Chronic pyelonephritis: symptoms and treatment

Chronic pyelonephritis is a chronic pathology characterized by nonspecific inflammation of the kidney tissues. As a result of the progression of the pathological process, destruction of the pelvis, organ vessels is observed.



Chronic pyelonephritis is usually a consequence of the previously transferred acute form of the disease. There are cases where patients can not remember having an attack of acute pyelonephritis, since this pathology can progress without a single symptom. Chronization of the process can occur because of such reasons:


  • disruption of excretion of urine due to the formation of concrements or due to narrowing of the urinary tract
  • inadequate therapy for the acute form of the disease;
  • urine reflux;
  • Chronic intoxication of the body. It is observed with the abuse of alcoholic beverages, smoking;
  • the presence of common pathologies. This includes obesity, immunodeficiency states, etc.,
  • inflammation in organs located in close proximity to the kidneys — cystitis, enterocolitis, prostatitis, acute appendicitis and the like.

It is worth noting that usually chronic pyelonephritis affects two buds at the same time. More often pathology is diagnosed in women. Chronic pyelonephritis in children progresses rarely.

Etiology

Progression of chronic pyelonephritis is provoked by infectious agents:


  1. Proteus
  2. E. coli
  3. Pseudomonas aeruginosa
  4. Staphylococcus;
  5. Streptococcus
  6. Enterococcus.

Risk Factors:


  • promiscuous sexual intercourse (possibly infection with dangerous microorganisms — chlamydia, gonococci, etc.)
  • Pregnancy. Quite often, chronic pyelonephritis is diagnosed during pregnancy, because hormonal changes occur during this period, an enlarged uterus can squeeze the organs of the urinary system;
  • violation of the normal outflow of urine
  • infringement of the innervation of the bladder;
  • burdened heredity.

Symptoms

Symptoms of chronic pyelonephritis are quite diverse. It should be noted that the course of the pathological process in the kidney may resemble other pathologies of the urinary system, so it is important to conduct a detailed differential diagnosis.

Symptoms may differ depending on which form of the disease progresses in the patient. Clinicians distinguish 5 forms:


  1. latent
  2. azotemic
  3. anemic
  4. Recurrent;
  5. Hypertonic.

Latent

With this form of pathology, the clinic is rather sparse. The patient can complain only of progressive weakness, increased fatigue. Rarely, but there may be a slight hyperthermia. Pain syndrome in the area of ​​the projection of the kidneys, dysuric phenomena and peripheral edema are absent.

Concentration of the kidneys decreases, which affects the density of urine, and is manifested by polyuria. If you make a urinalysis, then it can detect the presence of bacteria, leukocytes.

Anemic

The clinical picture is dominated by anemic symptoms:


  • weakness;
  • shortness of breath;
  • pallor of the skin;
  • There may be pain in the heart.

Changes in the urine are rather meager and not always detectable.

Hypertonic

Symptoms of the pathology are expressed quite clearly:


  1. dizziness;
  2. shortness of breath;
  3. a rapid increase in blood pressure
  4. Insomnia
  5. In the projection of the heart there are pains of a thrusting character.

Azotemic

This form of pathology progresses only at the stage of chronic renal failure. Symptoms are as follows:





  • Anemia
  • blood pressure increase
  • stool disorder;
  • decreased appetite
  • nausea and vomiting
  • the concentration of calcium in the blood decreases;
  • muscle weakness;
  • numbness of the feet and hands.

If there is a severe degree of renal failure, the clinical picture is supplemented by such symptoms:


  1. lipid metabolism disorder
  2. pain in joints and bones
  3. secondary gout;
  4. heart rhythm disorder
  5. atrial fibrillation
  6. bad taste in the mouth
  7. enlargement of the salivary glands
  8. the puffiness of the face.

Recurrent form

For this form of pathology, intermittent periods of remission and exacerbation are characteristic. The patient is periodically disturbed by uncomfortable sensations at the site of the projection of the kidneys, chills and hyperthermia. Later, dysuric manifestations are added.

The exacerbation of chronic pyelonephritis, according to the symptoms, resembles a clinic of acute inflammation. At this stage, the appearance of such symptoms:


  • headache;
  • pain in the heart area
  • blood pressure increase
  • anemic syndrome
  • Decreased visual function.

If a person often has periods of exacerbation of the disease, then this may result in the onset of kidney failure.

With the aggravation in the OAM, the following changes are observed:


  1. cylinderuria
  2. proteinuria
  3. bacteriuria
  4. Microhematuria
  5. leukocyturia

In the analysis of blood during an exacerbation, acceleration of ESR, an increase in the number of leukocytes, and anemia are detected.

Diagnostics

Diagnosis of the ailment during the exacerbation stage presents some difficulties, since the manifested clinical picture resembles other pathologies of the urinary system. To accurately diagnose, doctors use such diagnostic techniques:


  • Urine analysis (most informative)
  • a general blood test;
  • X-ray of the kidney;
  • urine accumulation
  • blood biochemistry
  • radioisotope renography
  • kidney biopsy.

Treatment

Treatment of chronic pyelonephritis should only be complex. Conservative methods are used:


  1. diet therapy. The diet for chronic pyelonephritis is developed individually for each patient. Observe it is necessary not only during treatment, but also after it;
  2. pain relievers
  3. antibiotics
  4. antipyretics
  5. anti-inflammatory drugs
  6. antiaggregants. These drugs are prescribed to normalize microcirculation.

Treatment of chronic pyelonephritis is carried out in a hospital setting so that doctors can monitor the patient’s condition and, if necessary, make adjustments to the treatment plan.

Diet

Proper nutrition can help get rid of pathology. Diet in chronic pyelonephritis during the exacerbation excludes use:


  • Acute
  • bold
  • Spicy foods
  • Salts.

Must be included in your diet:


  1. dairy products
  2. fruit;
  3. Berries.

It is also shown to consume at least 2 liters of fluid per day. This will help to quickly eliminate infectious agents from the kidneys.

Prevention

To prevent the progression of chronic pyelonephritis, the following recommendations should be adhered to:


  • Strengthen the immune system so that the body can fight off various infectious agents on its own;
  • timely diagnosis and full treatment of acute ailments of the urinary system



  • eliminate local factors that violate urodynamics (cure urolithiasis, etc.).