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Pyelonephritis, what tests should a man take? What you need to know about diagnosing pyelonephritis

In the structure of inflammatory kidney diseases, pyelonephritis does not occupy a leading position, but is still considered a rather dangerous pathology. In most cases, it is asymptomatic, and mild symptoms and sluggish exacerbations do not always prompt patients to contact the clinic. However, it is extremely important to undergo an examination, since this will allow you to quickly identify the pathological process and begin it timely treatment, and also exclude the presence of other diseases with similar symptoms. A blood test for pyelonephritis is considered an irreplaceable and highly informative clinical study that will confirm or refute the presence of the disease.

In the presence of typical symptoms the diagnosis is beyond doubt, especially if it is confirmed by the results laboratory research. Fever, pain, increased urination, increased tone muscles, blood in the urine during pyelonephritis, symptoms of intoxication directly indicate the development of an inflammatory process in the renal tubules.

Doctors highlight a number of the most important manipulations to confirm or refute disease of the urinary system.

Test according to the method of Nechiporenko and Zimnitsky;
Bacteriological culture urine.
General blood and urine analysis.
Biochemical blood test.

All of them are of equal value for making a primary diagnosis. Changes in the main indicators can tell us about the extent of the inflammatory process, as well as what type of pathogen caused the disease. For a more detailed and detailed examination, a specialist may prescribe a number of additional tests.

Blood test and its specifics

The main role in diagnosis is played by a general analysis of urine and blood in case of pyelonephritis. A thorough study of the latter allows us to identify signs of inflammation and the presence of other pathological processes. Patients are asked to collect urine themselves, but blood is drawn in laboratories or treatment rooms under especially sterile conditions.

The simplest method is to obtain the finished material from capillaries located on the fingertips close to the surface. To select the required amount of anatomical fluid, the laboratory assistant uses a scarifier. Another option is to obtain a blood sample from a vein. A needle is used to puncture a vessel in the bend of the elbow joint or back side brushes, and the required volume is taken with a syringe. Taking material from these places is considered the most convenient, since the veins are located close to the surface of the skin.

If specific signs are present, the diagnosis becomes obvious, so it is not necessary to examine a number of blood markers.

An assessment of its main parameters, changes in which are characteristic specifically for pyelonephritis, is considered sufficient. This:

Some of these indicators are detected by CBC, the rest by biochemical examination. To obtain a clear and reliable result, it is necessary to follow the established rules.

Types of analyses, features and purposes

The main option for diagnosing the disease has been and remains the method of studying the characteristics of urine, but in some cases the data obtained as a result of its implementation is not enough. Then, during the examination, several blood tests are used for pyelonephritis, the indicators of which make it possible to create a general picture of the pathology.

General blood analysis

The method is leading because it demonstrates what changes blood elements undergo during the development of a particular disease. The study pays attention to the erythrocyte sedimentation rate (ESR), the total number of platelets and leukocytes, and hematocrit. The presence of an inflammatory process is indicated by leukocyturia (increased level of leukocytes), the number of red blood cells and hemoglobin is reduced.

The presumptive presence of pyelonephritis is indicated by obvious indicators of the inflammatory process:

increase in erythrocyte sedimentation rate - ESR;
decrease in the amount of hemoglobin;
decrease in the number of red blood cells;
increased levels of leukocytes;
identification of young forms of neutrophils.

For a general analysis, a laboratory technician takes blood from the capillaries by piercing the skin of the finger with a scarifier right hand.

It is important to know! It is considered informative to obtain multiple samples, as well as to take material from both hands for testing. comparative characteristics indicators.

Biochemistry

Biochemical analysis is considered the most popular because it allows you to assess the condition internal organs, monitor the speed of metabolic processes and identify micronutrient deficiencies. With its help, you can determine the increase in the amount of nitrogenous metabolic products and urea, which, when the kidneys are damaged, is slowly eliminated from the body. The sample is taken from a vein in the elbow of the left arm in the morning on an empty stomach.

A specialist can learn about damage to the filtering capacity of the kidneys from the characteristics of a detailed biochemical analysis of anatomical fluid.

Increased concentration of sialic acids.
Reduced quantity total protein in blood serum.
The development of azotemia is an increase in the blood plasma concentration of substances released as a result of nitrogen metabolism.
Anomalies in the concentration of electrolytes, in particular, changes in the ratio of calcium, sodium and potassium ions, and an increase in the amount of the latter indicates the development of a pathological process.

Serological study

Serological analysis is one of the modern types of diagnostics. To detail the pathogen infectious process for antibodies and antigens this study considered very significant. The purpose of the analysis is: firstly, to directly identify the genes of the bacteria that caused the disease. Secondly, indirect confirmation of the presence and increase in the concentration of antibodies and antigens to certain types of infectious agents. It is carried out using the indirect (passive) hemagglutination reaction - RNHA or RPHA.

Based on the results of the reaction, the form of the disease can be determined. Acute pyelonephritis is highly likely to be confirmed if the titer of antibacterial bodies is increased in 60-70% of patients, while in the chronic stage it does not exceed the norm.

Of the above tests, the first two are prescribed in mandatory, the third is necessary, since it is of a clarifying nature.

Decoding indicators

If you just need to confirm the diagnosis, then there is no need to check the extended list of markers in the laboratory. It is enough just to study the signal parameters to identify pyelonephritis. Exists specific table, which indicates all their types, their norms and meanings. A specialist with a medical education can decipher the test results; the patient is only able to notice that the indicators are exceeded.

Leukocytes

The values of the total number of leukocytes are leading in determining the inflammatory process. In a healthy state, the level of these components of anatomical fluid in a child is from 7 to 11 * 109 l, in adult patients - from 5 to 9 * 109 l. In the case of pyelonephritis, the number of leukocytes exceeds the upper limits of values. The number of young forms is normally 2-5%, in the presence of the disease - more than 6%.

Hemoglobin

The task of this component is to transport oxygen from the lungs to the tissues. With the development of an acute inflammatory process, its content in the blood decreases, during the chronic stage it decreases slightly, or generally remains within the boundaries of the lower level. Normally, the concentration in representatives of the weaker half is 120, and in men – 140 g/l. At renal disorders it varies depending on the form, and is noted at the level of 85 and 150 in women, and 95 and 135 in representatives of the stronger sex.

Creatinine and urea

The most important role of the kidneys is to filter the blood and cleanse it of metabolic products. When proteins are broken down, nitrogenous compounds are released, which, during normal functioning of the excretory apparatus, are quickly eliminated from the body. Based on the presence of nitrogen metabolism substances and their quantity, the ability of the kidneys to cope with their responsibilities is assessed. In the absence of disease, creatinine levels range from 42-47 micromol per liter in women, and 62-104 in men. In the case of the development of a pathological process, this indicator exceeds the values accordingly:

in women – 97 micromoles;
among representatives of the stronger sex – 124 µmol.

As for urea, in the absence of inflammation normal value does not go beyond 2.5-8.3 mmol/l. The normal level of ammonia in the blood is 11-32 µmol/l, and creatine – 102-408 µmol/l.

Blood plasma proteins

With pyelonephritis, albuminuria develops - a decrease in the amount of total protein (the mass of all molecules of a substance) in the blood plasma. If functional disorders occur in the chronic stage, then the indicators remain within the lower limits of the norm, with acute development process, a sharp drop in protein is observed.

It is important to know! Albumin makes up about 60% of the total amount of protein; it participates in metabolic processes, supports the transport of elements and maintains normal fluid properties of the blood.

The following phenomena are considered characteristic of the disease:

increased levels of gamma globulins (normally it is 12-22%);
an increase in the amount of alpha-2-globulins (in the absence of pathology 7-13%);
decreased albumin levels;
increase in the amount of fibrinogen;
the appearance of C-reactive protein, which indicates the development of the acute phase, since upon transition to the chronic stage it disappears until the next relapse.

All of the above indicators accompany the inflammatory process and are automatically calculated by special laboratory equipment. Specific parameter values are analyzed individually by a nephrologist.

Electrolytes

Electrolytes play important role in human life. Even minor deviations from the norm can cause the development of cardiovascular pathologies, affect the functioning of the myocardium, brain and spinal cord, and impair the conduction of nerve impulses. Maintaining an optimal ratio of ions of various substances, and primarily sodium and potassium, in the body is the task of the filtering organ.

Most important indicators are the concentration values of these elements. The adult human body contains about 100 g of sodium. Up to 90% of this substance is found in the intercellular environment. B active ion exchange approximately 70% of the total is involved.

Potassium level

In the adult human body, the total amount of potassium is about 150 g. The vast majority of it (almost 98%) is contained inside cells, and only 2% is present in the intercellular space, including blood plasma. Since the task of the kidneys is to remove excess of this substance from the body, exceeded test values indicate a decrease in their functionality.

Preparing for a blood test

To get a reliable result after taking a blood test, you need to properly prepare for the procedure and follow a number of rules.

Anatomical fluid must be donated in the morning. In exceptional cases, the collection is carried out immediately after the patient arrives at the hospital.
For the reliability of the indicators, finger sampling should be carried out on an empty stomach, and fasting before the procedure should last at least 10-12 hours. Allowed moderate consumption clean water without gas.
Before donating blood, it is not recommended to load the body with various physical exercise, you should also refrain from stress influences.
It is considered unacceptable to drink any alcohol on the eve of the procedure. In general, this break should be at least 2-3 days.
Before donating blood, you do not need to stretch your fingers or elbow joint, since this will provoke an increase in the number of leukocytes, which will negatively affect the results of the analysis.

It is important to know! In exceptional cases, the laboratory assistant will comparative analysis indicators of three blood samples that were taken from the finger and both sides of the lumbar region. An increased level of leukocytes in the area of the damaged organ indicates the development of an inflammatory process.

Anatomical fluid is also collected from a vein in the morning on an empty stomach. Preparatory manipulations are similar for fingerprint analysis.

Conclusion

To understand the magnitude and seriousness renal pathology, you should know about some interesting facts and numbers.

During a pathological autopsy, pyelonephritis is found in every tenth person who died for unspecified reasons, and it was not even suspected during life. It is in this regard that the diagnosis of the disease becomes particularly important.

It is one of the most common diseases of the urinary system. About 12% of the population experience this disease at least once in their life. Therefore, we will look at what tests need to be taken, how the preparation is carried out and what the numbers in their results say.

What tests need to be taken?

Pyelonephritis is determined by urine and blood tests in conjunction with the presence of corresponding symptoms. The main signs of the disease are pain on one or both sides in the kidney area, increased body temperature, accompanied by chills. Urine becomes cloudy. Sometimes with pyelonephritis, blood and pus appear in the urine. Laboratory tests can help determine the correct diagnosis:

General urine analysis.
Research on Zimnitsky, Nicheporenko.
Bacterial culture of urine and identification of pathogen sensitivity to medications.
Clinical blood test.

If necessary, for pyelonephritis, carry out instrumental examination patient. Using extensive radiography, ultrasound, and CT scans of the kidneys, the diagnosis, the severity of the pathology, and the involvement of other organs of the urinary system are clarified.

Preparation

Before taking urine tests, it is recommended to exclude from the diet foods that can affect the color of the biomaterial, as well as fried and spicy foods. It is highly undesirable to take any medications, especially diuretics. During menstruation, women are not tested for pyelonephritis. You should warn the doctor about this and choose another day for examination. In other cases, it is necessary to adhere to the rules of personal hygiene and collect urine immediately after hygiene procedures.

Preparation for taking a blood test for pyelonephritis is that the day before the manipulation it is recommended to exclude physical exercise, experiences, alcohol and fatty foods. Taking medications is allowed only if they cannot be stopped. Before testing, it is important to maintain a drinking regime (at least 2 liters of clean water) for 3 days.

It is worth considering that blood for research is donated in the morning, on an empty stomach. These rules are the same for all patients age groups. Tests for pyelonephritis in children are also taken on an empty stomach from 8 to 10 am.

Carrying out analysis

If pyelonephritis is suspected, a general urine and blood test is taken at laboratory points in a local clinic, hospital, or private centers. All these institutions have the same requirements for the reception and collection of biomaterials:

Blood is taken from a vein.
For general analysis of urine, it is collected in the morning in a volume of 80-100 ml.
For the Nechiporenko test, an average portion of urine is taken, indicating the time of collection in the container.
To identify the pathogen, a laboratory, sterile jar is used, and the material is collected if the previous urination was less than 3 hours before.

In the laboratory, biomaterials are carefully studied and the results indicate the list and volume of each substance in the composition. This information allows the doctor to draw a conclusion about the severity of the pathology and the functioning of the kidneys.

Decoding the results

With pyelonephritis, urine parameters have the following deviations from normal values:

The presence of cylinders is observed, which in severe pathology have a granular structure.
Leukocytes in the urine with pyelonephritis are increased (more than 15 in the field of view).
The pH value is reduced, which indicates an increase in the acidity of the biomaterial.
Protein in the urine with pyelonephritis is present in a small amount (about 2%).
Epithelial cells are fixed.
Cloudiness appears.
The color of urine with pyelonephritis is paler than usual, but with significant discharge of pus it darkens.
Density indicators have been reduced.

At chronic course diseases, test results may remain within normal limits. In this case, they resort to additional ways diagnostics

If pyelonephritis is suspected, blood test results have the following abnormalities:

Leukocytes - more than 11 in children and 9 in adults.
Hemoglobin is below 120 in women and 140 in men.
Creatinine is above 97 µmol/l in women and 124 µmol/l in men.
Ammonia – more than 15-32 µmol/l.
Urea – more than 2.5-8.3 mmol/l.
Plasma protein is reduced.

Only a doctor can make a diagnosis of pyelonephritis based on test results. The patient himself, having noticed deviations from the norm, should not rush to conclusions. Deciphering analyzes is a complex process that must be trusted to a specialist.

Useful video about diagnostics and tests for pyelonephritis

List of sources:

Emergency urology and nephrology: Lyulko A.V. – 1996
Urology: Glybochko P.V., Alyaev Yu.G., Grigorieva N.A. – 2014

Pyelonephritis, like all other diseases, requires an accurate diagnosis. In combination with instrumental methods the necessary laboratory tests are carried out. Pyelonephritis is a kidney disease of an infectious-inflammatory nature. With the development of the inflammatory process, not only the calyces and pelvis are affected, the disease also spreads to the kidney tissue. The disease affects in most cases women over 50 years of age.

Stages of disease development

Characteristic feature pyelonephritis is alternating periods of remission and exacerbation. The disease has two phases of development:

primary;
Secondary.

Primary pyelonephritis is an independent disease, and secondary develops against the background of diseases genitourinary system, for example, cystitis. In most cases, pyelonephritis can be triggered by E. coli, fungi or viruses. When diagnosing pyelonephritis, laboratory tests of blood and urine are performed. Blood test for pyelonephritis shows:

decreased levels of hemoglobin and red blood cells,
Change leukocyte formula, leukocytosis,
Increased erythrocyte sedimentation rate (ESR);
The leukocyte formula shifts to the left. In addition to the above indicators, a number of other indicators indicate impaired renal function.

How to prepare for donating blood?

As a rule, blood sampling for laboratory tests is carried out in the morning, but in case of emergency the analysis is carried out without observing time restrictions, that is, as necessary. In medical centers, laboratories operate around the clock, which makes it possible to monitor the condition of patients during their hospital stay. The research results make it possible to evaluate the effectiveness of treatment.

The main condition is to donate blood on an empty stomach. Eating food must be avoided 10-12 hours before the procedure; drinking clean water in small volumes is allowed. Alcohol must be avoided two days before the test. Test results can be affected by physical stress on the body, so before going to the laboratory it is necessary to reduce it to a minimum. Some cases of the disease require comparison of the results of three tests, when blood is taken from a finger and from both sides of the lumbar region. An increased number of leukocytes in the blood is a sign of pyelonephritis.

Blood chemistry

Diagnosis of the disease also includes biochemical blood test for pyelonephritis. One of the signs of the disease is an increased content of nitrogenous metabolic products. At healthy kidneys the process of removing excess urea occurs quickly. Slowing down and disrupting the release of harmful substances from the body may indicate impaired kidney function and the development of pyelonephritis. For biochemical research, blood is taken from a vein in the morning on an empty stomach. Preparation for taking the test is the same as when donating blood for a general analysis.

Interpretation of analyzes

It is no secret that many of us make attempts not only to treat ourselves, but also to decipher test results. This should not be done, since competent interpretation of laboratory test results is only within the competence of a specialist. Even if you have “diagnosed” pyelonephritis, do not rush to start self-medication. You need to apply for medical Center in Moscow so that the doctor can diagnose accurate diagnosis and prescribed treatment. To make an appointment, call us by phone, the number of which can be found on the center's website. A consultant will answer any questions you may have. Our medical center is waiting for you!

– an inflammatory process that affects one kidney or both paired organs at once. Occurs in 10% of people on the planet, including children. To make a diagnosis, doctors conduct a series of tests.

Laboratory diagnostic methods are considered the main ones. They are used both to recognize the disease and to evaluate the effectiveness of treatment.

OAC, OAM – blood and urine tests, respectively, which are prescribed for the diagnosis of any disease, standard medical examination. If abnormalities are detected, a kidney problem may be suspected.

Pyelonephritis and its causes

Inflammation develops due to an attack by bacteria or viruses. To understand the essence of the problem, you need to delve into the work of the kidneys. The human urinary system consists of 2 kidneys, a bladder, 2 ureters, and a urethra.

The kidneys work around the clock, purifying the blood and producing 1-2 liters of urine. From the kidneys, fluid enters the bladder, and from it flows out through the urethra.

When the body is affected by infection, the kidneys may fail. - a serious illness that requires urgent treatment. If you miss time, the process will become chronic and provoke complications. When the diagnosis is made on time, a course of antibiotics will definitely help eliminate the problem.

Women are more likely to suffer from pyelonephritis, which is associated with their anatomy genitourinary organs. A common causative agent of infection is Escherichia coli, followed by streptococci, enterobacteria, enterococci, and Pseudomonas aeruginosa.

Main symptoms

The onset of inflammation can be recognized by an increased urge to urinate and painful urination. As the disease progresses, additional signs:

hematuria;
nausea to the point of vomiting;
, smells unpleasant;
consciousness becomes clouded;
chills, fever;
pain in the back, side.

Considering that the disease can develop from prostate hyperplasia, stones in the urinary organs, diabetes, the clinical picture will vary, complemented by symptoms of the underlying pathology. You should not engage in self-diagnosis; if the above symptoms appear, you need to visit a nephrologist, urologist, and undergo an examination.

Diagnostic methods

Suspecting a patient has pyelonephritis, the doctor, after studying the medical history and examination, will prescribe the following: diagnostic measures:

CT scan of the kidneys and other peritoneal organs;
urine test - OAM, according to Nechiporenko, Zimnitsky, tank culture;
blood test - CBC, biochemistry, C-reactive protein, sterility.

The main thing is a urine test, but this is not always enough. Then a blood test is crucial. It is deciphered by a doctor; you should not try to diagnose yourself.

Blood test and its purpose

Patients collect urine themselves, but donate blood in a medical facility under sterile conditions. The simplest method is a sample of capillaries located close to the fingertips.

The laboratory assistant uses a scarifier and removes the required amount of material into a test tube. Another option is a vein sample. It is somewhat more complicated, but is carried out quickly and safely.

A general blood test is the basis for diagnosing most known diseases.

When the diagnosis seems obvious, which is confirmed by urine tests, there is no need to evaluate a number of blood markers; it is enough to evaluate its main parameters, changes in which are characteristic of pyelonephritis:

creatinine;
hemoglobin;
protein;
leukocytes;
electrolytes.

Some of these parameters are detected using CBC, others - using blood biochemistry. For the result to be reliable, you must adhere to the following rules:

the analysis is taken from 8 to 10 am on an empty stomach, having had the last light snack 12 hours before taking the material;
48 hours before the test, avoid fatty, spicy foods and alcoholic beverages;
stop taking medications 24 hours before. The only exception is vital important drugs;
drink enough fluids;
Avoid excessive physical activity 24 hours before;
directly in the laboratory you need to sit for 10 minutes, calm down, and then go to the laboratory assistant.

General blood analysis

The study determines an increase in the number of leukocytes. This indicates the presence of inflammatory processes. The material is taken from the finger on the right hand. If pyelonephritis is suspected, attention is paid to a number of parameters.

Bacteriological culture is one of the most effective methods diagnosis of infections

The amount of hemoglobin and red blood cells is measured using hardware. Sometimes with pyelonephritis they do not deviate from the norm. Underestimated numbers do not directly confirm the presence of kidney inflammation; the kidney filter, from which red blood cells enter the urine, may be damaged.

The next indicator to be assessed is ESR, i.e., the rate at which red blood cells settle. It is calculated simply - the blood is left in a test tube, and after the required period of time the sedimentation rate is recorded on a special scale. Against the background of pyelonephritis, the figure greatly exceeds normal figures.

Another parameter is the number of leukocytes. Detected using medical devices. When the organ structures are inflamed, this indicator increases greatly, but it is more important for the laboratory technician to identify the leukocyte formula.

This is the composition of white blood cells. To do this, examine a drop of blood by placing it on glass under a microscope. For pyelonephritis, a characteristic picture is an increased number of granulocytes, a predominance of young cells, which differ significantly from already mature ones.

Blood chemistry

Considering that pyelonephritis changes Chemical properties blood, it is important to conduct a biochemical analysis to establish possible deviations. Medical devices calculate the amount of protein.

It matches normal indicators, but if the sample is examined in detail, more immunoglobulins are detected. For healthy body characterized by a predominance of albumin.

An increased concentration of protein in the urine is a sign of an inflammatory process in the kidney

A test for C-reactive protein can identify the inflammatory process. Blood healthy person does not contain such a component. On the form, the level of such protein is indicated by crosses, as the volume increases, from 1 to 4. Last digit indicates a serious inflammatory process affecting the kidneys.

During a biochemical analysis for pyelonephritis, the level of creatinine and urea is assessed. This test will show how well the kidneys are able to clear toxic substances from the blood.

The norms of the elements vary depending on the patient’s gender, age, and body weight. The doctor must take such features into account so as not to get false results. An increase in both indicators indicates violations affecting the organ filter.

Another parameter of biochemical analysis is the number of electrolytes. They are distributed inside the cell, in the surrounding fluid. For the body to function properly, the ratio of electrolytes must be in balance. If there are deviations, the tissues of the myocardium and brain suffer.

One of the most important indicators is the amount of sodium and potassium. The kidneys remove excess potassium from the body, and if its level is higher than normal, this indicates that the organ is not coping with its function. In this case, blood purification is carried out by hemodialysis, otherwise accumulated harmful substances will poison the body and lead to consequences.

Decoding analysis indicators

A specialist with a medical education can interpret the results of blood tests. The patient can independently see an increase in the indicators and suspect inflammation, but the doctor makes the decision.

Interpretation of indicators indicating pyelonephritis:

leukocytes are higher than normal;
increase in ESR;
alpha-2-globulins more than 13%;
reduction in specific gravity;
increase in uric acid more than 0.4 millimoles per 1 liter;
decrease in red blood cells, hemoglobin;
reduction in the amount of total protein;
gamma globulins more than 23%.

Standard results

When interpreting the results, the specialist takes into account the patient’s gender, age, condition, presence of pathologies, and medications taken. When assessing the data, the doctor compares them with the norms:

alpha-2-globulin 7-13%. An increase indicates kidney inflammation;
red blood cells. Men 0-1, women 0-3. Excess – pathologies of the kidneys, urinary organs;
gamma globulin 12-22%. Increased talk about severe inflammation;
protein. Its detection signals problems with the kidneys, tubules, and their nodes;
creatinine 53-115 µmol/l;
bilirubin. Exceeding the indicators indicates inflammation, the presence of infection, intoxication;
protein, urea. Exceeding the parameters indicates the onset of renal failure.

Doctors say that before going to the laboratory, you can suspect pyelonephritis by a change in the color of the urine. When the number of red blood cells in it increases, it acquires a red color of varying intensity, taking into account the number of red blood cells.

In addition to the color, the smell of the secreted liquid also changes - it becomes sharp; during an infectious process, urine smells unpleasantly of acetone. When faced with such manifestations, you need to go to the doctor, take simple tests and assess the state of the body, including the kidneys.

To summarize, we need to recall that pyelonephritis is a serious disease that requires timely diagnosis and immediate treatment. If you ignore the problem, refuse prevention, treatment, neglect hygiene and diet, the inflammation will become chronic, will remain forever and will periodically torment the patient with symptoms, which can cause serious consequences.

Pyelonephritis is an inflammatory process that affects one kidney or both paired organs at once. Occurs in 10% of people on the planet, including children. To make a diagnosis, doctors conduct a series of tests.

Laboratory diagnostic methods are considered the main ones. They are used both to recognize the disease and to evaluate the effectiveness of treatment.

The kidneys work around the clock, purifying the blood and producing 1-2 liters of urine. From the kidneys, fluid enters the bladder, and from it flows out through the urethra.

When the body is affected by infection, the kidneys may fail. Acute pyelonephritis is a serious illness that requires urgent treatment. If you miss time, the process will become chronic and provoke complications. When the diagnosis is made on time, a course of antibiotics will definitely help eliminate the problem.

Women are more likely to suffer from pyelonephritis, which is associated with the anatomy of their genitourinary organs. A common causative agent of infection is Escherichia coli, followed by streptococci, enterobacteria, enterococci, and Pseudomonas aeruginosa.

The onset of inflammation can be recognized by an increased urge to urinate and painful urination. As the disease progresses, additional signs appear:

hematuria;
nausea to the point of vomiting;
urine becomes cloudy and smells unpleasant;
consciousness becomes clouded;
chills, fever;
pain in the back, side.

Considering that the disease can develop from prostate hyperplasia, stones in the urinary organs, diabetes, the clinical picture will vary, complemented by symptoms of the underlying pathology. You should not engage in self-diagnosis; if the above symptoms appear, you need to visit a nephrologist, urologist, and undergo an examination.

Suspecting a patient has pyelonephritis, the doctor, after studying the medical history and examination, will prescribe the following diagnostic measures:

CT scan of the kidneys and other peritoneal organs;
Ultrasound of the kidneys;
urine test - OAM, according to Nechiporenko, Zimnitsky, tank culture;
blood test - CBC, biochemistry, C-reactive protein, sterility.

The main thing is a urine test, but this is not always enough. Then a blood test is crucial. It is deciphered by a doctor; you should not try to diagnose yourself.

Patients collect urine themselves, but donate blood in a medical facility under sterile conditions. The simplest method is a sample of capillaries located close to the fingertips.

Some of these parameters are detected using CBC, others - using blood biochemistry. For the result to be reliable, you must adhere to the following rules:

the analysis is taken from 8 to 10 am on an empty stomach, having had the last light snack 12 hours before taking the material;
48 hours before the test, avoid fatty, spicy foods and alcoholic beverages;
stop taking medications 24 hours before. The only exceptions are vital drugs;
drink enough fluids;
Avoid excessive physical activity 24 hours before;
directly in the laboratory you need to sit for 10 minutes, calm down, and then go to the laboratory assistant.

Another parameter is the number of leukocytes. Detected using medical devices. When the organ structures are inflamed, this indicator increases greatly, but it is more important for the laboratory technician to identify the leukocyte formula.

Considering that pyelonephritis changes the chemical properties of the blood, it is important to conduct a biochemical analysis to identify possible abnormalities. Medical devices calculate the amount of protein.

It corresponds to normal values, but if the sample is examined in detail, more immunoglobulins are detected. A healthy body is characterized by a predominance of albumin.

A test for C-reactive protein can identify the inflammatory process. The blood of a healthy person does not contain such a component. On the form, the level of such protein is indicated by crosses, as the volume increases, from 1 to 4. The last number indicates a serious inflammatory process affecting the kidneys.

During a biochemical analysis for pyelonephritis, the level of creatinine and urea is assessed. This test will show how well the kidneys are able to clear toxic substances from the blood.

One of the most important indicators is the amount of sodium and potassium. The kidneys remove excess potassium from the body, and if its level is higher than normal, this indicates that the organ is not coping with its function. In this case, blood purification is carried out by hemodialysis, otherwise the accumulated harmful substances will poison the body and lead to consequences.

Interpretation of indicators indicating pyelonephritis:

leukocytes are higher than normal;
increased ESR;
alpha-2-globulins more than 13%;
reduction in specific gravity;
increase in uric acid more than 0.4 millimoles per 1 liter;
decrease in red blood cells, hemoglobin;
reduction in the amount of total protein;
gamma globulins more than 23%.

alpha-2-globulin 7-13%. An increase indicates kidney inflammation;
red blood cells. Men 0-1, women 0-3. Excess – pathologies of the kidneys, urinary organs;
gamma globulin 12-22%. Increased talk about severe inflammation;
protein. Its detection signals problems with the kidneys, tubules, and their nodes;
creatinine 53-115 µmol/l;
bilirubin. Exceeding the indicators indicates inflammation, the presence of infection, intoxication;
protein, urea. Exceeding the parameters indicates the onset of renal failure.

To summarize, we need to recall that pyelonephritis is a serious disease that requires timely diagnosis and immediate treatment. If you ignore the problem, refuse prevention, treatment, neglect hygiene and diet, the inflammation will become chronic, will remain forever and will periodically torment the patient with symptoms, which can cause serious consequences.

source

Pyelonephritis (inflammation of the kidneys) is a fairly common disease, and quite dangerous, as it can lead to chronic renal failure. Sometimes the patient may hardly feel unpleasant symptoms, and attribute the presence of some minor signs of illness to other reasons. Therefore, timely and accurate diagnosis, which requires an examination, is very important. Thanks to blood testing, specialists can quickly specify the disease, excluding the presence of other diagnoses with similar symptoms, and quickly begin treatment, preventing severe complications at the patient.

Pyelonephritis is a nonspecific (of unclear origin) inflammatory disease of an infectious nature, in which the lesion can affect one or both kidneys, and not only renal pelvis and calyces, but also the tissue itself (parenchyma). The pathology is caused by direct contact with the kidneys of bacteria or mycoplasma and viruses, which is less common. Most often caused by Escherichia coli, less commonly by staphylococci, enterococci, Klebsiella and others; in 20% of cases the disease is caused by a mixed infection. Infectious agents can enter the kidneys in two ways:

Together with blood flow from a focus located outside the urinary system, for example, with tonsillitis, pneumonia, etc.
Ascending route (in 95% of cases), when bacteria enter the kidneys along with infected urine from the bottom up from the perineum and vagina through the urethra ( urethra), further - in bladder, and then through the ureters - into the renal pelvis, this occurs due to disruption of the urination process and urinary reflux (reverse flow of urine).

The second method of infection occurs more often in women and girls, especially in childhood and adolescence, due to the shorter urethra and its proximity to the vagina, in which, if normal microflora conditions for the proliferation of pathogenic bacteria appear. In male patients, pyelonephritis is more common after 60 years of age due to prostate hypertrophy, which leads to obstructive (characterized by the presence of an obstruction to the outflow of urine) urinary tract disorders that become inflamed when pressure increases, the outflow of urine becomes difficult, and normal kidney function is impaired .

With pyelonephritis, inflammation of an infectious nature affects the calyces, pelvis, and in severe cases, the parenchyma (tissue) of the kidney

Pyelonephritis is classified into the following forms:

And depending on the characteristics of the form of flow, it has a very wide range symptoms:

pain in the lumbar region,
swelling,
temperature increase,
chills,
tachycardia,
fatigue,
nausea and vomiting due to rapidly growing intoxication,
the appearance of blood in the urine (hematuria), urination disorders (dysuria).

Lower back pain is one of the symptoms of pyelonephritis

But not every patient has a complete picture of symptoms; the disease is almost asymptomatic. Therefore, it becomes crucial laboratory diagnostics pyelonephritis, which demonstrates objective changes in the main parameters. The doctor must prescribe urine and blood tests to the patient.

To study various blood parameters, tests are prescribed:

The first two are mandatory, the last one is prescribed as necessary, it is of a clarifying nature.

Before talking about the parameters of a blood test, it is worth dwelling on what the substance under study is. Blood consists of a suspension of various cells (also known as formed elements) in a special liquid (plasma) moving through circulatory system with the bloodstream, where each shaped element has its own special appearance and is responsible for its specific field of activity, performing important and specific (each has its own) tasks in ensuring the vital functions of the human body. Against the background of any disease, various changes occur in the blood, both quantitative (the number and mutual relationships change shaped elements), and qualitative (the outlines and size of the shaped elements change, and, consequently, the performance of their functions).

General, also known as clinical blood test (CBC), demonstrates what changes occur with the formed elements of the blood, because various diseases Each indicator changes in its own way. Individual parameters clinical analysis are designed to identify and demonstrate what specific deviations from the norm in one direction or another can occur with blood elements.

OAC must be performed for any diagnostic studies.

In the lumen blood vessel a suspension of formed elements (cells) of blood is in a liquid medium (plasma)

What is hidden behind the numbers in the table of the general blood test form, what parameters and why are of interest for the study? Usually, depending on the complexity of the diagnosed case, a doctor (general practitioner or nephrologist) may order a laboratory test to analyze biological material for signs that require laboratory analysis; how more complicated case for diagnosis, the more information the doctor will need.

The nephrologist decides whether to examine the blood according to the maximum number of parameters: pay attention to the erythrocyte sedimentation rate (ESR) and their number, hemoglobin and hematocrit (the volume of red blood cells in the blood), the total number of leukocytes and the relationship between their types (i.e. . leukocyte formula), platelet count and other parameters, or a “minimum set” of the most important ones is enough: ESR, hemoglobin, total number of leukocytes and their formula.

Which blood cells are most often given the honor of being examined under a laboratory microscope?

Erythrocytes, or red blood cells (RBC), are vital for the body, because they carry oxygen molecules necessary for respiration and supply them to cells and tissues, and on the way back they relieve them of unnecessary carbon dioxide. Clinical analysis examines the following parameters:

the total number of red blood cells, measured in pieces; more precisely, the number of cells per liter of blood is determined;
indicator of the level of hemoglobin (English HGB or Hb) - the same protein that is contained inside red blood cells and gives them a characteristic red color and, in fact, carries oxygen molecules, measured in grams per liter;
hematocrit, which expresses the ratio of the volume (proportion) of red blood cells to the total volume of blood plasma, measured as a percentage or mass fraction;
erythrocyte sedimentation rate (ESR) to the bottom of the test tube, it allows you to judge the inflammatory processes occurring anywhere in the body, measured in millimeters per 1 hour.

With pyelonephritis, erythrocyte mass indicators (number of red blood cells, hemoglobin, hematocrit) moderately decrease, and ESR, on the contrary, increases.

With pyelonephritis, the erythrocyte sedimentation rate (ESR) to the bottom of the tube increases

Platelets, or platelets (PLT), are responsible for stopping bleeding when blood vessels are damaged. The CBC shows their number in units per liter of blood; with pyelonephritis it sometimes increases, because the level of fibrinogen protein in the plasma increases.

Leukocytes (white blood cells, English WBC) - very important elements blood, there are several varieties of them, which differ in shape, size, appearance and the tasks performed, but all leukocytes guard the body from infections. When diagnosing pyelonephritis, the UAC examines the following parameters:

the total number of leukocytes (their conditional number is calculated per 1 liter of biological material), in this test all white blood cells, regardless of type, are to be counted, this is important, since the presence of infection (and pyelonephritis is exactly that) confirms the fact of leukocytosis, i.e. -increasing the number of leukocytes;
leukocyte formula - this concept expresses as a percentage how leukocytes are related different groups with the total number of all leukocytes, i.e., what percentage of lymphocytes, basophils, eosinophils, neutrophils and monocytes, if all leukocytes are 100% (can be expressed in shares, where one is the total number of leukocytes).

The number of leukocytes of certain types in relation to the total number of white blood cells is an important indicator for blood tests

Options for changes and deviations from a healthy state are called a shift in the leukocyte formula; it can shift to the right or left (based on the fact that the norm is in the middle). In the case of acute and chronic forms of pyelonephritis, the leukocyte formula is shifted to the left, i.e., towards an increase in the number of young forms of neutrophils, which are located on the left side of the leukocyte formula table of the standard form on which a general blood test is recorded. That is, it is young neutrophils that are more than normal.

The result of calculating the leukocyte formula cannot be used for self-diagnosis because of its nonspecificity (ambiguity): changes may have a similar appearance, although the diseases that caused such a picture are completely different, or, on the contrary, with the same diagnosis in different patients, changes in the leukocyte formula may differ, and when shifting the formula, the age norm should be taken into account.

The concept of a shift in the leukocyte formula to the left means an increase in the number of those types of neutrophils (young cells) that are on the left side of the table

Why is the number of young forms rapidly increasing with pyelonephritis? Neutrophils are the first to “rush into battle” and die in the fight against foreign microorganisms. In the case of inflammatory processes, many of them die while performing a “combat mission.” This means that the need for new neutrophils increases, and their reproduction increases (the so-called neutrophil response to inflammation).

The results of a clinical blood test for the parameters requested by the attending physician are obtained after testing the biological material of the blood in the laboratory and are recorded on a standard form; these numbers must be interpreted by the physician who ordered the study. Self-diagnosis in this matter is unacceptable. Only a specialist can say for sure whether there is enough information for a correct diagnosis and whether laboratory indicators reliably indicate pyelonephritis or another diagnosis is possible. If necessary, the doctor prescribes additional tests and examinations.

For a general blood test, a laboratory doctor takes biological material from the capillaries by piercing the skin on the end phalanx of the finger with a scarifier (less often, using a syringe from a vein on the elbow). For pyelonephritis, it is informative to take repeated daily blood samples (4–6 times), as well as to take material from both hands to compare indicators, for example, the total number of leukocytes is always higher on the side of the inflamed organ.

During a general blood test, biological material is taken from the capillaries of the last phalanx of the finger

So, the possible presence of pyelonephritis may be indicated by obvious indicators of the inflammatory process; with OAC they are as follows:

increased erythrocyte sedimentation rate (ESR),
decrease in the number of red blood cells,
decreased hemoglobin,
increased level of white blood cells (leukocytosis),
shift of the leukocyte formula to the left, i.e. identification of young forms of neutrophils.

A blood test for biochemical parameters can accurately determine the presence and concentration of biologically significant substances in the blood plasma (as opposed to a general test, which studies the number or characteristics of certain cells):

protein molecules (transport proteins, hormones, immunoglobulins, etc.),
residual decomposition products organic compounds nitrogen (creatinine, urea, uric acid and other compounds),
electrolytes: potassium, sodium, calcium, phosphorus, magnesium ions,
other biologically important substances.

A biochemical blood test allows you to accurately determine the presence and level of biologically significant substances in the blood plasma

With pyelonephritis, a biochemical analysis of blood plasma may show a deviation significant indicators, and it can manifest itself significantly or remain practically within the boundaries of the norm (the stronger the change, the more acute the process of inflammation of the kidney tissue).

The fact that kidney function is impaired and this may be due to the obvious presence of infection is indicated by the following characteristics of a detailed biochemical blood test:

reduced amount of total protein in the blood serum;
violation of the normal ratio of various functional protein groups in the blood plasma (dysproteinemia) - an increase in the proportion of any of the protein fractions (immunoglobulins, various hormones, etc.) has its own diagnostic value;
an increase in the concentration of nitrogen metabolism products in the blood plasma (excluding nitrogen contained in protein molecules); residual nitrogen is normally contained in an amount of about 0.2–0.4 g/l, so an increase in this indicator makes it possible to assess how well the kidneys cope with excretory function (because normally they quickly remove excess nitrogen in the urine);
abnormalities in the concentration of electrolytes: sodium, calcium, potassium ions (a strong increase in the number of the latter indicates the onset of renal failure);
increased concentration of sialic acids.

Blood for biochemistry is taken using a syringe from the veins in the elbow bend of the arm.

An analysis of serological (i.e., serum) blood parameters is very indicative for detailing the pathogen by antigens and antibodies. It is prescribed for diseases of infectious origin. This method helps:

indirectly detect the presence and increase in the concentration of antigens and serum proteins-antibodies in the blood plasma to certain infectious pathogens that cause inflammation, i.e., using a serological study, the culprit of the infection can be determined;
directly identify the genes of the bacteria that caused the inflammatory process in the kidneys.

In the first case, the main method is reaction indirect hemagglutination(aka passive hemagglutination reaction, RPHA, RNGA). In a test tube where samples of the patient’s blood are placed, in which red blood cells have adsorbed (captured) the antigen, and this is what the reaction to infection looks like, immune serum corresponding to this antigen is added (specific proteins inherent only to specific pathogens).

If erythrocytes with antigens of a bacteria suspected of infection are exposed to control serum with antibodies to this bacterium, then the erythrocytes stick together, that is, they agglutine. The reaction is registered only if there is a complete match. You can analyze for different infectious agents by adding new protein samples to the samples of the test material each time different cultures pathogenic microorganisms up to positive result.

The result of an indirect hemagglutination reaction is considered positive, in which red blood cells cover the entire bottom of the tube; if the result is negative, red blood cells in the form of a small disk are located in the center of the bottom of the tube

Based on the results of RPGA, it is possible to determine whether the form of pyelonephritis is acute or chronic. In acute pyelonephritis, the titer of antibacterial antibodies (the maximum degree of dilution of a blood serum sample at which antibody activity is detected using any serological reaction) in the passive hemagglutination reaction (RPHA) is increased in 60–70% of patients, in the latent phase (during a chronic process) it is normal.

The main method for identifying bacterial genes is polymerase chain reaction (PCR). This is an ultra-sensitive method for determining infection, which allows you to reproduce a prudently selected DNA fragment, indicative for accurate diagnosis, many times without involving the resources of the host cell, i.e., a living microbe.

At the first stage, using a special enzyme, copies of the material under study (a repeating DNA fragment) are repeatedly created. The second stage is to determine whether this sample belongs to a specific type of pathogen. After finding out who is to blame for the infection, the doctor has the opportunity to prescribe adequate targeted treatment for a patient suffering from pyelonephritis.

Precise molecular PCR diagnostics allows you to determine the presence of a pathogen, even if only a few molecules of its DNA are present in the sample

If the case is not very complicated and you only need to confirm the diagnosis established by urine tests, and they have a higher priority in relation to blood tests, then there is no diagnostic need to check an extended list of blood markers (indicators) in the laboratory. Enough signal parameters that are needed to confirm pyelonephritis are:

hemoglobin,
leukocyte formula,
total number of leukocytes,
creatinine content,
plasma protein level,
electrolyte balance.

The first four parameters are learned from a clinical test, the last three from a biochemical blood test.

Analysis of ESR is a key nonspecific (imprecise) marker for identifying any foci of inflammation in the body (it will help accurately determine the presence of a process, but will not show the location of the occurrence). The rate at which red blood cells settle (sediment) to the bottom of a special test tube is measured in millimeters per hour with a ruler. This reaction of red blood cells is due to the fact that certain proteins can stick red blood cells together into conglomerates (stacks), which are heavier than single cells and therefore settle faster. The rate of fall of glued groups of red blood cells allows us to draw conclusions about the presence and intensity of inflammation, since it can reflect the concentration of inflammatory proteins in the blood plasma; the higher it is, the more intense the inflammation and the higher the ESR.

Under the influence of inflammatory proteins, which are produced the more, the more intense the process, red blood cells stick together into groups that fall to the bottom of the test tube faster than individual cells, and this increases the ESR

In acute pyelonephritis, ESR can increase 2–2.5 times.

for children:
- newborns - 0–2;
- up to a year - 4–10;
- 1–17 years old - 0–15;
for men:
- 17–50 years old - 2–15;
- after 50 years - 2–20;
for women:
- 17–50 years old - 2–20;
- after 50 years - 2–30 mm/h;
after 60 years upper limit ESR standards calculated by the formula:
- for men - age divided by 2;
- for women - add 10 to the number of years and divide by two.

A blood test for ESR shows the presence of an inflammatory process if the erythrocyte sedimentation rate is high

The values of the total number of leukocytes and the leukocyte formula are important markers of the inflammatory process (pyelonephritis).

There are different types of white blood cells, each of which has its own function in the immune response.

The most important role of the kidneys in the overall harmonious picture of the functioning of the body is to be a selectively working filter that cleanses the blood of metabolic products that are constantly released into it by other organs. When proteins are broken down, nitrogen compounds are released, which the body must get rid of. Therefore, a study of which nitrogen metabolism substances are present in the blood and in what concentration can assess the extent to which the kidneys cope with the excretory function. The number of substances such as:

urea (norm - from 2.5–8.3 mmol/l), its content is about 50% of the total residual nitrogen;
creatinine (normal - 42–132 µmol/l);
creatine (normal - 102–408 µmol/l);
ammonia (normal - 11–32 µmol/l);
uric acid(the norm is from 0.14 to 0.54 mmol/l), its amount in the blood increases and is one of the first signs of the development of renal failure, and earlier than the urea content, which increases the diagnostic value of this criterion.

The kidneys filter waste products from the blood to form urine

The most often tested is the amount of urea and creatinine present in the blood. Their high level is an ominous indicator indicating a violation of the filtering function of the kidneys.

Hemoglobin carries oxygen from the lungs to body tissues

With pyelonephritis, laboratory tests show a decrease in the amount of total protein (the mass of all protein molecules) in the blood plasma (the norm is 65–85 g/l). This decrease (albuminuria) with functional kidney disorders in the chronic phase sometimes remains within the lower limits of normal, but with diseases in acute stage there is a sharper drop in blood protein levels.

Also, in the analysis of plasma proteins, it is noted whether there is an imbalance between individual fractions of proteins in the plasma (dysproteinemia); in pyelonephritis, immunoglobulin proteins predominate, whereas normally there is more albumin. The disease is characterized by the following phenomena:

increased levels of gamma globulins (normal - from 12 to 22%);
increased amount of alpha-2-globulins (normal - from 7 to 13%);
the appearance of C-reactive protein, which belongs to the group of beta globulins, which indicates that pyelonephritis occurs in an acute form (normally this protein is absent), and from the onset of the chronic stage of the disease, C-reactive protein sometimes disappears until the next exacerbation , this phenomenon allows us to draw a conclusion about how intense the inflammatory process is (measured from + to ++++);
decreased albumin levels;
increased fibrinogen levels.

These indicators accompany the inflammatory process; they are automatically calculated by modern laboratory diagnostic devices, and specific numerical characteristics are analyzed individually by a nephrologist.

Maintaining the correct level of electrolytes and their distribution between the intracellular and intercellular environment is the basis for the life of a healthy body. Even small deviations from the norm have a negative impact on the cardiovascular system, primarily on the work of the myocardium, as well as the brain and spinal cord, the conduction of impulses along nervous system. Sodium and potassium ions play a critical role in maintaining cell electrical potential and active properties cell membrane, they form the main part of the intra- and extracellular composition of ions. The concentrations of sodium and potassium are the most important indicators; the level of these substances is analyzed first.

The adult human body contains about 100 g of sodium. Of this amount, 90% is located outside the cells in the intercellular environment, about 70% of sodium ions are involved in active metabolism.

The total amount of potassium is slightly larger, about 150 g. The predominant part, up to 98%, is found inside cells, in the cytoplasm, and only about 2% is dissolved in the extracellular environment, which also includes blood plasma. Considering that the work of the kidneys also involves ridding the body of excess potassium, an increase in the amount of this substance in the blood plasma - warning sign insufficient kidney function.

Excess potassium in blood plasma is a cause for concern

Rules for preparing for laboratory tests blood are the same for everyone, regardless of gender and age of patients:

The blood test should be taken only on an empty stomach, the last meal before the test should be no earlier than 11–12 hours, since after food enters the stomach, a short-term release of a certain number of leukocytes into the blood follows, and other parameters may decrease, which masks the disease . This phenomenon occurs in any healthy person, and its purpose is to protect the body from pathogens that may be in food. A few hours after eating, the number of circulating cells decreases to normal, but a blood test taken after eating will demonstrate a false inflammatory picture and may distort the diagnosis.
The tests take place in the morning (8.00–10.00).
Two days before the test, you must strictly abstain from alcohol, fatty and spicy foods.
Maintain a drinking regimen and water balance, because if you drink little, the blood temporarily thickens (the concentration of formed elements in the plasma increases), so the quantitative parameters checked during the analysis increase and can be interpreted as signs of a pronounced inflammatory process.
During the day, limit your intake of medications, except those taken according to vital signs, because they can change the blood picture.
During the day you can do without active physical activity and stress.
Right before the test, you need to calm down and sit in a relaxed position for about 10–15 minutes to normalize your breathing and heart rate.

Stress can trigger the release of white blood cells, which will distort the results of a blood test; the day before the test, you should try to avoid situations that cause nervous tension

But still, sometimes a patient’s belonging to the stronger or fairer sex can affect the results of the study. For example, in women, a blood test will show an increased number of leukocytes if the test is done before menstruation, and immediately afterwards the hemoglobin level and the number of red blood cells will be reduced, so it is optimal to do a blood test in the middle of the cycle or a week and a week later. Also, hormonal changes during pregnancy and lactation make adjustments to the blood picture; it is necessary to warn the doctor about these conditions before the analysis so that he can make adjustments for them when interpreting the data.

Men who experience heavy physical activity should refrain from it 5–7 days before the tests, since excessive physical activity can significantly increase the release of leukocytes as a stress response; you need to take a blood test as soon as possible calm state.

Timely diagnosis pyelonephritis can significantly facilitate the treatment of this serious disease and speed up recovery. Changes in blood counts may be caused by for various reasons. Therefore, at the slightest suspicion of kidney inflammation, you should consult a doctor and get tested; their results in the overall picture of the disease should be interpreted only by a specialist.

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In the structure of inflammatory kidney diseases, pyelonephritis does not occupy a leading position, but is still considered a rather dangerous pathology. In most cases, it is asymptomatic, and mild symptoms and sluggish exacerbations do not always prompt patients to contact the clinic. However, it is extremely important to undergo an examination, since this will allow you to quickly identify the pathological process, begin its timely treatment, and also exclude the presence of other diseases with similar symptoms. A blood test for pyelonephritis is considered an irreplaceable and highly informative clinical study that will confirm or refute the presence of the disease.

If typical symptoms are present, the diagnosis is not in doubt, especially if it is confirmed by laboratory tests. Fever, pain, increased urination, increased muscle tone, blood in the urine with pyelonephritis, symptoms of intoxication directly indicate the development of an inflammatory process in the renal tubules.

Doctors highlight a number of the most important manipulations to confirm or refute disease of the urinary system.

Test according to the method of Nechiporenko and Zimnitsky;
Bacteriological culture of urine.
General blood and urine analysis.
Biochemical blood test.

The main role in diagnosis is played by a general analysis of urine and blood in case of pyelonephritis. A thorough study of the latter allows us to identify signs of inflammation and the presence of other pathological processes. Patients are asked to collect urine themselves, but blood collection is performed in laboratories or treatment rooms under especially sterile conditions.

The simplest method is to obtain the finished material from capillaries located on the fingertips close to the surface. To select the required amount of anatomical fluid, the laboratory assistant uses a scarifier. Another option is to obtain a blood sample from a vein. A needle is used to puncture a vessel in the crook of the elbow joint or the back of the hand, and the required volume is taken out using a syringe. Taking material from these places is considered the most convenient, since the veins are located close to the surface of the skin.

If specific signs are present, the diagnosis becomes obvious, so it is not necessary to examine a number of blood markers.

An assessment of its main parameters, changes in which are characteristic specifically for pyelonephritis, is considered sufficient. This:

Some of these indicators are detected by CBC, the rest by biochemical examination. To obtain a clear and reliable result, it is necessary to follow the established rules.

The presumptive presence of pyelonephritis is indicated by obvious indicators of the inflammatory process:

increase in erythrocyte sedimentation rate - ESR;
decrease in the amount of hemoglobin;
decrease in the number of red blood cells;
increased levels of leukocytes;
identification of young forms of neutrophils.

For a general analysis, a laboratory doctor takes blood from the capillaries by piercing the skin of the right finger with a scarifier.

Biochemical analysis is considered the most popular because it allows you to assess the condition of internal organs, control the speed of metabolic processes and identify the lack of microelements. With its help, you can determine the increase in the amount of nitrogenous metabolic products and urea, which, when the kidneys are damaged, is slowly eliminated from the body. The sample is taken from a vein in the elbow of the left arm in the morning on an empty stomach.

A specialist can learn about damage to the filtering capacity of the kidneys from the characteristics of a detailed biochemical analysis of anatomical fluid.

Increased concentration of sialic acids.
Reduced amount of total protein in the blood serum.
The development of azotemia is an increase in the blood plasma concentration of substances released as a result of nitrogen metabolism.
Anomalies in the concentration of electrolytes, in particular, changes in the ratio of calcium, sodium and potassium ions, and an increase in the amount of the latter indicates the development of a pathological process.

Serological analysis is one of the modern types of diagnostics. For detailing the causative agent of the infectious process for antibodies and antigens, this study is considered very indicative. The purpose of the analysis is: firstly, to directly identify the genes of the bacteria that caused the disease. Secondly, indirect confirmation of the presence and increase in the concentration of antibodies and antigens to certain types of infectious agents. It is carried out using the indirect (passive) hemagglutination reaction - RNHA or RPHA.

Of the above tests, the first two are prescribed without fail, the third is prescribed as necessary, since it is of a clarifying nature.

If you just need to confirm the diagnosis, then there is no need to check the extended list of markers in the laboratory. It is enough just to study the signal parameters to identify pyelonephritis. There is a certain table that indicates all their types, their norm and meanings. A specialist with a medical education can decipher the test results; the patient is only able to notice that the indicators are exceeded.

The task of this component is to transport oxygen from the lungs to the tissues. With the development of an acute inflammatory process, its content in the blood decreases, during the chronic stage it decreases slightly, or generally remains within the boundaries of the lower level. Normally, the concentration in representatives of the weaker half is 120, and in men – 140 g/l. In case of renal disorders, it changes depending on the form, and is noted at the level of 85 and 150 in women, and 95 and 135 in representatives of the stronger sex.

in women – 97 micromoles;
among representatives of the stronger sex – 124 µmol.

As for urea, in the absence of inflammation, the normal value does not go beyond 2.5-8.3 mmol / l. The normal level of ammonia in the blood is 11-32 µmol/l, and creatine – 102-408 µmol/l.

With pyelonephritis, albuminuria develops - a decrease in the amount of total protein (the mass of all molecules of a substance) in the blood plasma. If functional disorders occur in the chronic stage, then the indicators remain in the lower limits of normal; with the acute development of the process, a sharp drop in protein is observed.

The following phenomena are considered characteristic of the disease:

increased levels of gamma globulins (normally it is 12-22%);
an increase in the amount of alpha-2-globulins (in the absence of pathology 7-13%);
decreased albumin levels;
increase in the amount of fibrinogen;
the appearance of C-reactive protein, which indicates the development of the acute phase, since upon transition to the chronic stage it disappears until the next relapse.

All of the above indicators accompany the inflammatory process and are automatically calculated by special laboratory equipment. Specific parameter values are analyzed individually by a nephrologist.

Electrolytes play an important role in human life. Even minor deviations from the norm can cause the development of cardiovascular pathologies, affect the functioning of the myocardium, brain and spinal cord, and impair the conduction of nerve impulses. Maintaining an optimal ratio of ions of various substances, and primarily sodium and potassium, in the body is the task of the filtering organ.

The most important indicators are the concentration values of these elements. The adult human body contains about 100 g of sodium. Up to 90% of this substance is found in the intercellular environment. Approximately 70% of the total is involved in active ion exchange.

To get a reliable result after taking a blood test, you need to properly prepare for the procedure and follow a number of rules.

Anatomical fluid must be donated in the morning. In exceptional cases, the collection is carried out immediately after the patient arrives at the hospital.
For the reliability of the indicators, finger sampling should be carried out on an empty stomach, and fasting before the procedure should last at least 10-12 hours. Moderate consumption of clean water without gas is allowed.
Before donating blood, it is not recommended to overload the body with various physical exercises; you should also refrain from stress.
It is considered unacceptable to drink any alcohol on the eve of the procedure. In general, this break should be at least 2-3 days.
Before donating blood, you do not need to stretch your fingers or elbow joint, as this will cause an increase in the number of leukocytes, which will negatively affect the test results.

Anatomical fluid is also collected from a vein in the morning on an empty stomach. Preparatory manipulations are similar for fingerprint analysis.

To understand the scope and seriousness of kidney pathology, you should learn about some interesting facts and figures.