinary tract. For example, consuming foods containing significant amounts of protein increases the acidity of urine, which has an adverse effect on the body suffering from the disease. Food containing oxalic and lactic acid is completely prohibited. The consumption of easily digestible carbohydrates (beans, peas, chickpeas and others) has a negative effect on the patient’s body, since under the influence of such products a favorable environment is created for the spread of microorganisms.

The list of prohibited foods also includes smoked foods, fatty dairy products, processed foods, mushrooms, and pickled foods. Use confectionery should either be limited or completely eliminated from the diet.

The body of a person suffering from chronic pyelonephritis is beneficially affected by diets that normalize the patient’s metabolism, normalize blood pressure and help reduce the load on the kidneys.

The diet should contain a minimum amount of protein products. Carbohydrate and fat intake should be equal to physiological standards person. It is also necessary to enrich the diet with foods containing vitamins necessary for the health of the body.

As a result, the doctor prescribes the patient to take antibiotics - Oxacillin, Ampicillin, Amoxiclav, Sultamicillin and other drugs that eliminate chronic infections. The drugs are prescribed to the patient for a long time - up to eight weeks. Before treating the disease and prescribing medications, the specialist needs to monitor the acidity level of the patient’s urine and only after that determine the medicine that corresponds to these indicators.

Treatment of chronic pyelonephritis will be provided by visiting a sanatorium specializing in diseases of the excretory system.

Prevention

Treated pyelonephritis must be monitored to prevent recurrence of exacerbation. As a preventative measure, people suffering from this disease are advised to monitor their diet, limit salt intake, drink kidney tea. As soon as treatment for chronic pyelonephritis is completed, patients are registered at the dispensary to prevent the risk of recurrence of the disease. The past illness dictates the need to maintain normal immunity, which is facilitated by maintaining healthy image life, Fresh air, hardening, as well as moderate physical exercise. It is important to organize the right working environment for yourself, not to get a job at enterprises where people are exposed to hardships. physical labor, hypothermia and excessive nervous tension.

To prevent chronic pyelonephritis, it is necessary to ensure sufficient fluid intake, which guarantees normal urine outflow.