Chronic pyelonephritis

Chronic pyelonephritis is a chronic disease in which the inflammatory process is localized in the pelvicalyceal system and the kidney parenchyma.

This disease is one of the most common diseases and is a fairly common type of kidney damage for all ages.

The reasons

In the development of chronic pyelonephritis, the general state of urinary function is important. Hypovitaminosis, hypothermia, reduced immunity, fatigue, as well as foci of chronic infection (tonsillitis, inflammation of the uterine appendages, etc.) can contribute to the exacerbation of the disease.

Symptoms

There are local and general symptoms of chronic pyelonephritis. Local symptoms are more pronounced in patients with secondary chronic pyelonephritis, which is a complication of a number of diseases that disrupt the outflow of urine from the kidney (urolithiasis, prostate adenoma, uterine fibromyoma, prolapse of the kidney, etc.). Patients note periodic aching pain in the lumbar region, on the right or left. Their appearance is traditionally unrelated to the active movements of the patient, more often they appear at rest.

In primary pyelonephritis, the pain never takes on the character of renal colic and does not radiate. Urinary disorders are often noted, which are among the main symptoms of inflammation of the bladder, but are not often present in chronic pyelonephritis, since there is a certain relationship between these diseases.

In a significant proportion of patients, especially in women, pyelonephritis begins after several years or even decades of treatment for chronic cystitis with frequent exacerbations.

General symptoms of chronic pyelonephritis can be divided into early and late. Early general symptoms are typical for patients with unilateral or bilateral pyelonephritis, but without impaired renal function. They consist in fatigue, periodic weakness, loss of appetite, subfebrile temperature. Decrease in working capacity, which is explained by venous congestion in the kidneys, which is aggravated by a long stay in an upright position. In 38-69% of patients, an increase in blood pressure is determined. A slight rise in body temperature outside the active phase in chronic pyelonephritis is not often noted.

Late symptoms of chronic pyelonephritis: dry mouth, discomfort in the kidneys, heartburn, psychological passivity, puffiness of the face, pallor of the skin, which are a manifestation of chronic renal failure and are characteristic of bilateral kidney damage, excretion of up to 2-3 liters of urine per day or more .

The last stage of chronic renal failure, if there are no aggravating factors, develops 15 or more years after the onset of the disease.

Diagnosis

The main methods for diagnosing chronic pyelonephritis are: a general test of urine and blood, bacteriological examination of urine, ultrasound, X-ray and radioisotope methods.

Treatment

Treatment of chronic pyelonephritis presents certain difficulties, due to the unpredictability of the course of the disease. The leading method of treatment of chronic pyelonephritis is antibiotic therapy. Antibacterial products are selected that do not affect the toxic effect on the kidneys, to which the microflora of the urine is sensitive and which are excreted mainly by the kidneys. The main condition is the treatment of the patient until the complete cessation of the main clinical manifestations of the disease.

Antibacterial agents of different groups are used: antibiotics, sulfanilamide products, derivatives of nitrofuran, nalidixic acid, antiseptics, products of plant origin. The appointment of antibiotics is made in accordance with the properties of the identified microorganism-causative agent. In recent times, products of the fluoroquinolone group (ciprofloxacin, norfloxacin, pefloxacin, etc.) have become widespread.

Phytotherapy also occupies a significant place in the treatment of chronic pyelonephritis. Medicinal plants with anti-inflammatory, antimicrobial and diuretic properties are used (lingonberry leaf, bearberry leaf, chamomile flowers, horsetail, etc.).

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