The unstructive pyelonephritis is more often found. What is dangerous pyelonephritis? - "Moscow doctor. Types of treatment of obstructive pyelonephritis

Obstructive pyelonephritis is the inflammation of the renal pelletium (pylitis) and fabric (nephritis), arising against the background of the impairment of urine outflow due to the obstruction of the urinary system organs. The main reason is urinary tract infections. Bacterial invasion prevents urine outflow and increases the likelihood of kidney stones. Violation affects one or two kidneys. Due to the anatomical features of a woman, the problem occurs much more often than a man. In the article we will analyze what it is - obstructive pyelonephritis. In the international classification of the diseases of the 10th revision (ICD-10), pathology is denoted by code N11.1.

Acute obstructive pyelonephritis is an infectious damage to the urinary system organs, which occurs due to the blockade of the urine outflow by a stone or a foreign body. The diagnosis of chronic disease is made on the basis of visualization methods - ultrasound research (ultrasound) and computed tomography (CT).

Bubble-ureteral reflux (abbreviation: PMR) is a congenital condition associated with the insufficiency of the ureter valve and occurring in chronic unstructive pyelonephritis. PMR is present in 25-35% of people with symptomatic infections of urinary tract and kidney scars. The diagnosis of PMR is often established on the basis of radiographic data obtained during the evaluation of recurrent infectious pathology.

The unstructive acute pyelonephritis is the inflammatory process of renal tissue and pelvis, which is not due to the obstacle to the outflow of urine. The main reason is congenital anomalies for the development of the urinary system.

Causes and pathogenesis

The cause of obstructive kidney inflammation is usually urinary tract infections and renal disease. Even the constant use of catheters often leads to a recurrent cell and chronic pyelonephritis.

Bacteria from the bladder rose through the ureters into the kidneys with sharp peel. This leads to the formation of scars as a result of constantly emerging inflammatory processes.

It's important to know! Renal abscesses - Magni clusters, which are surrounded by a connective tissue capsule; Most patients suffer from severe fever, chill and kidney pain. Urination can be painful, and urine is purulent and bloody.

Factors affecting the development of pyelonephritis:

paul patient and his or her sexual activity;
pregnancy;
chronic malnutrition (hypovitaminosis A, C, D and B);
hereditary predisposition;
viral and bacterial infections;
neurogenic urinary bladder dysfunction.

Chronic pyelonephritis is associated with progressive scarring of renal tissue, which can lead to the terminal stage of malnutrition. In some cases, the scars can be formed by intrauterine in patients with kidney dysplasia. Sometimes normal growth can lead to the spontaneous disappearance of PMR and pyelonephritis at the age of 7.

More about symptoms

Acute obstructive and unstructive pyelonephritis causes nonspecific signs: from pain to completely asymptomatic manifestation. Sometimes a fever occurs, which lasts no more than 2-3 days.

Clinical symptoms:

pain in the side of the left or right;
chills;
body temperature above 40 degrees Celsius;
nausea and vomiting.

In rare cases, hematuria, dizuriy or anorya is observed. Weak patients (diabetics, HIV-infected) develop sepsis - system infection.

Forms and types of disease

On clinical flow, latent, hypertensive, asymptomatic and anemic pyelonephritis is isolated. Ethiology distinguishes primary and secondary forms of the disease. There is also a classification of morphology and the path of penetration of invasion.

Potential complications

Fine treatment can be aggravated by the flow of pyelonephritis and lead to arterial hypertension or renal failure. It is important at an early stage to start therapy to prevent possible irreversible damage to organs.

Complications of chronic pyelonephritis:

It's important to know! Acute renal failure is the most severe complication of obstructive (calculous) pyelonephritis, which is capable of leading the patient to death in a short time. In the event of any of the above symptoms, you need to seek the advice of a qualified medical specialist, since it will help to avoid irreversible tissue changes.

Methods for identifying pathology

Initially, a physical examination is carried out and an anamnesis (illness history) is collected. Characteristic renal scars are often present in patients during the initial examination, new can be formed in 3-5% of patients. The development of scars is back connected with the rate of appointing antibacterial therapy of a narrow spectrum of action. The presence of new scars often indicates the occurrence of systemic infections.

It's important to know! In the army during chronic pyelonephritis do not take.

Laboratory diagnostics

Urine laboratory tests are able to reveal the piura. It is recommended to carry out a bacteriological analysis of urine, which helps to detect gram-negative pathogenic pathogens - intestinal wand and proteins. The negative result of the microorganism survey does not exclude the diagnosis of chronic pyelonephritis. If Albuminuria is present, it indicates complications. The concentration of creatinine and uric acid in blood serum is rising.

Histology of kidney shows focal glomerosclerosis with a developed reflux nephropathy. A pregnant woman and a small child may need additional surveys to exclude secondary complications.

Instrumental examination

The urogram helps to establish with high pyelonephritis, because it reveals the dilatation of the renal cup and the scars. Sometimes the expansion of the ureter and reducing the value of the kidneys are also found.

X-ray examination with the help of succifer (hemeta) is more sensitive than intravenous pyroid, because it helps to identify the kidney scars. The diagnostic procedure is appointed by many pediatric specialists, because it is easily performed and able to detect pathology.

Computed tomography is a selection procedure in the diagnosis of obstructive pyelonephritis. Ultrasonographic images of kidneys can show concrections, but ultrasound is not a sensitive method for detecting reflux nephropathy.

Paths of treatment and forecast for patients

Patients prescribe medical therapy with antibiotics. It is recommended to continue treatment until sexual maturity and to completely disappear the reflux disease. Rule in these cases is spontaneous remission; The operation of such people is not needed. Birmingham Reflux research data has proven that conservative and operational methods for treating PMR are equally effective.

Indications for surgical intervention:

neglect of the conservative treatment regime;
sepsis;
renal ureter reflux.

Surgery is recommended for all children over 12 months with sclerosis fabric changes and urine back. Patients aged 1-4 years with right-sided PMR and without borders can be held antibioticophylaxis.

Kidney damage can be reduced by limiting the dietary protein. Reduction in blood pressure drugs helps slow down the development of renal failure; Calcium channel blockers (BKK) and angiotensin receptor antagonists are especially useful in hypertension.

Cephalosporin and penicillin antibiotics of the first generation in urology are the preparations of choice due to high efficiency against gram-negative microbes. Infants uses predominantly a series of penicillins of a wide range of action. In patients aged six months, therapy can be changed to imidazolidinedion in the form of sodium salt. Teens and adults can be treated by co-trimoxazole.

It is forbidden to change the already appointed antibiotic therapy to prevent the development of resistance. Research in Birmingham clearly showed that drug-surgical methods equally effectively prevent kidney damage from obstructive pyelonephritis. Most children with a chronic form of inflammation spontaneously get rid of the PMR. Approximately 2% there are renal failure, while 5-6% are long complications, including hypertension. If consequences are developing due to improper treatment, you need to consult a doctor.

It's important to know! Hypertension contributes to the accelerated loss of kidney function in people with chronic pyelonephritis. Reflux nephropathy is the most common cause of improving blood pressure in children and occurs in 10-20% of cases.

Recommendations on the diet depend on the main cause of pyelonephritis. Fast and complete treatment of cystitis and other infections helps prevent renal inflammation. Therapy of bubble-ureteral reflux or obstructive uralopathy also prevents the development of the disease. In some cases, recurrent cystitis, the use of antibiotics helps to eliminate Wrostsis.

Most cases of pyelonephritis are underway without complications. Sometimes treatment can be long and aggressive. The goal is to avoid sepsis and renal failure. Children and adults need to make an optimal amount of fluid, as well as vitamin supplements. Dehydration increases the likelihood of recurrence in the next 2 years.

If fever arises, chills, dizziness and night sweating - it is necessary to consult with the attending physician. With symptoms of exacerbation of pyelonephritis, you need to contact the doctor to prevent complications. Initially started therapy increases the chances of the patient's complete recovery.

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Odnoklassniki.

Obstructive pyelonephritis is an extremely dangerous infectious disease of the kidney, developing against the background of an acute violation of urine outflows in a cup-lowering system and rapid reproduction of bacterial microflora. This disease is quite common. Obstructive, as well as the unstructive pyelonephritis can develop in children, and in adults. People relaxed immunity are most susceptible to this disease.

The peak of morbidity usually falls on the spring and autumn when an increase in the number of cases of the development of IDV and influenza is observed. Against the background of these respiratory infections, human immunity is significantly reduced, therefore, bacteria, which are always present on the mucous membranes of the urogenital system, are able to multiply, becoming the cause of inflammatory kidney damage. There are many other factors that largely contribute to the appearance of this pathological condition.

Many different factors contributing to the difficulty of urine outflow create conditions for the development of this infectious disease. Stagnation processes lead to an increase in the number of bacteria provoking inflammatory lesions of the tissues. Often pyelonephritis arises against the background of congenital anomalies for the development of kidneys and urinary tract. Usually, such pathologies begin to manifest themselves with inflammation in early childhood.

Urolithiasis also often predisposes to the development of pyelonephritis, and then obstruction. Kidney stones under certain circumstances can descend into the ureter, partially or completely blocking urine outflows. In men, pyelonephritis is often developing against the background of adenoma or prostate cancer. In women, a pregnancy may be a provocation for such a defeat of the kidneys, since an increase in the uterus contributes to a change in the position of this pair of this organ, and sometimes it becomes the reason for squeezing the ureters. In addition, there are factors that contribute to the emergence of chronic obstructive pyelonephritis, including:

diabetes;
thyroid diseases;
long use of antibiotics;
supercooling.

Create conditions for the development of such damage to the kidney tissues can previously performed operations on the urinary tract. In addition, the occurrence of obstructive pyelonephritis is capable of kidney injury. The decrease in immunity of any etiology can provoke the development of this pathological condition.

In most cases, this disease is sharply manifested. There is a rapid increase in body temperature to +40 ° C. The main sign of this violation is the renal colic - the sharp pain in the lower back. Due to inflammatory damage to kidney tissues, urination problems are usually observed. Patients complain about chills and increased sweating. As a rule, general weakness rapidly grow rapidly. As the disease develops, the following symptoms may appear:

severe thirst;
vomiting;
nausea;
a feeling of dry blood;
headache.

The intensity of the signs of this pathological state is usually increasing for 3-4 days. This is due to the fact that toxins are increasing in the body, which due to the violation of the kidneys cannot be removed with urine. To avoid the development of severe complications, it is necessary at the first symptoms to consult a doctor. If the treatment was not started in a timely manner, this disease passes into a chronic form for which the alternation of recurrence and remission periods is characterized. Such an outcome is considered extremely unfavorable, as in the future leads to renal failure.

Diagnostics

First of all, the patient's inspection is carried out, collection of history and evaluation of the available symptoms. Even this happens enough for the specialist to suspect the development of obstructive pyelonephritis. Usually, research is carried out to confirm the diagnosis as:

general and biochemical analysis of blood and urine;
bakposiev urine;
urography;
angiography;
nephrocintigraphy;
radiography.

Nephrologist independently decides which research is required for diagnosis. Self-medication can represent a serious health hazard. After the comprehensive diagnosis, the doctor may assign the necessary drugs to suppress the inflammatory process.

Treatment of obstructive pyelonephritis

In the acute period, integrated therapy is required to avoid the transition of the disease in chronic form. First of all, a diet is assigned - table number 7a. On a day, it is necessary to drink at least 2-2.5 liters of liquid. This will allow faster to eliminate the pathogenic microflora and suppress the inflammatory process. To relieve pain and improve local blood circulation, the doctor can recommend thermal procedures.

Among other things, directed drug therapy is required. In the first days of the course of the acute period of obstructive pyelonephritis, there is an extremely strong pain syndrome. To eliminate it, nephrologist can assign antispasmodics. To suppress the infection requires directional antibacterial therapy.

Usually, when obstructive pyelonephritis uses such drugs as:

Benzylpenicillin;
Oxacillin;
Ampicillin;
Ampicillin sodium salt;
Streptomycin;
Tetracycline;
Metacycline;
Morphocyclin;
Tetraolean;
Etietin;
Gentamicin;
Cephaloridine.

The course of antibacterial therapy should be at least 4 weeks. It should not interrupt it, as this may contribute to the transition of the disease in a chronic form. Such drugs are usually introduced intravenously or intramuscularly. In addition, preparations are prescribed to reduce body temperature. Vitamin complexes can also be appointed, which contribute to improving immunity. However, if conservative treatments do not allow a pronounced effect, surgery can be shown. Usually, similar therapy is required in the presence of stones and various anomalies of urinary tract.

Treatment of chronic obstructive pyelonephritis represents a certain complexity. It involves maintaining the normal functioning of the kidneys and the relief of all symptoms during the exacerbation period. This disease requires special attention and frequent passage of antibacterial therapy courses and supporting treatment.

Acute pyelonephritis - non-specific inflammatory lesion of interstitial tissue tissue and a cup-making system. For the clinic of acute pyelonephritis is characterized by high fever with chills and sweating, headache, Malgia, arthralgia, general ailment, lower back pain, changes in the urine in the type of leukocyturia and pyuria. The diagnosis of acute pyelonephritis includes microscopic and bacteriological examination of urine, ultrasound kidneys; If necessary, carrying out excretory urography, radioisotope studies, tomography. With acute pyelonephritis, diet is assigned, abundant drink, antibiotics, nitrofurans, antispasmodics. With obstructive pyelonephritis, nephrostomy is shown; With purulent-destructive processes - the decapsulation of the kidney or nephrectomy.

Acute pyelonephritis

Acute pyelonephritis in urology is the most frequent disease of the kidneys. Acute pyelonephritis often occurs in childhood, when the burdens on the kidney is very intense, and their morpho-functional development is still unfinished. In adults, acute pyelonephritis is more common in women under the age of 40.

Acute pyelonephritis can be primary (unstructive) and secondary (obstructive). Primary pyelonephritis proceeds against the background of normal urine outflow from the kidneys; Secondary pyelonephritis is associated with a violation of the undergoing urinary tract due to their external compression or obstruction. According to the nature of inflammatory changes, the acute pyelonephritis can wear a serous or purulent-destructive nature (pyelonephritis of the apostatient, abscess or carbuncoon kidney). In severe cases, acute pyelonephritis can be complicated by necrotic papillitis - nobility necrosis. One or both kidneys can be involved in acute pyelonephritis.

Causes of acute pyelonephritis

Acute pyelonephritis develops with endogenous or exogenous penetration of pathogenic microorganisms in the kidney. More often, the acute pyelonephritis is caused by an intestinal stick (in 50% of cases), proteate, a blue rod, less often - staphylococci or streptococci.

In the primary acute pyelonephritis, the infection can be in a hematogenic kidney from primary foci of inflammation in the urinary organs (with adnexite, cystitis, prostatitis, etc.) or from remote organs (with tonsillite, caries, sinusite, furunculosis, bronchitis, cholecystitis, etc. .). Less often infection occurs on the ascending mechanism, along the wall or lumen of the ureter (with bubble-ureteral reflux).

The secondary acute pyelonephritis is associated with a violation of the passage of urine against the background of the stricture of the ureter, the obstruction of the ureter of stone, strictures and valves of urethra, prostate adenoma, prostate cancer, phimosis, neurogenic bladder. The predisposing moments to the development of acute pyelonephritis are supercooling, dehydration, hypovitaminosis, overwork, respiratory infections, pregnancy, diabetes mellitus.

Inflammation in acute pyelonephritis is connected not only with microbial invasion, but also by the contents of the pelvis in an interstitial tissue, which is due to the reverse current of the urine, that is, a formalist reflux. Kidney with acute pyelonephritis is full, slightly increased. The mucous membrane of the renal pelvis of the edema is inflamed, ulcerated; In Lohanks there may be inflammatory exudate. In the following in the brain and cortex, the kidney layer can be formed by numerous uluses or abscesses; Sometimes a purulent-destructive melting of renal parenchyma is observed.

Stages of acute pyelonephritis

The stages of acute pyelonephritis correspond to the morphological changes occurring in the kidney.

The initial phase of serous inflammation is characterized by an increase in the kidney increasing and tension, an edema of the ololyopochnye fiber, perivascular infiltration of interstitial tissue. With a timely appropriate treatment, this stage of acute pyelonephritis is subjected to reverse development; Otherwise, it goes into the stage of purulent-destructive inflammation.

In the stage of acute purulent pyelonephritis, the phases of the apostatient pyelonephritis, the carbuncule and the kidney abscess are isolated. Apostatient (rotored) pyelonephritis proceeds with the formation of multiple small guns of 1-2 mm in the cortical layer. In the case of merging of the guns, a local joining focus can be formed - kidney carbuncoon, having inclinations to progressive abscess. Carbuncules are of size from 0.3 to 2 cm, can be solid or multiple. Under the purulent melting of the parenchyma in the foci of the merging of the guns or the carbuncule, the kidney abscess is formed. The danger of the kidney abscess is the possibility of emptying the reels of the waste into the paranefral tissue with the development of purulent paranefrites or the retroperitoneal phlegmon.

With a favorable outcome of acute pyelonephritis, infiltrative foci is gradually absorbed, replacing the connective tissue, which is accompanied by the formation of scar puments on the kidney surface. The scars first have dark red, then a white and gray color and a wedge-shaped form, on the cut breathing to the lochank.

The course of acute pyelonephritis is characterized by local symptoms and signs of a pronounced common infectious process, which differ depending on the stage and form of the disease. Serous pyelonephritis proceeds more calmly; With purulent pyelonephritis, pronounced clinical manifestations are developing. In acute unstructive pyelonephritis, general symptoms of infection prevail; With obstructive pyelonephritis - local symptoms.

The clinic of acute unstructive pyelonephritis develops lightning (from several hours to one day). There is ailment, weakness, stunning olar with a significant increase in temperature to 39-40 ° C, abundant sweating. Significantly worsens well-being headaches, tachycardia, arthralga, myalgia, nausea, constipation or diarrhea, meteorism.

From the local symptoms in acute pyelonephritis, there is a lower back pain, propagating along the ureter in the thigh area, sometimes in the stomach and back. By nature, pain can be constant stupid or intense. Urination, as a rule, is not violated; Daily diuresis decreases due to the abundant loss of fluid from then. Patients may pay attention to urine turbidity and its unusual smell.

The secondary acute pyelonephritis caused by the obstruction of the urinary tract usually manifests with renal colic. At the height of the pain attachment there is a fever with chills, headache, vomiting, thirst. After an abundant sweating, the temperature is critically reduced to subnormal or normal numbers, which is accompanied by some improvement in well-being. However, if the urinary tract obstruction factor is not liquidated in the coming hours, then the attack of colic and temperature rise will repeat again.

The purulent forms of acute pyelonephritis proceed with a thrust pain in the lower back, a hectic type fever, chills, a sharp voltage of the muscles of the abdominal wall and lumbar region. Against the background of severe intoxication, the confusion and nonsense may be marked.

In the process of recognizing acute pyelonephritis, data of physical examination is important. When palpation of the lumbar region and hypochondrium estimates the size of the kidney, consistency, surface structure, mobility, soreness. With acute pyelonephritis, the kidney is usually increased, the muscles of the lower back and belly are tense, the tendering of the edge of the palm in the XII edge is painful, the symptom of Pasternatsky is positive. In case of acute pyelonephritis, men need to carry out a rectal inspection of prostate and palpation of the scrotum, in women - vaginal research.

In the urine in acute pyelonephritis, a total bacteriuria, a slight proteinurium, leukocyturia, is observed, with secondary defeat - red blood cell. Bacterial sowing urine allows you to decide on the type of pathogen and its sensitivity to antimicrobial drugs. Blood indicators are characterized by anemia, leukocytosis, an increase in ESP, toxic grit of neutrophils.

Ultrasound of the kidneys during acute pyelonephritis is used not only in diagnosis, but also for dynamic control of the treatment process. The value of these echoscopy is the possibility of visualizing destructive foci in the parenchyma, state of paranefral fiber, identifying the cause of the obstruction of the upper urinary tract. The exact detection of destructive foci, the causes and level of obstruction in acute purulent pyelonephritis is possible with the help of MRI or CT kidney.

With a survey urography, an increase in the size of the kidneys, blowing the contour with an abscess or carbuncule, the fuzziness of the outlines of the paranefral fiber is not paid.

With the help of an excretory urography, the restriction of kidney mobility is determined during breathing, which is a characteristic sign of acute pyelonephritis. With severe patient or renal failure, they resort to retrograde pyelureterography.

Selective renal angiography, radionuclide nephrocintigraphy in acute pyelonephritis, mainly applied to clarify the diagnosis as auxiliary methods. Differential diagnosis of acute pyelonephritis is carried out with appendicitis, cholecystitis, cholangitis, adexite.

Treatment of acute pyelonephritis

When the acute pyelonephritis is detected, the patient's hospitalization is carried out; Treatment is carried out under the control of the nephrologist. Therapeutic tactics in the unstructive and obstructive acute pyelonephritis, serous and purulent-destructive form differ. Common events include the appointment of bed regime, abundant drinking (up to 2-2.5 liters per day), a fruit-dairy diet, an easy-to-carry protein food.

With primary acute pyelonephritis, pathogenetic therapy immediately begins, the basis of which is antibiotics, active with respect to gram-negative flora, is cephalosporins, aminoglycosides, fluoroquinolones. When choosing an antimicrobial drug, the results of the antibioticogram are also taken into account. Additionally, NSAIDs, nitrofurans, immunocormers, disintellation therapy, Ufok, physiotherapy (SMV therapy, electrophoresis, UHF) are prescribed.

When detecting acute obstructive pyelonephritis, the priority is decompression - the restoration of urodynamics in the affected kidney. For this purpose, the catheterization of the lochanks with a urine catheter or catheter-wall is undertaken, in some cases - puncture imposition of percutaneous nephrosty.

In the presence of purulent-destructive foci, they resort to the decapsulation of the kidneys and the imposition of nephrostomas, with the help of which reduction in intravenous pressure, intermediate tissue edema, expanding the lumen of renal vessels. When the formed urns are found, their autopsy is made. In the case of total damage to the renal parenchyma and the impossibility of organ-powder tactics is carried out nephrectomy.

Forecast and prevention of acute pyelonephritis

Timely adequate therapy allows you to achieve cure of acute pyelonephritis in most patients within 2-3 weeks. In a third of cases, there is a transition of acute pyelonephritis in chronic form (chronic pyelonephritis), followed by the sclerosing of the kidney and the development of nephrodic arterial hypertension.

Among the complications of acute pyelonephritis may occur paranephritis, retroperitonitis, UROSPSIS, renal failure, bacteriotoxic shock, interstitial pneumonia, meningitis. Heavy septic complications worsen the forecast and are often caused by death.

The prevention of acute pyelonephritis is the sanitation of chronic inflammation foci, which can serve as sources of potential hematogenous drift of pathogens into the kidneys; elimination of the causes of possible urinary tract obstruction; compliance with the hygiene of the urinary organs to prevent the ascending distribution of infection; Compliance with the conditions of aseptics and antiseptics during urological manipulations.

The acute pyelonephritis is an inflammatory disease, in which the intermediate cloth of the kidneys, cups and lochanks are affected. The disease can be provoked by infectious and non-infectious causes.

Urologists argue that pyelonephritis of various etiologies are one of the most common diseases, while this pathology is most often diagnosed in children (due to the unformed urinary system) and in women (due to the features of the structure of the urogenital system, due to which infections are easier to get into the kidneys ).

Acute pyelonephritis: What is it and what is different from the chronic inflammatory process?

The acute inflammatory process of a cup-laughter system is different from chronic pyelonephritis. The following features of the flow:

in acute pyelonephritis, the inflammatory process develops rapidly, when a slower progresses in a chronic disease;
the clinical signs of the disease in acute form are pronounced brightly, and in chronic inflammation of the kidney symptoms are blurred or absent at all;
the acute inflammatory process, with proper and timely treatment, ends with complete recovery of the patient or the transition to a chronic form, whereas chronic pyelonephritis is characterized by frequent relapses;
a chronic inflammatory process in the kidneys is more difficult to antibiotic therapy, since the microorganisms are resilient to most drugs.

The inflammatory process in acute form captures only 1 kidney or both at once.

Symptoms of acute pyelonephritis

Symptoms of acute pyelonephritis in women, children and men are largely dependent on the nearingness of the inflammatory process, from the presence of other diseases and the stage.

The following stages of the inflammatory process in the kidneys are distinguished:

Stage of serous inflammation - It is characterized by an increase in the affected organ in size (one kidney or both), edema of the octopic fiber.
Penalty inflammation stage:

apisematous inflammation;
kailbunkul kidney;
abscess kidney.

The stage of purulent inflammation of the kidney is characterized by the formation of guns in the cortical layer, which in the absence of adequate therapy merge with each other and form a carbuncle. There may be several such carbuncons, they merge with each other, the pus melts the kidney tissue, resulting in an abscess of the organ.

Important! If at the stage of serous inflammation of the patient will be rately diagnosed and adequate treatment carried out, the pyelonephritis successfully passes within 14-20 days and does not affect the performance and further life of the patient.

Unstructive acute pyelonephritis: symptoms

In the development of the inflammatory process, the patient appears the following signs of acute pyelonephritis:

start sharp, symptoms are developing rapidly - sometimes in a few hours, but more often than 1-2 days;
increase body temperature up to 39.5-40.0 degrees;
weakness and malaise;
nausea, vomiting sometimes;
reinforced sweating, tachycardia, strong headaches, sometimes the blood pressure increases;
stupid pains in the waist area on one side or both, depending on the prevalence of the inflammatory process - pain can be irradiated into the crotch, back, belly;
a slight decrease in daily diurea, oliguria - this syndrome is due to increased sweating;
muddy urine with an unpleasant odor;
dysuric symptoms in women are usually absent, the child may have complaints about the feeling of incomplete emptying of the bladder.

Secondary sharp pyelonephritis: symptoms

Secondary acute pyelonephritis develops in most cases against the background of the existing diseases of the urinary tract. Often symptoms arise as a result of a violation of urine outflow and urinary tract obstruction.

The patient has:

sharp pains in the lumbar region by the type of renal colic, often associated with the obstruction of the urinary tract;
increase body temperature up to 39.0 degrees, fever;
increased thirst;
nausea and vomiting.

Important! If the reasons for obstruction are identified and this factor is eliminated, the patient's condition is normalized, all signs of pyelonephritis pass. If the reason is not installed, after a few hours after subsidiaries of the sharp clinic, all the symptoms are returned again with a double strength.

Purulent sharp pyelonephritis: symptoms

Signs of acute pyelonephritis with purulent defeat of kidney parenchyma are as follows:

non-passable stupid pains in the lumbar region with irradiation in the back, belly, thigh;
hectic type fever (body temperature drops up to 3-4 degrees, arise several times a day) - that is, from 40.0 degrees, the temperature drops to 37.0 and rises again to 40.0 and so 2-3 times per day;
pronounced inxication of the body - nausea, vomiting, weakness, headaches;
urine stands out in a small amount of turbid with a sharp unpleasant odor.

Causes of disease development

The main reason for the development of pyelonephritis is the penetration into the parenchyma of the kidneys of pathological microorganisms. The most common pathogens of the acute inflammatory process are intestinal sticks, staphylococcus, streptococcus, a blue chopstick, aebe of protea. A little less often pyelonephritis cause viruses and fungi.

According to statistics, several associated bacteria, provoking the development of inflammation, are revealed in the course of the patient's survey. Signs of acute pyelonephritis arise if the causative agent of infection penetrates the kidney and began to actively multiply and distinguish toxic substances.

This happens in two ways:

Hematogenic - The infection falls into the kidneys with a blood current from other internal organs in which the inflammatory process proceeds. Most often, not treated cystitis, urethritis, adnexites, prostatites contribute to this timely. The long-term causes of the development of the disease are not treated sinusitis, sinusitis, tonsillites, bronchitis, and even launched carious cavities of teeth.
Urinogenic (or ascending) - This path of penetration of the causative agent in the kidneys is the most common. The infection falls into the kidneys from the lower departments of urinary tract (urethra, bladder, ureters).

Predisposing factors for the development of acute pyelonephritis are:

thrush in women or intestinal dysbiosis;
violation of the hormonal background - women often occur pyelonephritis in the second half of pregnancy and during menopause;
estrogen deficiency in the female body, which leads to a violation of the acid-alkaline balance in the vagina;
active sex life and a frequent change of sexual partners - it causes inflammatory processes of urethra and bladder, from where the infection easily enters the kidneys;
venereal diseases, including a hidden nature;
diabetes;
general supercooling of the body;
immunodeficiency states - hypovitaminosis, transferred beams of radiation therapy, poor non-balanced nutrition;
urolithiasis disease;
prostate adenoma in men.

Important! The risk of acute pyelonephritis increases if a person has several predisposing factors in a person.

Forecast and possible complications of the disease

The recovery of the patient at proper therapy occurs after 3-4 weeks. If the patient does not pay attention to the symptoms and the treatment of pyelonephritis was not conducted or began to be too late, the progressive pathological process in the kidneys often leads to a threatening life to complications:

Pyelonephritis is called nonspecific inflammatory processes that affect the kidney channel system. And although this disease may suffer from any gender and age, starting with tiny babies and ending with deep elderly, yet this disease is most often diagnosed with women. According to statistics from 100 people who were diagnosed with pyelonephritis, 75 is a fair sex representative. And it has its own reasons.

Why are women more often faced with pyelonephritis?

The acute and chronic course of the disease in women is found five times more often than in men. This is caused by an anatomical feature of the structure of the genitourinary system. Ureyeing channel in women is otherwise formed than in men. In a female bladder, a different infection plan is much easier and often penetrate, which is why such a large percentage of pyelonephritis disease in women and girls. In most cases, the pyelonephritis is characterized by the so-called "ascending" infection in which the pathogenic bacteria from the urinary tract, moving up, penetrate into the kidneys and already begged their "work". Sometimes the development of pyelonephritis does not make itself felt, and the patient has no discomfort, the general health state does not deteriorate. It often happens that a woman learns about the pathological process in its body a few years after the development of the disease. That is why it is very important to know the symptoms of pyelonephritis in order for as early as possible to undergo a survey and in case of confirmation of concerns, to begin comprehensive and effective treatment.

Symptoms of the development of pyelonephritis in women

The species and subspecies of this kidney disease are much, but if briefly and generalizable, it can be said that the pyelonephritis is divided into two main types: acute and chronic. Each of these two types of the course of the disease has its causes and, of course, the symptoms.

Acute pyelonephritis and his symptoms

The acute flow of pyelonephritis is divided into obstructive pyelonephritis and unstructive. The unstructive pyelonephritis is characterized by the predominance of common symptoms of infection in the body. Obstructive pyelonephritis has more pronounced local symptoms.

Acute unstructive pyelonephritis

It is designed to develop with a lightning speed (3-24 hours). The patient is overwilling overall disabilities, severe weakness, bodies. The body temperature rises sharply to critical marks of 40 degrees. Muffed headaches. It is often observed by the malfunction of the cardiovascular system, tachycardia appears (rapid heartbeat). Disorders of the gastrointestinal tract in the form of constipation, diarrhea and increased gas formation are possible. The local symptoms of the unstructive pyelonephritis is characterized by pain in the lumbar spine, which extends depending on the stroke of the ureter into the hip zone, less often - in the abdomen and back area. The pain can be worn as a constant stupid character and sharp and intense. The urination process is not violated in most cases, but the total daily amount of urine can significantly decrease. This is due to intense sweating, which is unpredictable with a significant increase in body temperature.

Acute obstructive pyelonephritis

It always begins with renal colic. Along with this, fever begins with the strongest chills, pain in the head, wearing a sharp shooting character. Often there are vomit urge and diarrhea. Sickness constantly want to drink. The body temperature rises quickly and critical. However, strong sweating quickly reduces the temperature to normal or almost normal marks. At this stage, general well-being is somewhat improved. In this, there is a cunning of the disease: the patient decides that everything is normalized and in no hurry for the help of a specialist. At the same time, if you do not get qualified assistance, such attacks can repeatedly repeat.

Chronic pyelonephritis and his symptoms

The diagnosis of chronic pyelonephritis in women is hampered by the fact that in the overwhelming majority of cases, the disease does not exhibit in any way. However, it is only at first glance. Still, if you carefully listen to your body, then it is quite possible to suspect the problem in time. There are some indirect symptoms that talk about the sluggish development of chronic pyelonephritis. Symptoms of chronic pyelonephritis include:

diskforphic sensations in the lumbar spine. Disadvantage of the body of a general nature Epizodic subtaching small changes in the emptying mode of the bladder sharp changes in the temperature regime of the body

These are indirect symptoms of chronic pyelonephritis. However, in rare cases, there is a pain and a feeling of burning directly in the kidney itself. Periodic increasing body temperature indicate that a serious, often irreversible inflammatory process began in the kidneys. Symptoms of chronic pyelonephritis is quite wide and at the same time blurred. In individual cases, the patient may show symptoms that are characteristic of diseases such as peritonitis and cholecystitis.

Pyelonephritis is acute - acute nonspecific infectious inflammation of the cup-lowering system and tubula interstal kidney zone. There are one-sided and bilateral, unstructive (primary) and obstructive (secondary), serous and purulent acute pyelonephritis (OP).

In the development of OP, the leading role is played by the gram-negative intestinal microflora (E. coli, enterococci, protea). The old (seenile) op often causes a blue rod. The more rare and most pathogenic causative agent of OP is plasmoagulating staphylococcus.

Nephropathogenicity of these bacteria is associated with the adhesion phenomenon, which prevents the flushing of microbes from a cup-lowering system, as well as a phenomenon of physiological obstruction, due to the release of endotoxin, which reduces the normal tone and the peristaltics of urinary tract.

Urinogenic infection is also facilitated by violations of urodynamics in bubble-urine reflux (PMR), spinal cord lesions, prostate adenoma, a number of gynecological diseases, nephrolithiasis, kidney development anomalies, pregnancy. The hematogenic and lymphogenic path of infection at the OP are also possible.

It has been established that favorable conditions for the development of infection in an interface create hypoxia of the renal tissue, arising in nephroptosis, hypertensive disease, atherosclerosis and nephrosclerosis, electrolyte disorders (hypokalemia), abuse of non-scientific analgesics, impaired carbohydrate metabolism (diabetes mellitus).

Morphologically, in the serous OP, focal neutrophilic infiltration of the brain layer of the kidney and pyramids, a pronounced interstitial swelling of stroma, perivascular infiltration.

In the hematogenous distribution of infection in the kidney in the form of infected embols located in its vessels, guns are formed in the cortical layer (apostatomatic nephritis, carbuncoon kidney), purulent panephritis and neurosis of renal papillars can develop. Due to the acute occlusion of the urinary tract, a shake-renal reflux is formed, as a result of which the water-saturated urine penetrates into the bloodstream, which leads to bacteriamic shock with DVS-syndrome, Wroseppsis. Bacteremic shock, mortality at which reaches 20%, develops in each tenth patient obstructive OP, especially often during seden and gestational pyelonephritis.

Clinical picture of acute pyelonephritis

At various forms of OP, characteristic symptoms are observed.

The unstructive form of acute pyelonephritis

it is manifested by a sharp increase in body temperature (up to 38-39 ° C) with chills, blunt pains in the lower back, headache, nausea, myalgia. Characterized by dizuriy and the release of turbid urine with an unpleasant odor. During the examination: blood pressure is normal, neutrophilic leukocytosis, pyuria, bacteriuria, moderate (less than 1 g / l) proteinuria.

Obstructive form of acute pyelonephritis

usually debut at the height of the renal colic. Pains become intense, cutting, there is a stunning chill with a fever of 39-40 ° C (a sign of laughter-renal reflux), intoxication increases. Recove a sharply positive symptom of Pasternatsky, increasing neutrophilic leukocytosis. Urine analysis may be normal with complete obstruction, which is confirmed during chromocystoscopy.

Purulent sharp pyelonephritis

it is characterized by repeated (3-4 times a day) with a pouring chill, expressed by intoxication and leukocytosis (to leukemoid numbers), local pain and muscle tension during bimanual palpation of the lumbar region. However, it should be emphasized that the sedenive purulent op often proactively, without high fever and strong pain, but at the same time general intoxication and severe complications are particularly quickly joined.

Hazardous complications of purulent OP consider the appearance of massive macrohematuria with secondary renal columns and the presence of necrotic tissues in the urine (necrotic papallitis), the sudden development of a deep collapse with signs of DVS syndrome, an increase in azotemia and jaundice (bacteramemic shock).

Diagnosis of acute pyelonephritis

the unstructive OP normally does not cause difficulties (Lambalgia, Dizuriy, Piura). With obstructive purulent OP, when changes in the urine may be absent, the differential diagnosis is carried out with acute surgical (appendicitis, acute cholecystitis, pankecenecosis), infectious (types, brucellosis, brute pneumonia, subacute infectious endocarditis) and oncological (hemoblastosis, lymphognulomatosis) diseases. Especially big difficulties cause the diagnosis of apostatient jade, in which renal failure appears late (on the 2-3rd week of high fever). The resulting metastatic jams and the joining lesion of the liver (jaundice, hyperfermenia) mask the primary focus in the kidney and often lead to death (from purulent meningitis, abscessive pneumonia) even before Uremia.

Endoscopic (chromocystoscopy) and instrumental (intravenous urographics, echography, computer radiography) methods are important in the diagnosis. An purulent focus in the kidney helps to detect static nephrocintigraphy with gallium or laundered outolocytes. When a suspicious focus is detected for an uffin in difficult to diagnose cases, the aspiration biopsy of this kidney zone is carried out under the control of sectoral ultrasound scanning.

Treatment of acute pyelonephritis

The decisive factor of successful treatment is the elimination of obstruction with the restoration of the normal passage of urine. Only after that begin antibacterial therapy. When OP antibiotics are prescribed as early as possible - until the results of sowing urine. If there is no possibility to determine the pH of urine, choose the drug (or a combination of drugs), effective with any urine reaction. With a non-heavy (serous) OP, oral therapy is possible: Levomycetin in combination with fragine, ampicillin monotherapy or cephalosporins. Correction of therapy is carried out after receiving the results of sowing urine. The parenteral administration of antibiotics begin in the absence of an effect (and in the difficult course of the disease - in the first day). The pronounced bactericidal effect gives a combination of ampicillin with fraginine, carbenicillin with nanidixic acid, gentamicin with cephalosporins, especially with clafranoran.

In the case of the development of bacteriamic shock, intravenous administration of polyglyukine, hemodesa, sodium bicarbonate, pressing amines (dopamine, mesonon), prednisolone (300-1000 mg / day) is necessary. In the presence of signs of the DVS syndrome, heparin and infusion of Reopolyglyukin are prescribed.

Surgical treatment is carried out with apostleatous jade, purulent paranefritis.

In contact with

diabetes;
thyroid diseases;
long use of antibiotics;
supercooling.

Create conditions for the development of such damage to the kidney tissues can previously performed operations on the urinary tract. In addition, the occurrence of obstructive pyelonephritis is capable of kidney injury. The decrease in immunity of any etiology can provoke the development of this pathological condition.

Symptoms

severe thirst;
vomiting;
nausea;
a feeling of dry blood;
headache.

Diagnostics

general and biochemical analysis of blood and urine;
bakposiev urine;
urography;
angiography;
nephrocintigraphy;
radiography.

Nephrologist independently decides which research is required for diagnosis. Self-medication can represent a serious health hazard. After the comprehensive diagnosis, the doctor may assign the necessary drugs to suppress the inflammatory process.

Treatment of obstructive pyelonephritis

Usually, when obstructive pyelonephritis uses such drugs as:

Benzylpenicillin;
Oxacillin;
Ampicillin;
Ampicillin sodium salt;
Streptomycin;
Tetracycline;
Metacycline;
Morphocyclin;
Tetraolean;
Etietin;
Gentamicin;
Cephaloridine.

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The reasons

Primary pyelonephritis is a non-specific infectious damage to the renal tissue with propagation on the jelly and cups.

Distinguish the following types of pathogens:

intestinal wand, Prota, Klebsiella, Enterococci - usually fall from the following departments of the genitourinary system;
golden Staphylococcus, tuberculosis mycobacteria - is entered with blood flow;
adenoviruses, pathogenic fungi, east herpes virus - are rare provocateurs of pyelonephritis.

In the elderly women, pyelonephritis arises due to gynecological problems or incontinence, in men of older age - with the prostate adenoma.

It is necessary to mention the risk factors for the development of pyelonephritis. These include the following circumstances:

elderly age;
female;
bubble-ureteral reflux;
pregnancy;
diabetes;
immunodeficiency diseases;
prolonged or improperly found catheter in the urinary bubble cavity;
anomalies for the development of the urogenital system, violating the normal formation and outflow of urine.

Symptoms and species

The kidneys are amazed from one or both sides. Characterized focal and polymorphic changes in the renal and decumbal system. The main classification of unstructive pyelonephritis is based on the etiology of infection and the degree of acuteness of the inflammatory process.

Acute unstructive pyelonephritis is a sudden and fast-growing inflammation of the renal fabric.

For the course of the disease, such symptoms are characteristic:

heat;
one- or bilateral pains in the lower back;
frequent urges for urination;
muddy urine due to the impurity of the pus.

There is a pronounced intoxication: thirst, abundant sweating, head and muscular pain, chills, vomiting. Possible signs of dehydration. A person refuses meals and can not sleep.

It develops after an acute form of the disease, sometimes suffered in childhood. Recurrements may be provoked by any disease or negative factor. There is an increasing degradation of the renal-looping system with gradual shrinking of the kidneys.

The clinic is not demonstrative, there is no violation of urination. To suspect the presence of unstructive chronic pyelonephritis will help the following signs:

constant pain in the drawing of a pulling character;
unstable and minor increase in temperature;
hypertenna and combination with.

Depending on the paths of microbes to the organ, distinguish the ascending and downward form of pathology:

Rising variety of pyelonephritis - penetration of microbes from ureters and. The form is common in the elderly, pregnant and recently born women, often due to the return of urine. Also the cause of unstructive pyelonephritis are urogenital infections. Unfortunately, the disease may occur after medical intervention - surgery, cystoscopy.
Downward shape of pyelonephritis - Bar of infection with blood flow from an existing septic focus or after its liquidation. Such a phenomenon often cause a furuncle, mastitis, tonsillitis, panaria.

With ascending infection, the lesion of the kidney tissue comes from the depth of the organ, with hematogenous penetration, the process begins with its surface.

What doctor treats the unstructive pyelonephritis?

Initially, the patient needs to appeal to the precinct therapist. After passing the tests and the emergence of suspicion of the kidney disease, the doctor will give a referral to a consultation to nephrologist. When a combined defeat of urinary tract, assistance will have a urologist.

Diagnostics

The unstructive pyelonephritis requires laboratory and instrumental examinations. In case of acute variation of the disease, it is necessary to implement the following activities:

general blood test - leukocytosis and ETE growth;
general urine analysis - the presence of leukocytes and bacteria in the urine (with hematogenous genesis);
bacteriological examination is to identify the pathogen and its susceptibility to antimicrobial means.

In the chronic form of unstructive pyelonephritis, in general analysis of urine, a mixture of pus, protein and blood in minor quantities are found. Against the background of a long disease, the proportion of urine decreases. Out of the exacerbation of pyelonephritis in the blood, there are no sharp changes in general and biochemical indicators.

The stronger the atrophide the kidney, the laboratory violations are expressed less.

In pain in the lumbar-sacral division increase when the edge of the palm of the doctor (Symptom of Pasternatsky) is enhanced in the projection of the organ. The palpation of the front abdominal wall reveals the muscle tension from the side of the same name. In addition, a significant decrease in the amount of urine allocated is characterized.

Conduct special tests - samples of Addis-Kakovsky, Zimnitsky - to clarify the diagnosis. Instrumental methods of diagnosis of unstructive pyelonephritis are needed:

radiography;
excretory urography;
scanning;
angiography;
radioisotope examination;
biopsy.

In controversial cases, MRI of the urinary system or nuclear magnetic resonance is carried out.

In the elderly, even an acute form of pyelonephritis is distinguished by an erased symptomatics from the kidneys. Complaints are characterized by a low temperature, backing back pain, no appetite. In blood tests and urine change minor. Therefore, the diagnosis of pyelonephritis in this category of patients is particularly difficult.

Treatment

Upon timely treatment, the acute form of pyelonephritis is cured without consequences. Therapy of chronic variety is aimed at preventing recurrences and achievement of remission.

Conservative treatment of unstructive pyelonephritis

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Medicase treatment of pyelonephritis includes drugs of various pharmacological groups. First of all, the means affecting the cause of the disease is a pathogenic microorganism. For this purpose, the following antimicrobial means are prescribed:

Antibiotics - cephalosporins (ceftriaxone), tetracycline (viscin), aminoglycosides (gentamicin). Preparations are used depending on the sensitivity of the selected microorganism.
Nitrofurans - Furadonin.
Sulfanimamides - Bactrim Forte.

The normalization of urine tests is happening, but antibiotic therapy continues within a month with the change of medicines from different groups.

As the symptomatic treatment of unstructive pyelonephritis, drugs of the following medicinal groups are used:

spasmolitics - but-shpa, papaverine;
diuretics with urine delay - Laziks;
disinfectants - Reopolyglyukin, hemodez.

To accelerate recovery, vitamins (Milgamma, ascorbic acid) are prescribed. Patients must comply with drinking mode - consumption of at least 2.5 liters of pure water. In the launched chronic forms, the water volume depends on the state of the patient and the survey results.

During the rehabilitation period, the physiology is shown - the diathermy of the lumbar-sacral department, electric and phonophoresis using anti-inflammatory agents and antispasmodics, paraffin and mud appliques.

In chronic species of pyelonephritis, antimicrobial therapy is applied regularly during the year. Recommended active vitamin therapy. In stationary conditions, the testimony is carried out, blood transfusions or plasma.

With a resort of chronic pyelonephritis, sanatorium-resort treatment is recommended in specialized sanatoriums - Zheleznovodsk, Essentuki.

Surgical treatment of unstructive pyelonephritis

If, with acute pyelonephritis, conservative therapy measures are ineffective, a surgeon is needed. Making a dissection of the kidney capsule and the drainage of the kidney to eliminate the pus.

Operations in chronic varieties are carried out according to strict testimony, more often the excision of the kidney part.

Prevention

To prevent the acute form of pyelonephritis, the following simple events are important:

exclusion of supercooling;
the destruction of any infectious focus in the body;
timely elimination of inflammation in urinary tracts;
balanced diet enriched with vitamins and minerals.

The best prevention of chronic pyelonephritis is the timely treatment of the acute phase. To prevent recurrences, warming heating were used, drink champs and rugged, anti-inflammatory herbs, vitamin fees.

An annual examination of various profiles with the main laboratory tests is required.

The danger of unstructive pyelonephritis is the likelihood of a chronic form. This leads to the formation of chronic renal failure, fraught with a fatal outcome. Therefore, it is so important timely appeal to the doctor and the fulfillment of its recommendations.

Useful video about unstructive pyelonephritis

List of sources:

Handbook of a practicing doctor ed. Denisova I. N., Ulumbekova E. G. Ed. "Medical Academic Book", 2000
Directory of the therapist ed. Astapenko M. G. Ed. "Medicine", 2001

The unstructive pyelonephritis is a kind of kidney tissue inflammation, the disease is very common and well-studied.

It occurs with characteristic symptoms and in most cases is secondary in nature (acts as complications). It has several forms of flow.

With incorrectly selected therapy or late treatment, pyelonephritis is able to cause renal failure or septic shock.

general information

There are several varieties, since this disease is inflammatory in nature, it proceeds in several "scenarios" and in most cases with normal urine outflow.

The unstructive pyelonephritis is the type of disease in which diuresis is not disturbed, that is, ureters are not blocked or pathogenic bacteria. There are no ischemic changes in organs. The influx of blood to the kidneys is not broken.

Specific procedures will help diagnose diseases:

analysis of urine and blood on biochemistry;
positive;
extensive urography.

CT and MRI are rare, most often enough to do ultrasound, detect structural changes in the structure of organs or spend. In this case, the condition of blood and urine of the patient is evaluated, the presence of pathogenic microorganisms in biological fluids indicates an infectious process.

Methods of therapy

Preference is given to drug treatment, they rarely resort to the help of surgical interventions, because urine outflows estabutive pyelonephritisnot broken. Operation is required only in the case of the development of complications.

Traditional methods

It implies the reception of the antibacterial spectrum of action. Help to stop the inflammatory process.

Assign can:

Eminent antibacterial therapy can be vitamins and anti-inflammatory preparations of plant origin. But therapy is chosen individually.

Do you need an operation?

If the outflow of urine is not disturbed, then the disease does not require operational treatment. Surgical manipulations are carried out only with the development of complications (carbuncule, abscess).;

st. John's wort

Of these plants it is easy to prepare the collection and take it daily. The ingredients are mixed in equal proportions (total weight 35 gr.). The mixture is poured with 1 liter of boiled water, and put on a water bath for 15 minutes, then fixed, cool and drink 3 glasses per day.

If not, you can drink juice and lingonberry with honey, daily 200 ml in the morning, diluting the drink with a spoonful of honey.

Possible complications

If we talk about the acute type of disease, then the transition of pyelonephritis in chronic form is considered. Against the background of what structural changes in the tissues occur.

With a long and noncompensated course, the disease can also cause:

carbuncule or kidney abscess;
sepsis of blood of bacteriological character.

These are the most frequent complications to which pyelonephritis can lead, but the disease often leads to the defeat of nearby organs and tissues. Inflammation passes to the liver, intestines, stomach. What significantly worsens the overall condition of the body and leads to the emergence of additional symptoms.

Prevention and forecast

With timely handling, competently selected treatment, the forecast is favorable. In the event of complications, the likelihood of surgical manipulations increases.

timely treat bacterial and infectious diseases;
in the chronic type of flow, contact the nephrologist 1 time in 12 months;
in case of unpleasant symptoms, contact the doctor;
strengthen the immune system with the help of appropriate drugs.

The unstructive pyelonephritis is a common, but dangerous disease, a doctor should do it.

When the first signs appear in an emergency to consult a doctor and pass tests. This will help to avoid severe complications and stop the development of the inflammatory process.