Pyelitis

The renal filtration system plays a leading role in cleansing the human body. In 24 hours, no less than 1,500 liters of blood are cleaned through the kidneys. In this case, a significant role is given to the renal pelvis - the distribution elements of the kidneys, which determine what part of the fluid from the blood should go to the bladder, and what should return to the bloodstream. What is pyelitis?

This is an inflammatory process in the tissues of the renal pelvis, which can affect only one kidney, or be bilateral, with damage to both kidneys. Let's consider the main points of the disease.

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Causes pyelitis

Pyelitis is caused by pathogenic microorganisms, most often E. coli, streptococcal or staphylococcal infection, which can penetrate the renal pelvis through the ascending urinary organs, as well as with the blood or lymph flow.

Infection enters the urinary organs via an ascending route from the inflamed bladder or from the anus up to the kidneys.

Bacteria can spread from the affected intestine or reproductive system via the lymph flow. This situation is often observed in the presence of chronic inflammation in the prostate gland.

With the bloodstream, bacteria can penetrate from almost any source of infection in the body. These can be general diseases, such as acute respiratory viral infections, acute respiratory infections, and local ones, such as sinusitis, dental caries, etc.

The following patients are most susceptible to the spread of infection:

• with weak immunity (risk zone – childhood and pregnancy);
• smokers and alcohol drinkers;
• after hypothermia;
• those who have been on strict diets for a long time, or simply eat poorly;
• leading a sedentary lifestyle;
• those who have a habit of holding back for a long time before going to the toilet.

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Symptoms pyelitis

Symptoms of pyelitis can be confused with signs of other diseases. Pyelitis does not have a characteristic clinical picture. During examination, the doctor notes signs of general intoxication of the body, a gray complexion, loss of appetite. The temperature may be subfebrile, or periods of a sharp increase in temperature will be replaced by a sharp drop.

Acute pyelitis occurs against the background of a persistent fever (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. The urine is cloudy, with protein elements.

Chronic pyelitis can worsen and progress to acute pyelitis with the following symptoms:

• severe pain in the lumbar region on one side, or throughout the entire lower back;
• a sharp rise in temperature;
• fever;
• lack of desire to eat, possible bouts of vomiting;
• dehydration: the tongue is dry with a gray or light coating.

Outside the period of exacerbation, chronic pyelitis often proceeds without any symptoms, only in some cases a slight increase in temperature and a constant feeling of fatigue are observed. Signs of chronic pyelitis in such situations are detected in urine analysis.

Bilateral pyelitis (damage to the pelvis of both kidneys) is more pronounced, the patient complains of poor general condition, pain in the lumbar region (sometimes spreading to the ribs and perineum). Urination may be more frequent, accompanied by unpleasant painful sensations.

To make a diagnosis, as a rule, the clinical picture alone is not enough; a number of diagnostic procedures will need to be completed.

Forms

Pyelitis in children

How does the course of pyelitis differ in children? In childhood, it is not always possible to distinguish in which part of the urinary system inflammation has developed. For this reason, any disease that occurs with the detection of pus in the urine is often called pyuria, without rushing to diagnose pyelitis.

Pyelitis in children can appear after intestinal diseases, after a viral disease or acute respiratory infection.

The disease is characterized by an acute onset, with a sharp increase in temperature to high numbers. The child begins to worry, refuses to eat. Vomiting attacks may occur. The fever can last for a different amount of time, while the temperature jumps are uncontrollable, with a large amplitude of indicators.

As a rule, pyelitis in children is a long-term disease: the disease can last a month or more, and with insufficient or incorrect treatment it can become chronic.

Pyelitis in infants is the most severe, often complicated by persistent dyspeptic disorders, and sometimes even sepsis (general infection of the body), which can result in extremely unfavorable consequences. Infants look pale upon examination, they refuse to eat, and their skin becomes gray and flaccid. Pyelitis in infants requires immediate medical care and constant medical supervision.

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Diagnostics pyelitis

The main objects of pyelitis diagnostics are blood and urine.

Blood tests are carried out in the form of general and biochemical analysis, and changes in the following indicators can be seen:

• increased white blood cell count;
• accelerated ESR (erythrocyte sedimentation rate);
• increased creatinine and urea levels (in complicated cases).

A blood test for sterility may also be prescribed (in case of a secondary source of infection).

Urine analysis for pyelitis will definitely indicate leukocyturia, which will help to assess the degree of the inflammatory process. Urine culture is performed to accurately identify the bacteria that caused the inflammatory process. In the future, this will allow prescribing the most effective antibiotic that will destroy the identified pathogen.

If the doctor suspects complications, then along with laboratory tests, other procedures may be prescribed: ultrasound of the kidneys, X-ray and radionuclide examination.

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Treatment pyelitis

Treatment of pyelitis should be carried out in a timely manner, immediately after the appearance of clinical symptoms of the disease. First of all, the patient is prescribed a diet, with predominant use of dairy and plant products. Food that irritates the renal parenchyma is completely excluded from the diet: fat, smoked foods, spices, salt, alcohol, etc. Bed rest is prescribed, plenty of fluids (up to 4 liters per day), preferably freshly squeezed vegetable juices and mineral water. In some cases, herbal teas are allowed, to which horsetail, lingonberry, cranberry, juniper, and bearberry are added.

Drug therapy is based on the use of drugs that suppress and kill bacterial cells, as well as painkillers and immunostimulants.

• Antibiotic therapy involves the administration of chloramphenicol, amoxicillin, cefotaxime or cefazolin.
• Antimicrobial agents: fluoroquinolone series (ofloxacin, norfloxacin), nitrofuran series (furadonin, furazolidone), oxyquinoline derivatives (nitroxoline), sulfanilamide drugs (streptocide, sulfadimethoxine, biseptol), phosphonic acid-based agents (monural).
• Analgesics (painkillers): spazmalgin, spazgan, no-shpa. It is not recommended to prescribe NSAIDs such as ibuprofen, nimesulide, etc., as 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 use. Phytolysin eliminates signs of inflammation, inhibits bacterial growth, relieves spasms and increases diuresis.

If the treatment of pyelitis is started in a timely manner, the duration of the therapeutic course may not exceed 2 weeks. Chronic pyelitis can be treated for years: sometimes even surgical intervention may be required if serious pathologies of the urinary system occur.

Prevention

Standard prevention of pyelitis consists of simply following some well-known rules:

• regular hygiene of the external genitalia;
• intimate hygiene;
• avoiding hypothermia, especially in the lumbar and perineal areas;
• active lifestyle;
• proper nutrition, adherence to drinking regimen;
• timely treatment of any pathologies of the reproductive system and urinary organs.

In the autumn-spring periods, as well as during flu and acute respiratory viral infection epidemics, it is recommended to take multivitamin preparations to maintain immunity at a sufficient level.

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

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Forecast

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

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

Other possible complications include purulent inflammation of the renal parenchyma with the development of paranephritis and retroperitonitis. In some cases, pyelitis can lead to urosepsis and the development of renal failure.

If there is a large systemic infection, apostematous nephritis may develop, in which the patient's condition suddenly worsens. The most severe complication is sepsis and bacteremic shock.

Pyelitis is a complex disease that, if left untreated, can lead to various adverse effects. However, if you see a doctor in time, recovery will occur quickly and without complications. Therefore, do not self-medicate: at the first unpleasant symptoms, consult a specialist.

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