Pyelitis

The system of renal filtration plays a leading role in the purification of the human body. Within 24 hours, 1500 liters of blood are purified through the kidneys. In this case, a significant role is assigned to the renal pelvis - the distributing elements of the kidneys, which determine how much of the fluid from the blood should enter the bladder and which part should return to the bloodstream. What is Pyelitis?

This inflammatory process in the tissues of the renal pelvis, which can affect only one kidney, or be bilateral, with the defeat of both kidneys. Consider the main points of the disease.

[1], [2], [3]

Causes of the pyelitis

Pyelitis is caused by pathogenic microorganisms, more often by E. Coli,  streptococcal  or  staphylococcal infection, which can enter the renal pelvis along the ascending pathway through urinary organs, as well as with blood or lymph flow.

In the urinary tract along the ascending path, the infection penetrates from the inflamed bladder or from the anus to the kidneys.

With the current of the lymph, bacteria can spread from the affected intestine or reproductive system. This situation is often observed in the presence of chronic inflammation in the prostate gland.

With the bloodstream, the penetration of bacteria can occur from virtually any foci of infection in the body. It can be common diseases, such as ARVI, ARD, and local, such as sinusitis, dental caries, etc.

The following patients are most likely to spread the infection:

• with weak immunity (risk zone - child age and gestation period);
• smoking and drinking alcohol;
• after hypothermia;
• long-sitting on strict diets, or simply poorly nourished;
• leading sedentary lifestyle;
• those who have a habit of tolerating long before going to the toilet.

[4], [5], [6], [7], [8], [9]

Symptoms of the pyelitis

Symptoms of pyelitis can be confused with signs of other diseases. A typical clinical picture does not have a pyelitis. Upon examination, the doctor observes signs of a general intoxication of the body, a gray complexion, loss of appetite. The temperature can be subfebrile, or the periods of a sharp rise in temperature will be replaced by its sharp drop.

Acute pyelitis occurs against a background of persistent febrile state (up to 39 ° C), with attacks of chills and increased sweating. There is pain in the head and in the lumbar region. Sometimes there is a slight delay in urination. Urine has a murky color, with elements of protein.

Chronic pyelitis can become aggravated and proceed as an acute pyelitis with the following symptoms:

• severe soreness in the lumbar zone on one side, or along the entire back;
• a sharp rise in temperature;
• fever;
• no desire to eat, vomiting may occur;
• dehydration: the tongue is dry with a gray or light bloom.

Outside the period of exacerbation, chronic pyelitis often occurs without any symptoms, only in some cases there is a slight increase in temperature and a constant feeling of fatigue. Symptoms of chronic pyelitis in such situations are found in the analysis of urine.

The bilateral pyelitis (defeat of the pelvis of both kidneys) is more pronounced, the patient complains of a poor general condition, pain in the lumbar region (sometimes with the transition to the ribs and the perineal region). Micturition can be increased, accompanied by unpleasant painful sensations.

To diagnose, as a rule, only one clinical picture is not enough, you need to undergo a number of diagnostic procedures.

Forms

Pyelitis in children

What is the difference between pyelitis in children? In childhood, it is not always possible to distinguish which part of the urinary system the inflammation developed. For this reason, often any disease that occurs with the detection of pus in the urine, called pyuria, without hurrying to diagnose pyelitis.

Pyelitis in children can appear after intestinal diseases, after a viral illness or ARI.

The disease is characterized by a sharp onset, with a sharp rise in temperature to high digits. The child begins to worry, refuses to eat. There may be attacks of vomiting. Fever can last for a different amount of time, with temperature jumps uncontrolled, with a large amplitude of indices.

As a rule, pyelitis in children takes a long time: the disease can last for a month or more, and if there is insufficient or incorrect treatment, it can go on into a chronic form.

Pyelitis in infants is most difficult, often complicated by persistent dyspeptic disorders, and sometimes even sepsis (general infection of the body), which can result in extremely adverse consequences. Breast children on examination have a pale appearance, they refuse to eat, the skin becomes gray and sluggish. Pyelitis in infants requires immediate medical attention and constant medical supervision.

[10], [11], [12], [13], [14], [15], [16]

Diagnostics of the pyelitis

The main objects of the diagnosis of pyelitis are blood and urine.

The blood test is carried out in the form of general and biochemical analysis, while the following indicators can be seen:

• increased content of leukocytes;
• accelerated ESR (sedimentation rate of erythrocytes);
• increased values of creatinine and urea (with complicated flow).

A blood test for sterility (with a secondary focus of infection) may also be prescribed.

The analysis of urine  at a pyelitis necessarily will specify on a leukocyturia that will help or assist to estimate or appreciate a degree of inflammatory process. Urine boiling is performed to accurately identify the bacteria that caused the inflammatory process. In the future, this will allow the appointment of the most effective antibiotic, which will destroy the identified pathogen.

If the doctor suspects complications, then along with laboratory tests, other procedures may be prescribed: renal ultrasound, x-ray and radionuclide study.

[17], [18], [19], [20], [21]

Treatment of the pyelitis

Treatment of the pyelitis must be done in a timely manner, immediately after the appearance of clinical symptoms of the disease. First of all, the patient is prescribed a diet, with the predominant use of dairy and plant products. Absolutely excluded from the diet is food that irritates the kidney parenchyma: fat, smoked foods, spices, salt, alcohol, etc. It is prescribed a bed rest, a plentiful drink (up to 4 liters per day), preferably freshly squeezed vegetable juices and mineral water. In some cases it is allowed to drink herbal teas, to which add field horsetail, cranberries, cranberries, junipers, bear's eyelets.

Drug therapy is based on the use of drugs that depress and kill bacterial cells, as well as pain killers and immunostimulants.

• Antibiotic therapy involves the appointment of levomitsetin, amoxicillin, cefatoxime or cefazolin.
• Antimicrobial agents: fluoroquinolone series (ofloxacin, norfloxacin), nitrofuran series (furadonin, furazolidone), derivatives of oxyquinoline (nitroxoline), sulfonamide preparations (streptocid, sulfadimethoxin, biseptol), phosphonic acid (monoral).
• Analgesics (painkillers): spasmalgin, spazgan, no-shpa. It is not recommended to use NSAIDs such as ibuprofen, nimesulide, etc., since they have some degree of toxicity to the kidneys.
• Antipyretic drugs (paracetamol).

Complex treatment can be supplemented with herbal preparations, based on bearberry or birch buds. In the pharmacy you can buy a special urological collection, which is prescribed for kidney diseases. A good effect is observed from the use of phytolysin, a herbal preparation for internal administration. Phytolysin eliminates signs of inflammation, depresses the growth of bacteria, relieves spasms and increases diuresis.

If the treatment of pyelitis is started in time, then the duration of the therapeutic course can be no more than 2 weeks. Chronic pyelitis can be treated over the years: sometimes even surgical intervention may be required, in the event of serious pathologies of the urinary system.

Prevention

The standard prevention of pyelitis consists in simple observance of some well-known rules:

• regular hygiene of the external genitalia;
• hygiene of intimate life;
• prevention of hypothermia, especially the lumbar region and perineum;
• active lifestyle;
• high-grade food, observance of a drinking mode;
• timely treatment of any pathologies of the reproductive system and urinary organs.

In the autumn-spring periods, as well as during epidemics of influenza and ARVI, it is recommended to take multivitamin preparations in order to keep the immunity at a sufficient level.

It is recommended to get rid of bad habits, exercise, eat right, and then the immunity will cope with any pathogenic bacteria that can penetrate the body.

[22], [23], [24], [25],

Forecast

With timely measures taken to treat the disease, the prognosis can be considered favorable. Recovery occurs after 10-14 days.

In some cases, in the absence of treatment, or with improperly prescribed treatment, a number of complications may develop. For example, acute pyelitis can develop into a chronic, with periodic exacerbation of the disease. In such a situation, there is often an increase in blood pressure.

Among other possible complications can be called a purulent inflammation of the renal parenchyma with the appearance of paranephritis and retroperitonitis. In some cases, pyelitis can lead to urosepsis and the development of renal failure.

If there is an extensive systemic infection, development of apostematous nephritis is possible, in which a sudden deterioration of the patient's condition occurs. The most serious complication is sepsis and bacteremia shock.

Pyelitis is a complex disease, which in the absence of treatment can lead to the emergence of various adverse effects. However, if you consult a doctor on time, the cure will come quickly and without complications. Therefore, do not self-medicate: at the first unpleasant symptoms, contact a specialist.

[26], [27], [28], [29]