Chr pyelonephritis symptoms. Chronic pyelonephritis, symptoms, treatment, exacerbation

Chronic pyelonephritis is considered one of the most common diseases among girls and women. Symptoms and treatment depend on the degree of neglect of the pathology. This article discusses its main causes, signs and stages of development.

Description of the disease

Represents infectious process inflammatory in nature, forming in the renal tissues. This disease develops as a result of active life various types bacteria. It is predominantly common among the fair sex. This is explained by the morpho-functional characteristics of the urethra. Thanks to its special structure, the penetration of microorganisms into internal organs is greatly facilitated. Pathology can develop during certain periods female cycle(defloration, pregnancy, menopause).

What is the difference between chronic pyelonephritis? The stage of remission and subsequent exacerbation - these two stages usually alternate with each other. Therefore, various polymorphic changes (foci of inflammation, scar zones, areas of unchanged parenchyma) can be simultaneously detected in the kidneys. Involvement in this pathological process all new plots healthy tissue organ causes its gradual death and the formation of renal failure.

The disease itself does not cause serious discomfort to a person, but it can cause the development of very serious complications. First of all, the inflammatory process does not allow the kidneys to fully perform their main function. As a result, the patient’s usual water-salt metabolism, swelling appears. In addition, against the background of inflammation, other urological pathologies may occur. The most dangerous consequence is the addition of a purulent infection, which is very difficult to fight.

Main reasons

The etiological factor causing this disease is microbial flora. As a rule, these are so-called colibacillary bacteria ( coli), enterococci, staphylococci. Special role in development inflammatory process belongs to L-forms of bacteria, which are formed as a result of ineffective antimicrobial therapy or changes in the pH of the environment. Such microorganisms are difficult to identify, activate under certain conditions, and are resistant to treatment.

Very often, chronic pyelonephritis is preceded by a stage of exacerbation of the pathology. Chronic inflammation is promoted by failure to promptly correct urine outflow disturbances due to stones in prostate adenomas. Other diseases can support such a pathological process in the body. bacterial nature(otitis media, prostatitis, urethritis, cholecystitis, appendicitis, etc.), general somatic ailments (diabetes mellitus, obesity), as well as immunodeficiency.

Young ladies have an impetus for development of this disease may be the onset of sexual activity, childbirth and pregnancy. Quite often, doctors diagnose and among young patients chronic can be caused by disturbances in the functioning of the body at the congenital level, which change the usual urodynamics (ureterocele, bladder diverticula).

Clinical signs

Symptoms of the disease are nonspecific, and in Lately Asymptomatic disease is becoming increasingly common. A patient who has previously dealt with acute pyelonephritis or other urological pathologies must be responsible for their own health and listen to the body. Often the occurrence of the disease is a consequence of a violation of the body’s immune response, which accompanies diabetes mellitus and tuberculosis. A weakening of the defenses is also observed due to insufficient intake of vitamins and minerals. Despite all the specificity clinical manifestations, there are a number of signs of this disease that need to be paid special attention to:

• Temperature rise in evening time for no apparent reason.
• Headache.
• Increased fatigue, weakness.
• Frequent urge to urinate.
• Painful discomfort in the lumbar region, which manifests itself when walking.
• Changes in the color and smell of urine, cloudiness.

All of the above signs indicate chronic pyelonephritis. The symptoms and treatment of the disease are general in nature, this has already been discussed in the article. Patients often perceive such clinical manifestations as a common cold and begin treatment with appropriate medications. Such therapy can really relieve symptoms and improve the patient’s condition at first. And the inflammatory process will continue to develop. That is why in in this case It is recommended to seek advice from a specialist rather than try to overcome the disease on your own.

It is easy to confuse the symptoms of exacerbation of pyelonephritis with ARVI, because they are inherent in many inflammatory processes in the body. As a rule, if a person has already been diagnosed with a chronic form, he understands the signs associated with the disease. In this case, the patient may experience the following conditions:

• Dysuria.
• Head and
• Febrile temperature.
• Cloudiness of urine (proteinuria) and the appearance of an uncharacteristic odor.
• Hematuria.

Classification

How is chronic pyelonephritis classified? The stages of the disease are distinguished depending on the manifestation of the inflammatory process. At the first stage, active inflammation with pronounced symptoms is observed. The second stage is characterized by a pathological process. It can only be detected after a series of laboratory tests. The patients' condition is accompanied the following symptoms: fatigue, chills, slight increase in temperature. The third stage of development is chronic pyelonephritis in remission. What does it mean? If over the next five years there is no exacerbation of the disease, the doctor confirms a complete cure.

In addition, pyelonephritis can be unilateral or bilateral, depending on the number of affected organs.

Based on the severity of the disease, the following forms are distinguished:

1. Pyelonephritis without complications.
2. Pyelonephritis complicated by tumors, congenital anomalies, urolithiasis, diabetes mellitus, HIV infection.
3. Anemia.
4. Secondary reno-parenchymal arterial hypertension.

Pyelonephritis and pregnancy

Many pregnant women who have had to deal with this disease worry about how it can affect the baby’s health. All those who let this pathology take its course and do not seek treatment qualified help, may encounter very serious problems. Why is chronic pyelonephritis dangerous during pregnancy?

The consequences of the disease primarily affect the fetus. The child may be seriously harmed by developing intrauterine infection. As a rule, such kidney pathology causes spontaneous abortion or premature birth. The consequences of infection for children manifest themselves in different ways. Some are diagnosed with the most common conjunctivitis, which does not pose a threat to life, while others have severe infectious lesions of the systems internal organs.

During pregnancy with this disease there is also a risk of intrauterine hypoxia. This means that the fetus receives less oxygen than it actually needs. As a result, a child is born with low weight and insufficient development. Based on all of the above, we can come to the conclusion that chronic pyelonephritis should not be left to chance.

Symptoms and treatment of the disease should be determined exclusively by a specialist. If an inflammatory process is detected, the doctor prescribes antibiotics to the expectant mother. Of course, it is undesirable to take such medications while carrying a baby. However, a specialist can select remedies that will not cause serious harm to the fetus and will help the mother cope with the disease. Also in this kind of situation, painkillers, antispasmodics, vitamins, sedatives, carry out physiotherapeutic procedures.

Establishing diagnosis

Quite often it is difficult to confirm chronic pyelonephritis. Symptoms in women can vary; moreover, cases of latent disease are not uncommon. The diagnosis is usually made taking into account the medical history, laboratory results, and the presence of a characteristic clinical picture. Additional may be required following methods diagnostics:

• General urine/blood test.
• Quantitative determination of cells (Stenheimer-Malbin method).
• Examination of urinary sediment.
• Determination of electrolyte content in urine and blood.
• X-ray of the kidneys.
• Radioisotope renography.
• Kidney biopsy.

Chronic and treatment

Drug therapy for the disease should be aimed at eliminating its main causative agent. For this purpose, antibiotics and uroseptics are prescribed. It is considered optimal to conduct a urine culture to determine sensitivity to antibiotics before starting therapy. In this case, the choice of drugs will be more accurate. As a rule, the following drugs are used for treatment:

• Penicillins that have wide range actions (“Amoxicillin”, “Azlocillin”).
• Second and third generation cephalosporins.
• Fluoroquinolones (“Levofloxacin”, “Ofloxacin”, “Ciprofloxacin”). Drugs in this group are prohibited for use by pregnant and lactating women.
• Nitrofurans (“Furadonin”, “Furamag”). Sometimes patients have side effects in the form of nausea, bitter taste in the mouth, vomiting.
• Sulfonamide drugs (“Biseptol”).

The duration of therapy is at least 14 days. If symptoms of the disease persist, the course of treatment may increase to one month. It is advisable to periodically repeat urine cultures and change medications.

Chronic pyelonephritis: diet

Regardless of the stage of the disease, patients are advised to follow a special diet. It implies the exclusion from the diet of spicy foods and spices, alcoholic beverages, coffee, meat and fish broths. On the other hand, nutrition should be as fortified and balanced as possible. It is allowed to consume almost all fruits and vegetables (preferably raw), eggs, boiled meat/fish (low-fat varieties), and dairy products.

It is very important to pay attention to your drinking regime. It is recommended to drink at least two liters of still water per day to prevent excessive concentration of urine. It is useful to drink the most common cranberry juice, because these berries contain natural antibacterial substances that help fight pathologies such as chronic pyelonephritis.

The diet during the period of exacerbation of the disease is somewhat different. At this time, it is recommended to reduce fluid intake, as the outflow of urine slows down significantly. It is equally important to limit the consumption of table salt (up to 4 g per day).

Help from traditional medicine

Herbal medicine can be used as additional treatment to the main thing. You should not try to use it yourself traditional medicine overcome chronic pyelonephritis. Treatment with antibiotics is usually more effective and safer for human health.

Medicinal plants used for this disease most often have a diuretic effect. The course of treatment can range from several months to one and a half years. This duration helps prevent the development of complications and re-entry of infections.

Treatment with herbs involves taking them orally and using baths. For example, taking a bath with parsley has not only an anti-inflammatory, but also a cleansing effect. It increases blood flow and helps eliminate existing toxins. Chamomile has an antibacterial and at the same time calming effect on all internal organ systems. St. John's wort is an excellent assistant in the fight against various types of infections.

Sometimes in patients the disease is accompanied by the formation of polyps (small growths). In this case, it is recommended to take celandine, but do not abuse it. For a glass of boiling water you only need one teaspoon of herb. It is recommended to drink this infusion in small sips throughout the day. Celandine has an anti-inflammatory effect and is an excellent remedy in the fight against many cancer diseases.

Some experts advise drinking tea with blueberry and lingonberry leaves before bed. Blueberries are rich in vitamins and minerals, and lingonberries are an excellent natural antiseptic. This tea helps strengthen the immune system, increase the level of hemoglobin in the blood and reduce pain discomfort in the lumbar area.

Once again, it should be noted that you should not try to overcome chronic pyelonephritis on your own. Symptoms and herbal treatment are two mutually dependent factors that the doctor must pay attention to. Each patient has clinical manifestations of the disease, the degree of their severity may vary. Moreover, not in every case does herbal medicine have a positive effect; sometimes it significantly aggravates the health condition.

Prevention

How can chronic pyelonephritis be prevented? How long do people with this diagnosis live?

Prevention of the disease primarily implies timely treatment of all diseases of a urological nature. Here we are talking, first of all, about competent drug therapy. Many patients resort to traditional medicine or prefer to be treated on the advice of friends and relatives. This approach is highly undesirable. The whole point is that in this way you can harm your own health, and the disease itself will progress.

It is equally important to maintain the correct amount (about two liters of fluid per day). If possible, hypothermia and taking non-steroidal analgesics should be avoided. It is not recommended to endure a small need; it is necessary to empty the bladder every time before going to bed and after the next sexual intercourse.

This article provides information about the dangers of chronic pyelonephritis during pregnancy. Symptoms in women of this disease during the period of carrying a fetus inside the womb should alert and become a reason to consult a doctor. Only a specialist can recommend truly effective and safe treatment. In order not to encounter this pathology during pregnancy, it is recommended to check your body before planning it. If you have any ailments, you must undergo a course of treatment. Very important role in the prevention of pyelonephritis at this time belongs to compliance. Of course, one should be active and healthy image life.

As for the question of life expectancy with this disease, there is no clear answer. If the patient strictly follows all the doctor’s recommendations, eats right and monitors his condition, he can live a long and happy life. If the disease is aggravated by constant alcohol intoxication, lack of competent therapy, the probability of death increases several times.

Conclusion

It is important to remember that only a qualified specialist can recommend how to cure chronic pyelonephritis. Symptoms, diagnosis, causes of the disease - all these factors are an important component of timely therapy. Be healthy!

How to treat chronic pyelonephritis in women and men at home?

Chronic pyelonephritis is a disease characterized by periodic exacerbations. This disease is understood as a nonspecific inflammatory process in which the kidneys are affected, followed by sclerosis of the parenchyma. According to medical statistics, pyelonephritis affects about 20% of the population.

IN childhood From 2 to 15 years old, it affects girls more often; in old age, the disease affects more men. Despite this, pyelonephritis is considered predominantly a female disease due to anatomical location genitourinary organs and other functional characteristics of the female body.

What it is?

Chronic pyelonephritis is a disease of an infectious-inflammatory nature in which the calyces, pelvis and tubules of the kidneys are involved in the pathological process with subsequent damage to their glomeruli and vessels.

According to 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.

Causes

The main causes of pyelonephritis are microbes - Escherichia coli, staphylococcus, enterococci, Proteus, Pseudomonas aeruginosa. In development chronic pyelonephritis especially relevant are those resistant to negative factors and antibiotics forms of microbes. They can persist for a long time in the area of ​​the calyxes and pelvis, with a decrease in immune defense, causing activation of inflammation.

Why does an acute process become chronic?

The causes of chronic pyelonephritis can be considered:

• poor-quality treatment of acute pyelonephritis, failure of the patient to comply with the doctor’s clinical recommendations, failure to monitor a child or adult;
• untimely diagnosis and treatment of diseases that impair the outflow of urine (nephroptosis, vesicoureteral reflux, congenital anomalies narrowing of the urinary tract);
• the presence of concomitant chronic diseases that undermine the body’s immunity or are constant foci of infection (obesity, diabetes, diseases of the gallbladder, intestines, pancreas);
• the ability of some pathogens to form L-forms, which can remain in the kidney tissue for a long time in an inactive state, but cause an exacerbation when the defenses are reduced or in immunodeficiency states.

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

• pregnant women;
• children up to three years, predominantly bottle-fed;
• girls during the onset of sexual activity;
• elderly people.

Prevention of chronic pyelonephritis is most indicated for these patients.

Classification

Forms of chronic pyelonephritis:

1. Latent form. Characterized by minor clinical manifestations. The patient may experience general weakness, fatigue, headache, and sometimes the temperature may rise slightly. As a rule, there is no lower back pain, swelling or dysuria, although some experience a positive Pasternatsky symptom (pain when tapping the lumbar region). A general urine test reveals slight proteinuria; leukocytes and bacteria may be excreted in the urine periodically. With a latent course, the concentrating ability of the kidneys is usually impaired, so a decrease in urine density and polyuria are characteristic. Sometimes mild anemia and slight increase blood pressure.
2. Recurrent form. Characterized by alternating periods of exacerbation and remission. The patient may experience discomfort in the lower back, chills, and fever. Dysuric phenomena appear (frequent urination, sometimes painful).
3. Azotemic form. These include those cases when the disease manifests itself in the form of chronic renal failure. They should be qualified as a continuation of an already existing, but not timely identified latent course of the disease. It is the azotemic form that is characteristic of chronic renal failure.
4. Hypertonic form. Arterial hypertension predominates. Headache, dizziness, sleep disturbance, stabbing pain in the projection of the heart, frequent hypertensive crises, and shortness of breath occur. Changes in urine are subtle and not constant. Hypertension with pyelonephritis is often malignant.
5. Anemic form. It is characterized by the fact that among the signs of the disease, the symptoms of anemia predominate - a decrease in the number of full-fledged red blood cells in the blood. This form of the disease in patients with chronic pyelonephritis is more common, more pronounced than in other kidney diseases, and is usually hypochromic in nature. Disturbances in urination are mild.

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

Stages

In chronic pyelonephritis, there are three stages of disease progression:

• the initial degree is characterized by the development of inflammation, swelling of the connective tissues of the inner layer of the urinary organ, as a result of which the vessels are compressed, tubular atrophy appears, and renal bleeding decreases;
• the second degree is detected through a nephrogram, where diffuse narrowing of the arterial renal bed is noted, the size of the cortex becomes smaller, interlobar arteries are absent;
• the third degree of pyelonephritis is expressed by a narrowing and change in the shape of all vessels of the urinary organ, the kidney tissue is replaced by scar tissue, the kidney becomes wrinkled.

Symptoms

The degree of manifestation of symptoms of pyelonephritis depends on the location of inflammation (one side or both kidneys), the degree of activity of inflammation, concomitant obstacles to the outflow of urine and previous treatment. During the remission stage, there may be no manifestations at all, or they may be minimal - minor changes in urine tests.

The main symptoms of pyelonephritis in women and men:

1. Deterioration of health, fatigue and weakness, more pronounced in the morning, decreased mood, headaches.
2. Temperature rise, not higher than 38 C, usually in the evening, for no apparent reason.
3. Frequent urination, especially at night.
4. Increased blood pressure. During remission, this may be the only symptom.
5. Slight swelling of the face, hands, more in the morning, feet and legs - towards the end of the day.
6. 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 and heaviness in the lower back, especially when walking or standing for long periods of time. 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.

In the remission stage, all symptoms of pyelonephritis are minimal, but the longer pyelonephritis is present, the higher the likelihood of arterial hypertension, cardiac hypertrophy, the development of chronic renal failure and secondary degenerative changes in the kidneys. In the later stages, polyneuritis, bone pain, hemorrhages, polyuria with the release of up to 3 or more liters of urine with thirst and dry mouth, and anemia may occur.

Complications

As chronic pyelonephritis progresses, it develops. It manifests itself as an increase in the amount of daily urine and especially the nightly portion, a decrease in the density of urine, thirst, and dry mouth.

A sharp exacerbation of chronic pyelonephritis may be accompanied by the development of acute renal failure.

Diagnostics

Acute and chronic pyelonephritis is diagnosed based on patient complaints and the clinical picture of the disease. The doctor finds out whether the attacks were suffered acute pyelonephritis, cystitis, inflammation of the urinary tract and kidneys in childhood or during pregnancy in women.

When interviewing men, special attention is paid to injuries to the spine, bladder and inflammation of the genitourinary organs. The doctor identifies the presence of factors that predispose to the occurrence of pyelonephritis - the presence of chronic diseases (adenoma prostate gland, diabetes mellitus, etc.).

Differential diagnosis is carried out with a number of such diseases:

1. Hypertension. Elderly people are susceptible to the disease; there are no changes in blood and urine.
2. Chronic glomerulonephritis. In pathology, there are no active leukocytes and pathogens, but red blood cells are present.
3. Amyloidosis of the kidneys. There are no bacteria or signs of inflammation. The disease is characterized by the presence of foci of infection and scanty urine sediment.
4. Diabetic glomerulosclerosis. Accompanies diabetes mellitus and manifests itself with signs of angiopathy.

Examining a patient with chronic pyelonephritis in this way will help to avoid medical errors and prescribe effective treatment.

How to treat chronic pyelonephritis?

Therapy should be aimed at eliminating the following problems:

• elimination of the causes that cause disruption of the normal functioning of the kidneys;
• use of antibacterial medications and other medications;
• increasing immunity.

The most effective medications are: Levofloxacin, Amoxicillin, Biseptol, Furadonin, as well as their analogues.

Drug treatment

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

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

Typically, the following drugs are used to treat chronic pyelonephritis:

1. Nitrofurans – Furazolidone, Furadonin.
2. Sulfonamides - Urosulfan, Etazol, etc.
3. Nalidixic acid – Negram, Nevigramon.
4. Cephalosporins - Kefzol, Ceporin, Ceftriaxone, Cefepime, Cefixime, Cefotaxime, etc.
5. Semi-synthetic penicillins - Oxacillin, Ampicillin, Amoxiclav, Sultamicillin.
6. Fluoroquinolones: Levofloxacin, Ofloxacin, Tsiprinol, Moxifloxacin, etc.
7. Antioxidant therapy comes down to taking Tocopherol, Ascorbic acid, Retinol, Selenium, etc.
8. Aminoglycosides are used in severe cases of the disease - Kanamycin, Gentamicin, Kolimycin, Tobramycin, Amikacin.

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

Physiotherapeutic treatment

Physiotherapeutic techniques have the following effects:

• increase blood supply to the kidney, increase renal plasma flow, which improves the delivery of antibacterial agents to the kidneys;
• relieve spasm of smooth muscles renal pelvis and ureters, which promotes the discharge of mucus, urinary crystals, and bacteria.

Physiotherapeutic treatment is used in complex therapy chronic pyelonephritis.

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.

Damp cold, smoking and alcohol adversely affect the course of pyelonephritis. A regular examinations with monitoring of urine tests, and preventive courses of treatment contribute to long-term remission and prevent the development of renal failure.

Diet and nutrition rules

The chronic course of the disease requires serious attention to diet. Recommended:

• cereals, dairy products and vegetarian dishes;
• watermelons, melons and pumpkin dishes;
• increase fluid intake to 2.5 liters;
• include a small amount of meat or fish broth in the diet;
• Boil fish and meat of non-fatty varieties, or cook only by steaming;
• fresh and boiled vegetables and fruits;
• Horseradish, garlic and radish should be excluded from the diet;
• Limit salt intake per day to 8 grams.

A balanced diet helps quick recovery. When the disease worsens, the diet should include fresh fruits and vegetables, as well as at least 2 liters of liquid. Fried, spicy, fatty and salty foods are not allowed in the diet.

Prevention

Even in the absence of signs of active infection, it is necessary to periodically (once a year or every six months) examine the function of a previously affected kidney. In the presence of frequent exacerbations in women, long-term use of antibacterial agents in low doses (biseptol or furadonin) is recommended.

All pregnant women require a bacteriological examination of urine in the first trimester. If bacteriuria is detected, treatment is carried out with penicillins or nitrofurans.

To prevent exacerbations, it is also recommended to carry out 10-day antibacterial courses, and then for 20 days a course of herbal medicine (decoction of bear's ear grass, birch leaves, horsetail, juniper fruits, cornflower flowers) is carried out. It is necessary to carry out several such courses; it is recommended to change the antibacterial agent every month.

Is it possible to cure pyelonephritis at home and what should I take for recovery? The answers to these and many other questions concern people suffering from kidney inflammation. According to experts, self-treatment pyelonephritis in the initial stages can be very effective, but extreme caution must be exercised. After reading this article, you will receive general information about the methods of treating the disease and find out in what cases emergency treatment may be required medical care.

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 pathogen microorganisms enter the human blood (this can be E. coli, all kinds of cocci, etc.). Before you find out how to cure pyelonephritis, read the list of factors associated with infection:

• chronic conditions of fatigue/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 complex. medicinal measures aimed at normalizing the condition of the kidneys. The program to combat the disease includes the use of drugs and procedures aimed at eliminating foci of inflammation. Kidney treatment options depend on the person's age, general health, and current form of the disease.

Diet therapy

The first thing you should take care of is your diet, because the body gets everything useful material 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/condiments;
• coffee;
• broths with broth;
• legumes;
• cakes/creams;
• mushrooms;
• sparkling water;
• alcohol.

• dairy products;
• fruits high in potassium (dried apricots, apricots, raisins);
• white bread (salt-free);
• butter (in moderation);
• boiled and grated vegetables;
• porridge;
• sugar.

• herbal infusions;
• compotes/fruit drinks/jelly/juices;
• teas (green, weak black);
• mineral soda waters without gas.

During the treatment of chronic pyelonephritis, the list of products to be excluded remains unchanged. The basis dietary nutrition includes the following products:

• lean varieties of fish/meat/poultry (minced or boiled meat);
• vegetarian and dairy soups (fruit/vegetable);
• dairy and dairy products;
• flour products;
• chicken eggs;
• pasta (well boiled);
• cereals;
• puddings;
• raw/boiled vegetables (except radish, cauliflower, garlic and onion);
• fruits and berries of all kinds;
• melons;
• jam, honey, sugar and some other harmless sweets.

The nuances of the diet for pyelonephritis (kidney disease) must be agreed upon with the attending physician, otherwise digestive disorders may occur. You will have to forget about foods recommended for exclusion from the diet until the kidneys are completely healed, otherwise the effectiveness of treatment measures will be significantly reduced. The sooner the patient ensures the balance of substances in the body, the less chance there is of pyelonephritis.

Drug therapy

Treatment of acute forms of pyelonephritis with medications is aimed at quickly eliminating foci of inflammation in the kidneys and preventing the disease from getting worse. The average course duration is 12-16 days. General complex therapeutic measures are based on the following principles:

• elimination of factors that cause infection in the kidneys;
• antibiotic therapy after collection of samples for culture;
• strengthening immune system to prevent relapses in the future;
• pathogenic/symptomatic treatment.

To alleviate the condition, a patient diagnosed with “acute pyelonephritis” is prescribed antispasmodics (“Drotaverine”, “No-Shpa”, “Spazmalgon”). During the direct treatment of kidney inflammation, specialists conduct a number of laboratory tests and prescribe complex treatment drugs of several pharmacological groups:

1. Antibiotics: Cephalexin, Cefaclor, Amikacin, Gentamicin. Highly effective, but 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 inflammatory processes 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 intestinal microflora damaged during the treatment of acute pyelonephritis with antibiotics. Probiotics contain beneficial microorganisms that reduce the level of intoxication and remove toxins.
4. Anticoagulants: Dipyridamole, Heparin, Troxevasin. Drugs in this category normalize blood flow in the kidneys, which significantly increases the effectiveness of treatment.

Treatment chronic form pyelonephritis requires a long, methodical approach. After the examination, doctors prescribe long-term treatment with drugs from the following pharmacological groups:

1. Penicillins: Carbenicillin, Azocillin, Amoxicillin. They are prescribed for the treatment of chronic pyelonephritis (kidney disease) with a minimal level of nefortoxicity.
2. Fluoroquinols: Ofloxacin, Ciprofloxacin, Levoflonsacin. Prescribed in the form of injections. The powerful antibacterial effect of these drugs significantly increases the effectiveness of the fight against pyelonephritis (kidney disease).
3. 2nd and 3rd generation cephalosporins: Cefaclor, Cephalexin. Low-toxic drugs to combat inflammatory processes. Active ingredients These cephalosporins destroy the cell walls of bacteria that cause pyelonephritis (kidney disease) and kill them, restoring normal functioning of the tubular system.
4. Nitrofurans: “Furagin”, “Furazolidone”, “Furadonin”. They are 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. Hydroxyquinolines: Nitroxoline, 5-Nok. 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 affecting the internal tissues of the kidneys do not respond to antibiotics and NPS drugs. Surgical intervention is performed to prevent neforsclerosis and pyonephrosis. Advanced stages of pyelonephritis lead to unilateral shrinkage of the kidney.

To prevent further inflammation of the urinary system, nephrectomy is prescribed - an operation to remove the kidney (under general anesthesia, the retroperitoneal space is opened to the patient and the affected organ is cut off). In rare cases, when destruction of one of the halves of a double kidney is observed, surgeons resort to resection. This operation involves removing part of the kidney tissue affected by purulent inflammatory processes.

Folk remedies for treatment at home

Traditional methods of combating pyelonephritis (kidney disease) involve the use of medications in a hospital hospital, but is there really no way to do without doctors? Experts in home recipes say: in the early stages, effective treatment of pyelonephritis with folk remedies at home is quite possible. Write down a few of your grandmother's recipes for yourself so that you can be prepared if there is a threat of kidney inflammation:

1. Propolis with butter. Melt 60-70 grams of butter, add 15 grams of propolis and mix. Consume the resulting gruel 5-7 grams at intervals of 7-8 hours.
2. . An excellent remedy for the treatment of acute and chronic forms of pyelonephritis (kidney disease). Boil 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, the kidney disease will subside.
3. Saline dressing. Pour 230 grams of salt onto a thick, large towel and soak it with water. Before going to bed, tie it around your lower back and go to bed. By performing this procedure every night, you can relieve an exacerbation of pyelonephritis (kidney disease) in less than two weeks.

Phytotherapy

Increase efficiency drug treatment Natural herbal decoctions will help with kidney inflammation. Natural components help normalize the balance of substances and cleanse the body of toxins. Official medicine recognized by the majority existing techniques 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 For acute forms of pyelonephritis (kidney disease), drink the decoction every 12 hours, 30-40 ml.
2. Fireweed, chamomile, birch. An incredibly effective remedy for the treatment of chronic pyelonephritis (kidney disease). Mix the ingredients in equal quantities and pour three glasses of boiling water. The application regimen is extremely simple: drink 50-60 ml of the decoction every 8 hours, and after 2-3 weeks the kidney disease will disappear forever.

Features of treatment of the disease

The main task of a 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 kidney inflammation are treated according to the standard regimen, but there are certain categories of people for whom treatment is selected taking into account additional factors.

In children

By definition, a child’s body cannot normally absorb potent drugs, so doctors are especially careful when choosing which antibiotics to treat the baby so as not to damage the gastrointestinal tract. Under the age of 12, it is not recommended to get carried away with 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 delayed.

In pregnant women

Potent antibacterial drugs for the treatment of acute pyelonephritis during pregnancy are used only after a full examination and only as prescribed by the attending physician. Any amateur activity in such situations should be excluded. The exhausted body of a pregnant woman may react inadequately 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 kidney function. If the outcome is successful, all symptoms disappear, the person’s health status returns to normal, but the disease itself remains. Under the influence of negative external/internal factors, be it decreased immunity, hypothermia, stress, or something else, the disease will manifest itself again, and then re-treatment will be required.

Video about symptoms and treatment of acute pyelonephritis

The video below contains recommendations from experts on how to behave if you suspect kidney inflammation. After watching this video, you will receive a lot of valuable information about identifying and treating acute pyelonephritis. Take the information you received so that a dangerous infectious disease does not land you in a hospital bed!

Chronic pyelonephritis - the most common infectious-inflammatory disease of the kidneys, occurring with alternating periods of latent inflammatory process in the kidneys with phases of exacerbations, which is chronic in nature.

The disease is usually associated with development in the kidneys bacterial infection, which first affects the renal pyelocaliceal system and tubules, and then moves to the glomeruli and vessels of the kidneys, affecting the renal papillae, as well as the cortex and medulla of the kidney.

Causes of chronic pyelonephritis

According to statistics, every tenth person on the planet suffers from pyelonephritis. Infection with pyelonephritis penetrates the kidneys or upward path through the bladder and ureters, or hematogenously through the bloodstream. The source of infection can be focal purulent-inflammatory diseases of other organs, such as sinusitis, tonsillitis (tonsillitis), stomatitis, dental caries, pneumonia, bronchitis, inflammatory processes in the genitals, cystitis. Often the cause of pyelonephritis is relatively harmless E. coli, which enters the urinary tract through the bloodstream, or as a result of improper hygiene of the genitourinary organs.

However, simply getting microbes into the kidney tissue is not enough for the development of pyelonephritis. The disease occurs under the influence of a complex of reasons: lack of vitamins in the body, hypothermia, overwork, stress and much more. Most of all, the development of pyelonephritis is facilitated by a delay in the outflow of urine associated with compression or obstruction of the urinary tract. This may be stones in the ureters and bladder, prostate adenoma in men, inflammation of the ovaries in women, various congenital defects of the urinary system. It is no coincidence that pyelonephritis and urolithiasis are so closely related to each other. Inflammation stimulates the formation of stones, and stones, by making it difficult to excrete urine, contribute to inflammation of the renal pelvis.

Usually, chronic pyelonephritis occurs as a result of incompletely cured acute pyelonephritis. Often the disease is asymptomatic for months and even years and is discovered either during an exacerbation or as a result of a long-term persistent impairment of kidney function, leading to the death of part of the kidneys. renal nephrons and the emergence .

Often enough chronic pyelonephritis has no obvious symptoms. The patient sometimes complains that his lower back hurts, his head often hurts, and his blood pressure jumps, but he attributes all these manifestations of the disease to climatic factors and physical fatigue. The clinical picture depends on the form in which chronic pyelonephritis occurs in a given patient.

Forms of chronic pyelonephritis:

• By occurrence chronic pyelonephritis is divided into primary(occurring for the first time in a patient with no other urological diseases) And secondary(arising against the background of any existing urinary tract disease).
• By localization of the inflammatory process chronic pyelonephritis can be unilateral or bilateral.
• According to the clinical picture The following forms of chronic pyelonephritis are distinguished: latent, recurrent, hypertensive, anemic, azotemic, hematuric.

Symptoms of chronic pyelonephritis depending on the form of the disease:

• Latent form chronic pyelonephritis has an unexpressed clinical picture. Patients mainly complain about frequent urge to urination, general weakness, headache, hypertension, fatigue, and occasionally there is an increase in temperature to low-grade fever. The latent form of chronic pyelonephritis is usually accompanied by impaired concentrating ability of the kidneys, decreased urine density and frequent urination with the release of urine light color. Urinary retention, pain in the lumbar region and swelling are usually absent in this form of the disease. Patients sometimes experience Pasternatsky's symptom, a small amount of protein is found in the urine, the number of leukocytes and bacteria remains normal. The disease is sluggish and dangerous in that it gradually leads to loss of kidney function and progressive chronic renal failure.
• Recurrent form chronic pyelonephritis is characterized by alternating periods of exacerbations and remissions. Patients complain of discomfort in the lumbar region, urination problems, sudden fever and increased body temperature. During exacerbations, symptoms are similar to those acute pyelonephritis . There are pronounced changes in the composition of urine (proteinuria, leukocyturia, cylindruria, bacteriuria and hematuria), ESR increases and the number of neutrophils increases (neutrophilic leukocytosis). Gradually, patients may develophypertensive syndromewith headaches, dizziness, heart pain, visual impairment, oranemic syndrome,manifested by general weakness, fatigue, shortness of breath, decreased performance. As the disease progresses, it develops.
• Hypertensive form chronic pyelonephritis manifests itself by the development of severe hypertension . Patients complain of frequent headaches, dizziness, pain in the heart, shortness of breath, and sleep disturbances. Patients periodically experience hypertensive crises. This form of pyelonephritis is not characterized by urinary disorders, so diagnosing it is sometimes quite difficult.
• Anemic form chronic pyelonephritis is manifested primarily by symptoms of severeanemia. Patients experience a sharp decrease in the number of red blood cells in the blood. This form of the disease is the most common in patients with chronic pyelonephritis and is accompanied by general weakness, fatigue, shortness of breath, and decreased performance. Urinary problems are minor or absent altogether.
• Azotemic form chronic pyelonephritis is characterized by an increasechronic renal failure. This form of the disease, as a rule, is a continuation of an existing one, but not detected in a timely manner.latent pyelonephritis. Patients suffer from an increase in azotemia, which manifests itself as swelling and itching of the skin. Kidney function declines and a severe form of chronic renal failure gradually develops.
• Hematuric form chronic pyelonephritis is manifested by repeated attacks of macrohematuria and persistent microhematuria, which is associated with venous hypertension, which contributes to the disruption of the integrity of the vessels of the fornical zone of the kidney and the development of fornical bleeding.

Chronic pyelonephritis usually develops over 10-15 years or more and ends with shrinkage of the kidneys. Wrinkling occurs unevenly with the formation of rough scars on the surface. If only one of the kidneys shrinks, then, as a rule, compensatory hypertrophy and hyperfunction of the second kidney is observed. That is, within a few weeks the mass of the remaining kidney increases, and it takes over the functions of the diseased kidney. At the final stage of chronic pyelonephritis, when both organs are affected, chronic renal failure.

Diagnosis of chronic pyelonephritis

It is often not possible to identify chronic pyelonephritis in a timely manner and accurately determine the form of its course, especially in a clinic setting. This is due to the variety of clinical manifestations of the disease, as well as its relatively frequent latent course.

Chronic pyelonephritis is recognized on the basis of anamnesis (medical history), existing symptoms, results of leukocyturia (examination of urinary sediment using the Kakovsky-Addis method), quantitative detection of active leukocytes in the urine, called Stenheimer-Malbin cells, bacteriological analysis urine, as well as intravital kidney biopsy. If chronic pyelonephritis is suspected, they also do general analysis blood to determine residual nitrogen, urea and creatinine in it, identify the electrolyte composition of blood and urine and examine the functional state of the kidneys.

Using the X-ray method, changes in the size of the kidneys, deformation of their pelvis and calyces, and disturbances in the tone of the upper urinary tract are determined, and radioisotope renography allows one to obtain a graphic image and assess the functional state of each organ separately. As additional research methods for the diagnosis of chronic pyelonephritis, intravenous and retrograde pyelography and scenography, echographic examination of the kidneys, and chromocystoscopy are used.

Amyloidosis can be recognized by the presence of foci of chronic infection, paucity of urinary sediment (there are only single leukocytes, red blood cells and casts, no sugar at all), as well as by the absence of bacteriuria and radiological signs of pyelonephritis.

As for hypertension, it is more often observed in older people, occurs with hypertensive crises and more pronounced sclerotic changes in the coronary arteries, cerebral vessels and aorta. In patients with hypertension, there is no leukocyturia, bacteriuria, or pronounced decrease in the relative density of urine characteristic of chronic pyelonephritis, and X-ray and radioindication studies do not reveal changes inherent in chronic pyelonephritis.

With diabetic glomerulosclerosis, the patient has signs of diabetes mellitus, and other symptoms of diabetic angiopathy are determined - generalized damage to blood vessels.

One of the diagnoses may sound like this: chronic bilateral pyelonephritis, recurrent, exacerbation phase, chronic renal failure, intermittent stage, arterial hypertension.

Treatment of chronic pyelonephritis

The treatment time for chronic pyelonephritis is usually at least four months. However, if the disease proceeds without complications, therapy can be reduced on the recommendation of a doctor. At the end of each month, the patient undergoes a urine test and an antibiogram. If the white blood cell count is still higher than normal, the drug should be replaced. Sometimes it happens that a month after the start of treatment, the tests are normal. But this does not mean that the disease has passed and the kidneys are out of danger. Under no circumstances should you give up treatment.

Antibiotics for pyelonephritis

The main treatment method for chronic pyelonephritis today is still antibacterial therapy. Taking antibiotics begins only after the causative agent of the infection has been identified and its sensitivity to drugs has been determined. Antibiotics that suppress gram-negative flora are usually indicated. The doctor should prescribe only those drugs that do not have a toxic effect on the kidneys. Treatment is carried out with regular laboratory monitoring of the sensitivity of microflora to the antibiotic.

Good therapeutic effect with low probability of relapse and adverse reactions provide modern antibiotics fluoroquinolone series: ciprofloxacin, norfloxacin, levofloxacin, pefloxacin; cephalosporins: cephalexin, cefuroxime, cefenim, semisynthetic penicillins with beta-lactamase inhibitors augmentin, unasin.

Complex treatment of chronic pyelonephritis also involves taking non-steroidal anti-inflammatory drugs that prevent the formation of blood clots in the vessels. This can be aspirin, movalis, voltaren, ibuprofen and others.

To improve microcirculation in the kidneys, patients take chimes, trental or venoruton, and to activate renal circulation - urolesan, cystenal, olimetine, uroflux.

In case of severe disease and complications, especially in older people, the doctor may prescribe immunocorrective drugs. If a chronic urinary tract infection is detected, peptide bioregulators are prescribed.

To ensure that taking antibiotics, especially powerful ones (the so-called fourth line), does not lead to intestinal dysbiosis, you must observe fermented milk diet. But if dysbiosis does appear, then to restore the intestinal microflora, about a week before the end of the main therapy, it is necessary to start taking bifidumbacterin. IN difficult cases Your doctor may prescribe antifungal medications.

Prevention of chronic pyelonephritis

Prevention of chronic pyelonephritis must begin in childhood, instilling personal hygiene skills in children. In general, preventing the development of chronic pyelonephritis and its complications is possible only with constant monitoring of the patient by a urologist. Control tests and studies should be done at least three times a year. During this period, the patient should not have severe physical exercise, hypothermia, high humidity, such people should not work the night shift. Patients are removed from the register if they do not show signs of exacerbation of chronic pyelonephritis within two years.

For women suffering from chronic pyelonephritis, pregnancy is contraindicated. This is associated with a possible deterioration in health. After childbirth, they almost always develop chronic renal failure, and their further life expectancy is no more than 5 years. Therefore, before planning a pregnancy, women must first cure their kidneys.

To prevent chronic pyelonephritis, it is also recommended to conduct two two-month courses of herbal medicine with an interval of 3-4 weeks, using any of the known herbal preparations. In the future, it will not be superfluous to take a 2-3 month course. During prophylactic intake It is mandatory to do urine tests within 6-8 months of training camp.