Pyelonephritis: causes, symptoms, methods of diagnosis and treatment. Diagnosis and treatment of chronic pyelonephritis

Causes of pyelonephritis

Pyelonephritis is caused by a bacterial infection. Inflammation is often caused by the simultaneous activity of microorganisms of various types, activated against the background of predisposing factors.

The infection can enter the kidney in an ascending way - through the ureter, for example, from the bladder (in this case, pyelonephritis is a complication of cystitis) or from the genitals, which is especially typical for women: a woman’s urethra (urethra) is short, which facilitates the entry of infection. That is why pyelonephritis at the age of 18-30 years occurs in women more often than in men.

Another route of penetration is through the flow of lymph or blood. The infection can be transferred with blood even from distant foci of inflammation (for example, with tonsillitis, furunculosis, wound suppuration).

Factors contributing to the development of pyelonephritis

In most cases, the development of pyelonephritis requires the influence of local predisposing factors, including:

violation of the outflow of urine from the kidney;
impaired blood flow in the kidney;
diseases of nearby organs (primarily the intestines);
systemic diseases (diabetes mellitus, etc.).

Among these factors, the most significant is the disruption of urine outflow. Stagnation of urine creates an environment favorable for the growth of bacteria, therefore, if the outflow of urine from the kidney is impaired, pyelonephritis is an expected disease.

Impaired urine flow may result from:

prostatitis or prostatic hyperplasia (prostate adenoma). Similar diseases are observed in many men over the age of 30, and the higher the age, the more likely the disease;
urolithiasis;
pregnancy (the growth of the uterus leads to compression of the ureter. Hormonal changes also affect).

What are risk factors?

There are a number of extrasexual factors that increase the risk of developing acute pyelonephritis:

Congenital or acquired anomaly, pathology of the structure of the kidneys and other organs of the urinary system.
AIDS virus.
Urolithiasis disease.
Diabetes. With increased sugar content in the urine, pathogenic microorganisms will multiply.
Age.
The spinal cord and peritoneal organs are injured.
Surgery or other medical intervention on the urinary system.
Bacterial chronic disease, the presence of an infectious focus in the body.

The occurrence of acute pyelonephritis in a man may be associated with prostate disease and an increase in its size.

Symptoms of pyelonephritis

There are acute and chronic pyelonephritis.

Symptoms of acute pyelonephritis

Acute pyelonephritis begins suddenly. The main symptoms are as follows:

high temperature (39-40° C);
profuse sweat;
chills;
general weakness;
pain concentrated in the lumbar region (with unilateral pyelonephritis - on one side). The pain is dull in nature, but can be very severe.

Pyelonephritis often occurs against the background of obstructed urine outflow, but problems with urination are not a symptom of this disease.

Symptoms of chronic pyelonephritis

If during treatment the severity of the symptoms was relieved, but the inflammation did not completely stop, pyelonephritis becomes chronic. Often chronic pyelonephritis develops without a preceding acute process.

Chronic pyelonephritis manifests itself as a dull aching pain in the lumbar region, especially in cold and damp weather. There may be periods of exacerbation during which the severity of symptoms returns again.

Often chronic pyelonephritis occurs secretly. A moderately elevated body temperature (37-37.5° C) may persist, the cause of which remains unknown for a long time. Often, chronic pyelonephritis is accidentally discovered during a medical examination, caused by completely different patient complaints.

If chronic pyelonephritis is not detected in time and left untreated, it leads to the development of chronic renal failure, which in the early stages manifests itself as an increased number of nighttime urinations (two or more per night).

Signs of the disease in women

Women are most susceptible to developing pyelonephritis. Symptoms of the disease may vary depending on its form. As a rule, signs of acute pyelonephritis in a woman are:

Change in the color and odor of urine. The fluid may become cloudy and contain bloody or purulent inclusions.
Increased body temperature above 38 degrees. In some cases, there is a sharp change in indicators.
Burning sensation when urinating, frequent visits to the toilet.
Nausea, accompanied by vomiting, chills.
Having a headache.
Painful sensations when tapping with the edge of the palm in the kidney area.

Methods for diagnosing pyelonephritis

The implicit nature of chronic pyelonephritis contributes to its prevalence (in the chronic form, pyelonephritis is much more common than in the acute form).

Meanwhile, pyelonephritis, including chronic one, is a serious disease that cannot be left without treatment. Each exacerbation of pyelonephritis involves more and more new areas of kidney tissue in inflammation. As a result of inflammation, the tissue dies and a scar appears in this place. The more such scars, the less normally functioning tissue remains. The kidney shrinks and stops working.

Diagnosis of pyelonephritis is carried out using laboratory and instrumental methods.

General urine analysis

A general urine test will reveal the presence of an inflammatory process. Pyelonephritis is characterized by an increase in the number of leukocytes, as well as the presence of bacteria (normally, bacteria should not be detected in the urine). The presence of protein and glucose is also likely. However, a general urine test cannot confirm the diagnosis of pyelonephritis, as similar results can be obtained for other diseases.