One of the most common urological diseases
infectious nature, affecting the cup-pelvis system and
the kidney parenchyma is pyelonephritis. This is quite dangerous
pathology in the absence of timely competent treatment can
lead to violation of excretory and filtering functions
What is this kidney disease, why is it important to know first
symptoms and see a doctor in time, as well as how to start treatment
different forms of pyelonephritis, consider further in the article.
What is pyelonephritis
Pyelonephritis is an inflammatory disease of the kidneys,
characterized by damage to the kidney parenchyma, cups and renal
In most cases, pyelonephritis is caused by the spread of
infections of the bladder. Bacteria enter the body from the skin
around the urethra. Затем они поднимаются от уретры в мочевой
bladder and then get into the kidneys, where it develops
Pyelonephritis can be an independent disease, but more often
complicates the course of various diseases (urolithiasis,
prostate adenomas, diseases of the female genital organs,
tumors of the genitourinary system, diabetes mellitus) or occurs as
Kidney pyelonephritis is classified:
- Due to the development – primary (acute, or non-obstructive) and
secondary (chronic, or obstructive). The first form is
a consequence of infections and viruses in other organs, and the second – anomalies
- At the location of the inflammation – bilateral and unilateral.
In the first case, both kidneys are affected, in the second – only one,
the disease may be left- or right-sided.
- According to the form of kidney inflammation – serous, purulent and
- Acute pyelonephritis is caused by a large kidney
the number of microorganisms, as well as the weakening of the protective properties
of the body (weak immunity, previous cold,
overwork, stress, poor nutrition). Inflammatory process
pronounced bright. Most often it is diagnosed in pregnant women,
whose body is especially vulnerable.
- What is chronic pyelonephritis? This is the same kidney inflammation,
only characterized by a latent course. Of-за изменений в
urinary system disrupts the flow of urine, resulting in
the infection gets to the kidneys in an ascending way.
According to the phases of the flow:
- Active inflammation is characterized by symptoms: increased
temperature, pressure, pain in the abdomen and lower back, frequent
- Latent inflammation is characterized by the absence of any
symptoms and, accordingly, complaints of the patient. However, in urine analysis
- Remission – there are no pathologies in the urine and
In pyelonephritis, as we have already identified, the kidneys are affected, and in
This is mainly due to the effects of bacteria.
Microorganisms, being in the renal pelvis or in itself
urinogenous or hematogenous, deposited in the interstitial
kidney tissue, as well as in the fiber of the renal sinus.
The disease can occur at any age. More often pyelonephritis
- in children under the age of 7 years (the likelihood of pyelonephritis
increases due to the nature of anatomical development);
- young women aged 18-30 years (the occurrence
pyelonephritis is associated with the onset of sexual
жизни, беременностью и родами);
- in older men (with urinary tract obstruction due to
развития аденомы предстательной железы).
Any organic or functional obstacles
normal outflow of urine, increase the likelihood of developing
diseases. Often pyelonephritis appears in patients with urolithiasis
The most common cause of inflammation of the urinary tract
- Kolya bacterium (E. coli), staphylococcus or
- Less likely to provoke non-specific inflammatory process
may other gram-negative bacteria.
- Often, patients are found combined or
multi-resistant forms of infection (the latter are due to
uncontrolled and unsystematic antibacterial treatment).
Ways of infection:
- Ascending (from the rectum or foci of chronic inflammation,
located in urogenital organs);
- Hematogenous (realized through the blood). In this situation
the source of infection can be any remote focus located
outside the urinary tract.
It is not enough to penetrate pyelonephritis
microflora in the kidney. For this, moreover, are needed
предрасполагающие факторы, среди которых основными are:
- violation of urine outflow from the kidney;
- disorders of blood and lymph circulation in the organ.
However, it is believed that in some cases, highly pathogenic
microorganisms capable of causing acute pyelonephritis in intact
kidney in the absence of any predisposing causes.
Factors that will help bacteria develop in paired
- Lack of vitamins;
- Reduced immunity;
- Chronic stress and overwork;
- Kidney disease or genetic predisposition to fast
defeat of paired organs.
Симптомы пиелонефрита у взрослых
Symptoms of pyelonephritis can vary depending on
person’s age and may include the following:
- Fever and / or chills, especially in case of acute
- Nausea and vomiting;
- Боли в боку под нижними ребрами, в спине, иррадиирующая в
iliac fossa and suprapubic area;
- Frequent, painful urination;
- Blood in urine (hematuria);
- Turbid urine with a pungent odor.
Pyelonephritis is often accompanied by dysuric disorders,
manifested in the form of frequent or painful urination,
separation of urine in small portions, the prevalence of nighttime diuresis
over the daytime.
Symptoms of acute kidney pyelonephritis
In this form, pyelonephritis occurs in combination with such
- high fever, chills. Patients noted enhanced
- Kidney from the side of the lesion hurts.
- At 3-5 days of the manifestation of the disease with the feeling, you can
to determine that the affected kidney is in an enlarged state,
besides, it is still painful.
- Also by the third day pus is detected in the urine (which
denoted by the medical term pyuria).
- Chills and fever with headache, pain
in the joints.
- In parallel with these symptoms, there is an increase in pain
sensations in the lumbar region, basically this pain is still
it is shown from that party from which the kidney is struck.
Признаки хронического пиелонефрита
The symptoms of the chronic form of kidney disease are very conditional and
current has no pronounced signs. Often inflammatory
the process in life is perceived as a respiratory infection:
- muscle weakness and headache;
- febrile temperature.
However, in addition to these characteristic signs of the disease, the patient
there is frequent urination, with the appearance of an unpleasant smell
urine. In the lumbar region, a person feels a constant aching pain,
is tempted to urinate frequently.
Late common symptoms of chronic pyelonephritis
- dryness of the oral mucosa (at first a slight
- discomfort in the adrenal region
- psychological passivity
- puffiness of face
- pallor of the skin.
Все это может служить которые проявлениями хронической
почечной недостаточности и характерны для двустороннего
kidney damage, discharge up to 2–3 liters of urine per day or more.
Serious complications of pyelonephritis include:
- renal failure;
- sepsis and bacterial shock;
- carbuncle buds.
Any of these diseases has serious consequences for
All of the above symptoms and signs of urological
diseases must have adequate medical evaluation. Not worth it
to endure and hope that everything will work out by itself, as well
engage in self-treatment without prior inspection
Diagnostics воспаления лоханок и паренхимы почек, как обычно,
begins with a general examination after collecting patient complaints.
Become instrumental and laboratory
studies that give a complete picture of what is happening.
Laboratory methods include:
- General urinalysis: when seeding urinary sediment on
the glass slide shows an increase in the number of white blood cells and
bacteria in sight. Urine should normally be acidic,
in infectious diseases, it becomes alkaline;
- General blood count: in peripheral blood
all signs of inflammation appear, increases
erythrocyte sedimentation rate and the number of
white blood cells in sight.
- в анализе крови определяется повышение лейкоцитов со
formula shift to the left, accelerated ESR;
- the urine is cloudy with mucus and flakes, sometimes has an unpleasant
smell. It contains a small amount of protein, a significant
leukocyte count and single red blood cells.
- in crops of urine is determined by the true bacteriuria – the number
микробных тел в миллилитре мочи >100 тыс.
- Nechiporenko test reveals the predominance of leukocytes in the average
portions of urine over red blood cells.
- in the chronic process there are changes in biochemical
Assays: increased creatinine and urea.
Among the instrumental research methods prescribed:
- Ultrasound of the kidneys and abdomen;
- computed tomography or x-ray to detect changes
structures of the affected kidney.
Treatment of kidney pyelonephritis
Treat kidney pyelonephritis in a comprehensive manner, including
drug and physiotherapeutic methods. Fully
treatment of kidney disease contributes to the speedy
recovery of the patient from an infectious pathology.
The goal of drug treatment is not only aimed at
elimination of pathogens and stopping of symptomatic
signs, but also on the restoration of vital body functions
while pyelonephritis has progressed.
- Antibiotics. If exacerbated, they cannot do without them, but optimally,
if they are prescribed by a doctor, even better if at the same time he explains
how to collect and where to pass urine for planting on microflora and
antibiotic sensitivity. Most often in ambulatory
practice are used:
- protected penicillins (Augmentin),
- 2nd generation cephalosporins (Ceftibuten, Cefuroxime),
- fluoroquinolones (Ciprofloxacin, Norfloxacin, Ofloxacin)
- nitrofurans (Furadonin, Furamag), as well as Palin, Biseptol and
- Diuretic drugs: prescribed for chronic pyelonephritis
(to remove excess water from the body and possible edema), with
acute not assigned. Furosemide 1 tablet 1 time per week.
- Immunomodulators: increase the body’s reactivity with
disease, and to prevent the exacerbation of chronic
- Timalin, intramuscularly on 10-20 mg once a day, 5 days;
- T-activin, intramuscularly, 100 μg 1 time per day, 5 days;
- Multivitamins, (Duovit, 1 tablet 1 time per day), tincture
Ginseng – 30 drops 3 times a day, also used for the purpose
- Nonsteroidal anti-inflammatory drugs (Voltaren),
have anti-inflammatory effect. Voltaren inside, at 0.25
g 3 times a day, after meals.
Treatment of chronic pyelonephritis is carried out according to the same
principles that therapy is an acute process, but differs more
duration and complexity. Therapy of chronic pyelonephritis
includes the following therapeutic measures:
- elimination of the reasons which led to obstruction of urine outflow
or caused impaired renal circulation;
- antibacterial therapy (treatment is prescribed taking into account
sensitivity of microorganisms);
- normalization of general immunity.
The task of treatment in the period of exacerbation is to achieve complete clinical
and laboratory remission. Sometimes even 6 week treatment
antibiotics do not give the desired result. In these cases
the scheme is practiced when for half a year every month at 10
days an antibacterial drug is prescribed (each time
– another, but taking into account the spectrum of sensitivity), and the rest
time – diuretic herbs.
Surgical intervention is prescribed in the event that
conducting a conservative treatment the patient’s condition remains
severe or getting worse. As a rule, surgical correction
is carried out in the detection of purulent (apostemozny) pyelonephritis,
abscess or carbuncle kidney.
During the operation, the surgeon produces lumen repair
ureter excision of inflammatory tissues and establishment
drainage for the outflow of purulent fluid. In case the kidney parenchyma
operation – nephrectomy – was significantly destroyed.
Diet and proper nutrition
The goal pursued by the diet for pyelonephritis –
- sparing kidney function, creating optimal conditions for their
- normalization of metabolism not only in the kidneys, but also in others
- lowering blood pressure
- reduction of edema,
- maximum excretion of salts, nitrogenous substances and
According to the table of medical tables by Pevzner, a diet with
pyelonephritis corresponds to the table number 7.
General characteristics of the treatment table number 7 is a small
protein restriction, while fats and carbohydrates correspond
physiological norms. In addition, the diet should be
Products that need to be limited or, if possible, excluded
for the period of treatment:
- broths and soups in meat, fish broth – it is
about the so-called “first” broths;
- first courses of legumes;
- fish in salted and smoked form;
- any fatty varieties of river and sea fish;
- caviar of any fish;
- fatty meat;
- lard and fat;
- bread with salt;
- any flour products with the addition of salt;
- mushrooms of any kind and cooked in any way;
- strong tea and coffee;
- confectionery (cakes and pies);
- sorrel and spinach;
- radish and radish;
- onion and garlic;
- sausages and sausages – boiled, smoked, fried and
- any smoked products;
- sharp and fatty cheeses;
- canned meat and fish;
- pickles and pickles;
- sour cream of high fat content.
- Low-fat meats, poultry and fish. Despite being fried
products are permissible, it is advised to boil and steam, simmer
and bake without salt and spices.
- Drinks are advised to drink more green tea, various fruit drinks,
compotes, herbal teas and decoctions.
- Low-fat soups, preferably on a vegetarian vegetable
- The most preferred vegetables for this diet is pumpkin,
- Cereals should be avoided, but are acceptable and useful in this
buckwheat and oat disease.
- Bread is advised to eat without adding salt, fresh immediately there is no
recommended. It is advised to make toast of bread, to dry it in
the oven. Also allowed pancakes, pancakes.
- When pyelonephritis is allowed dairy products, if they
low fat or low fat.
- Fruits can be eaten in any quantities, they are useful when
inflammatory process of the kidneys.
Dieting with pyelonephritis facilitates the work of sick kidneys.
and reduces the load on all organs of the urinary system.
Before use folk remedies for pyelonephritis, necessarily
consult with your doctor, because can be
individual contraindications for use.
- 10 grams of collection (prepared from cowberry leaves, mother-and-stepmother,
wild strawberry, cornflower, forest veronica grass, nettle and seed
sowing flax) pour boiling water (0.5 liters) and place in a thermos on
9 hours. You need to consume 1/2 cup at least 3 times a
- Pumpkin juice is especially in demand, providing strong
противовоспалительное действие во время цистита и pyelonephritis. Of
vegetable, you can cook yourself medicinal porridge for breakfast or cook
его на пару, а также в the oven.
- Corn silk – hair of ripe corn – as a diuretic
agent with elevated pressure. In addition, the plant has
antispasmodic action, which will eliminate pain during
inflammation in the kidneys and in other parts of the body, however
if blood clots are formed too often in the patient’s blood,
corn stigmas will have to be abandoned.
- Dry and grind the plant.
- Pour 1 dessert spoonful of hairs with 1 cup of boiling water.
- Cook for 20 minutes.
- Insist 40 minutes.
- Take 2 tbsp. decoction every 3 hours.
- Сбор от пиелонефрита почек: по 50 г – хвоща полевого,
strawberries (berries) and rosehips; 30 g nettle (leaves),
plantain, cowberry and bearberry; on 20 g – hop, juniper
and birch leaves. The whole medicinal composition is mixed and
fill 500 ml of water. Bring all medical mass to a boil. After
процедить и употреблять по 0,5 стакана 3 раза в day.
For the prevention of pyelonephritis recommended:
- visit a urologist (once every 3-4 months);
- time to treat urological and gynecological
- consume large amounts of fluid to normalize churn
- avoid hypothermia;
- lead a healthy lifestyle;
- stick to a balanced diet;
- do not abuse protein foods;
- men – to control the state of the urinary system,
Especially, if in the past there were transferred urological
- in case of urination, do not delay
- follow the rules of personal hygiene.
Пиелонефрит почек — это серьезное заболевание, которое
need to be treated at the first signs, so as not to arise
complications. Be sure to undergo a diagnosis by a nephrologist or
urologist, 1-2 times a year.