Acute pyelonephritis: symptoms, treatment, causes

What is it? Pyelonephritis is an inflammatory process that affects the calyx and pelvis of the kidneys and is caused by pathogens.

The danger of the disease is that it can be hidden for a long time without showing any clinical signs. However, the pathological process is progressing.

Pyelonephritis - the most common disease of the upper urinary tract, it accounts for 2 out of 3 all inflammatory processes of the urinary organs. From the point of view of the severity of the process, it can occur in two main forms - acute and chronic.

Causes of acute pyelonephritis

Pyelonephritis is always an infection-dependent pathological process. Therefore, all microbial agents that can cause the development of this inflammation are usually divided into two main groups:

1. 1) Conditionally pathogenic microorganisms that live on the skin and mucous membranes constantly, but cause the development of an inflammatory reaction only against the background of a decrease in the immunity of
   
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2. 2) Pathogenic microorganisms, which fall from outside and with a sufficient infectious dose become a source of inflammatory disease.

It is accepted to allocate so-called age peaks, when the incidence of pyelonephritis rises. To do this, a number of conditions are created, related to the patient's age.

The main most dangerous periods are:

1. 1) Babies under the age of 7 years who have a special structure of the urinary system, contributing to the easy entry of microorganisms
   
2. 2) Female representatives from 18 to 30 years. This is facilitated by the onset of sexual activity, pregnancy with its hormonal changes and childbirth, when there is a physiological decrease in the immunity of
   
3. . 3) Men of age who are often diagnosed with prostate adenoma that impedes normal urinary outflow through the urethra.

There are also a number of predisposing factors that have an unfavorable state on the organs of the urinary system. These include:

• urolithiasis, in which the stone can disrupt urinary outflow, causing it to stagnate
  
• attacks of renal colic accompanied by a spasm of smooth muscle, followed by a violation of urine outflow
  
• decreased activity of the immune system that predisposes to frequent attachment of the inflammatory process
  
• diabetes mellitus, against which the protective function of leukocytes, which are in a state of energy hunger, decreases. In addition, glucose is a good nutrient medium for many bacteria
  
• the presence of chronic inflammatory processes in the body that are the source of pathogenic microbes
  
• abnormalities of kidney development, for example, doubling of
  
• undercooling, reducing the activity of local immunity, etc.

Infection can occur in the following ways:

1. 1) Ascendant - microorganisms rise from the lower urinary tract to the kidney
   
2. 2) Hematogenous - microbes enter the kidney with blood flow( especially this pathway is realized in the presence of inflammatory diseases of the ENT organs)
   
3. 3) Lymphogenous- In the inflammatory process, a number of located organs that have lymphatic drainage connections with the kidneys
   
4. 4) Contact, in which the inflammation passes to the kidney from the organs that directly contact it.

Symptoms of acute pyelonephritis

Symptoms of acute pyelonephritis and exacerbation of the chronic inflammatory process are largely similar and are associated with the development of intoxication and the activity of pathogen microorganisms.

In the remission phase, chronic pyelonephritis is virtually asymptomatic. Thus, this process is characterized by alternation of periods of exacerbation and remission.

The main symptoms of pyelonephritis are the following:

1. 1) Pain in the lumbar region. The localization of pain corresponds to the side of the affected kidney. With an uncomplicated form of the disease for pain, irradiation is not characteristic. With urolithiasis, pain can be given to the groin, lower limb and urethra.
   
2. 2) Changes in urine - it can become turbid, and laboratory signs of the inflammatory process of
   
3. are found 3) Increase in body temperature
   
4. 4) Symptom of effleurage in the lumbar region reveals soreness
   
5. 5) Signs of intoxication - thirst, dry mouth, nausea,e.

Diagnosis of the disease

Diagnostic search for pyelonephritis consists in the following additional research methods:

• general clinical urinalysis
  
• urine analysis according to Nechiporenko, with the help of which the number of shaped elements in the urine is calculated.
  
• bacteriological examination of urine
  
• ultrasound examination of the kidneys and bladder with whichit is possible to exclude complications of pyelonephritis, as well as to identify predisposing factors to the development of pyelonephritis
  
• excretoryUrography - X-ray examination with contrast. This study reveals anomalies in the development of the kidneys, bladder, etc.

Treatment of acute pyelonephritis

Treatment of acute pyelonephritis and exacerbation of chronic is carried out in the same way.

Therapy of this disease should be comprehensive and aimed at the following objectives:

1. 1) Elimination of the causative microorganism - antibiotics are assigned to which the pathogenic microbes that caused the disease
   
2. are sensitive 2) Detoxification by introducing a sufficient amount of fluids that promotes the removal of toxic substances from the blood(and they are formed during the life of microorganisms)
   
3. 3) Immunostimulating therapy in the presence of reduced immunity, as confirmed by the specialal researches.

If a specific cause of pyelonephritis is identified, it should be eliminated if possible. This will prevent the progression of the pathological process. After laboratory recovery is achieved, antibiotics continue with intermittent courses to finally eliminate pathogenic microorganisms.

Complications of pyelonephritis

If a person turns late for medical help, then this predisposes to the development of a number of complications against the background of pyelonephritis. The main negative consequences of this inflammatory process are:

• kidney abscess - the presence of a purulent focus in its thickness
  
• kidney carbuncle - a purulent foci in the kidney that does not have an inflammatory capsule
  
• renal failure
  
• urinary retention
  
• cystitis - inflammation of the bladder
  
• urethritis - inflammation of the urethra
  
• paranephritis - inflammation of the peri-cellular tissue
  
• renal vein thrombosis, etc.

A number of these complications require urgent surgical intervention. Therefore, it becomes clear how important it is to diagnose pyelonephritis on time and to treat it with minimal costs.

In conclusion, it should be noted that pyelonephritis is a serious disease that affects the organs of the urinary system. It can occur in both acute and chronic forms. In some cases, this pathology has vivid clinical manifestations, while in others it proceeds almost asymptomatically, presenting a danger to the body. Therefore, for this disease, as for any other, it is necessary to conduct a timely diagnosis with subsequent treatment.

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