Pyelonephritis - what is it, symptoms and treatment. How to treat pyelonephritis with drug therapy


Pyelonephritis is a disease that affects some structures of the kidneys, namely the renal pelvis and adjacent parenchyma. This disease has several types, which greatly complicates the selection of the right medicines for its treatment. Next, let's try to figure out which drugs are most effective in the treatment of pyelonephritis.

What determines the choice of medicines?

Pyelonephritis is an inflammation of a bacterial nature. It can be caused by the following types of bacteria:

It is customary to distinguish between two types of formation of this disease - descending and ascending. The first of them is more common and is the occurrence of an inflammatory focus due to the entry of the above bacteria into the kidney through the circulatory system from other inflamed organs. In other words, if there is an inflammatory focus somewhere in the body, accompanied by the multiplication of these bacteria, then over time, microorganisms with the bloodstream can enter the kidney, provoking the development of pyelonephritis.

The second type - ascending - is characterized by a different way bacteria enter the kidney. In this case, they come from the lower urinary tract up the wall of the ureter. In this type of disease formation, pyelonephritis is preceded by other diseases, such as cystitis. It should be noted that pyelonephritis occurs most often in women, in men only in 15% of cases.

Pyelonephritis can be acute, chronic or chronic with exacerbations. Given that the kidneys are a paired organ, this disease can be one- or two-sided.

If the treatment of pyelonephritis is timely and effective, the disease will recede in about 20 days, otherwise the acute phase will turn into a chronic one, and it, in turn, will lead to pyonephrosis and secondary wrinkling of the kidney. In addition, this disease can lead to complications such as:

Any renal pathological process is fraught with serious complications and consequences, including pyelonephritis. Moreover, this disease can occur not only in adults, but also in children. For the treatment of pyelonephritis, mainly drugs of the antibiotic group are used. Which of them should be taken in each individual case is determined by the attending physician. kidneys alone, without consulting a specialist, is highly discouraged.

The insidiousness of this disease lies in the fact that it can be asymptomatic for a certain time. In addition, as its signs, symptoms such as:

  • increase in body temperature;
  • general weakness;
  • aches in the joints;
  • muscle pain.

Such a symptomatic picture does not contribute to the detection of pyelonephritis at an early stage, since it can be mistaken for signs of many other diseases, including colds or flu. However, over time, this list is often replenished with pain in the lumbar region and frequent urges to urination.

Do not forget that in addition to pyelonephritis, there are many other diseases that affect the kidneys. It is impossible to establish the nature and type of the disease on your own; professional diagnostics are required. To determine the disease, a series of diagnostic procedures, for example:


After making an accurate diagnosis, the doctor determines which drugs for pyelonephritis in this case should be drunk.

Principles of medical treatment of the disease

Despite the fact that pyelonephritis responds well to treatment, choosing the best medicine is not so easy. This is due to the nature of the disease. As noted above, its pathogens are bacteria. Currently, a huge number of various strains of these microorganisms have formed with varying degrees of resistance to certain drugs. Therefore, therapy begins with the fact that the drug is determined, to which the pathogen has retained sensitivity.

This process requires some time and constant monitoring by the doctor, regular testing and monitoring the presence / absence of changes in the patient's condition. Therefore, this disease is often treated in a hospital setting. In order to determine how to treat pyelonephritis, the doctor first prescribes standard antibacterial drugs and monitors the effect. If there is none, the doctor uses a new medication. In the complex of therapy, the following drugs are often used for pyelonephritis:


There are also active use of various herbal infusions, decoctions. In addition, appointed vitamin complexes, iron-containing drugs (often due to therapy, the patient develops anemia). If all the drugs used for pyelonephritis are divided into target areas, then three groups will be obtained:

  • drugs for the treatment of pyelonephritis directly;
  • symptomatic remedies;
  • drugs for the treatment, the primary focus of inflammation.

It should be noted that the latter circumstance requires special attention, since the primary focus is dangerous and requires immediate treatment.

If in any organ there is inflammatory process, during which pathogenic bacteria actively multiply and spread throughout the body through the circulatory system, then the suppression of this focus is a priority in the general course of therapy. In general, in the normal position, the entry of microorganisms into the kidney cannot be carried out. And if this nevertheless happened, then it is necessary to find out the cause and mechanism of such a deviation from the norm.

The most effective drugs for pyelonephritis

In the treatment of this disease, a whole range of drugs is prescribed, the list of which may vary depending on the characteristics of each individual case. If we talk about antibiotics, then, as mentioned earlier, the selection of the optimal medicinal product from pyelonephritis is produced by exclusion. It all depends on the strain of the causative agent of the inflammatory process.

Antibiotics are usually preferred initially penicillin series. From dosage forms tablet preparations are selected, however, with a serious degree of damage, injections are prescribed. Subsequently, the doctor may change the prescribed treatment or leave it the same. Antibacterial drugs prescribed in this case are quite diverse. With pyelonephritis, drugs of this type can be as follows:

  • penicillins (Ampicillin, Oxacillin, Augmentin);
  • tetracyclines (Metacycline, Doxycycline);
  • cephalosporins (cefazolin, cefotaxime, ceftriaxone);
  • aminoglycosides (Gentamicin, Amikacin);
  • sulfonamides (Urosulfan, Biseptol);
  • quinolones (Norfloxacin, Lomefloxacin, Pefloxacin);
  • Levomycetin (Chloramphenicol, Levomycetin succinate);
  • nitrofurans (Furadonin, Nitrofurantoin, Furamag).



If the drug taken during the first two days, for example, the penicillin series, did not give the expected result, then the pyelonephritis causative bacterium in this case is resistant to these antibiotics. Then it is replaced by another. At acute conditions and signs of intoxication, patients are urgently hospitalized, put on droppers, examined and treated in a hospital.

In addition to antibacterial agents, diuretic drugs are usually used for pyelonephritis (for chronic pyelonephritis - in prophylactic doses, for example, 1 tablet per week), since excess fluid accumulates in the body, edema forms. For example, you can take:


In addition, it is necessary to drink vitamins and immunomodulators, since a weakening of the body and a decrease in immunity are favorable conditions for the development of the disease. It can be:

  • vitamin complexes: Duovit, Supradin, Vitrum;
  • immunomodulatory drugs: Timalin, T-activin.

To reduce the severity of symptoms, antispasmodics (Atropine sulfate, Halidor, Papaverine, Scopalamin, Drotaverine), painkillers (Diclofenac, Ibuprofen, Indomethacin) and antihistamines (Diazolin, Suprastin) drugs are used. However, they should be taken only after visiting a doctor, so that a short-term decrease in the manifestations of the disease does not lead to an incorrect identification of the disease and, as a result, an incorrect prescription of treatment.

It is generally not advisable to treat pyelonephritis on an outpatient basis, since therapy requires not only constant monitoring of the results and regular testing, but also a high degree of responsibility and self-discipline of the patient. Violation of the drug schedule can not only reduce positive effect treatment, but also lead to the development of resistance of the pathogen to the prescribed antibiotic. In addition, the patient is required to comply with certain conditions and diets.

Tip: even with a significant improvement in the condition, in the absence of symptoms of the disease, it is necessary to complete the prescribed treatment, strictly adhering to the original scheme, because. untreated inflammatory processes of a bacterial nature often lead to complications and more complex forms of the disease.

Additional Methods and Tools

First of all, it is forbidden to overcool. Even during the period of remission, it is necessary to ensure that the body is not exposed to low temperatures, especially in combination with humidity. During therapy (in the period of exacerbation) prescribed bed rest. It is necessary to spend as much time as possible in a warm bed under the covers. Stay in horizontal position plays important role in the treatment of pyelonephritis. However, do not forget that regular urination with a frequency of about 3 hours is also necessary.

Dieting is required primarily in order to exclude the use of foods that contribute to water retention in the body. Thus, the following are excluded from the diet:


Of course, alcohol is completely excluded. Other liquids, on the contrary, should be drunk as much as possible to ensure frequent urination. It is better to give preference to those drinks that also bring additional benefits in the form of vitamins and minerals, for example, herbal teas, rosehip broth, berry fruit drinks and mineral water. It is better to replace black tea with green tea, as it has a diuretic effect.

Medicinal herbs are very effective. However, it should be immediately noted that it is enough to get by with only them alone, as well as folk remedies and herbs, in the treatment of pyelonephritis will not work. However, as an additional help, this method is very useful. First of all, such drugs have a diuretic effect. In addition, herbal preparations can reduce swelling or relieve spasm. urinary tract. You can also drink tea based on herbs that are part of the preparations.

To solve many of the problems that accompany pyelonephritis, drugs based on medicinal plants such as:

  • bearberry;
  • rose hip;
  • lovage;
  • nettle;
  • horsetail;
  • centaury;
  • sage;
  • parsley;
  • mint;
  • plantain;
  • chamomile;
  • oats, etc.



The most commonly used drugs of this type are:

  • Kanefron;
  • Phytolysin;
  • Urolesan;
  • Urocyst;
  • Urostin;
  • Flavia.

They can be purchased at the pharmacy without a prescription. It is recommended to drink such drugs also as a prophylactic, and not only in addition to the main treatment during exacerbations of the disease.

In order to avoid recurrence of the disease, it is necessary to monitor the state of the body, respond in a timely manner to warning signs, beware of hypothermia, provide yourself with a sufficient amount of vitamins.

- it's non-specific infection kidneys caused by various bacteria. The acute form of the disease is manifested by fever, symptoms of intoxication and pain in the lumbar region. Chronic pyelonephritis may be asymptomatic or accompanied by weakness, loss of appetite, increased urination, and mild back pain. The diagnosis is made on the basis of the results of laboratory tests (general and biochemical urinalysis, bakposev), urography and ultrasound of the kidneys. Treatment - antibiotic therapy, immunostimulants.

General information

is a widespread pathology. Patients suffering from acute and chronic pyelonephritis account for about 2/3 of all urological patients. The disease can occur in acute or chronic form, affecting one or both kidneys. Diagnosis and treatment is carried out by a specialist in the field of clinical urology and nephrology. In the absence of timely therapy, pyelonephritis can lead to such severe complications as renal failure, carbuncle or kidney abscess, sepsis and bacterial shock.

Causes of pyelonephritis

The disease can occur at any age. More often pyelonephritis develops:

  • In children under the age of 7 years (the likelihood of pyelonephritis increases due to the peculiarities of the anatomical development.
  • In young women aged 18-30 years (the occurrence of pyelonephritis is associated with the onset of sexual activity, pregnancy and childbirth).
  • In older men (with obstruction of the urinary tract due to the development of prostate adenoma).

Any organic or functional reasons that prevent the normal outflow of urine increase the likelihood of pathology. Often pyelonephritis appears in patients with urolithiasis. Unfavorable factors contributing to the occurrence of pyelonephritis include diabetes mellitus, immune disorders, chronic inflammatory diseases and frequent hypothermia. In some cases (usually in women), pyelonephritis develops after acute cystitis.

Asymptomatic course is often the reason for delayed diagnosis chronic pyelonephritis. Patients begin treatment when kidney function is already impaired. Since pathology very often occurs in patients suffering from urolithiasis, such patients need special therapy even in the absence of symptoms of pyelonephritis.

Symptoms of pyelonephritis

For acute process characterized by sudden onset sharp rise temperatures up to 39-40°C. Hyperthermia is accompanied by profuse sweating, loss of appetite, severe weakness, headache, and sometimes nausea and vomiting. dull pains in the lumbar region of varying intensity, often unilateral, appear simultaneously with an increase in temperature. Physical examination reveals tenderness on tapping in the lumbar region ( positive symptom Pasternatsky).

The uncomplicated form of acute pyelonephritis does not cause urination disorders. Urine becomes cloudy or takes on a reddish tint. Laboratory examination of urine reveals bacteriuria, slight proteinuria and microhematuria. For a general blood test, leukocytosis and an increase in ESR are characteristic. Approximately 30% of the time in biochemical analysis blood, an increase in nitrogenous slags is noted.

Chronic pyelonephritis is often the outcome of undertreated acute form. Possible development of primary chronic process. Sometimes the pathology is discovered by chance during the study of urine. Patients complain of weakness, loss of appetite, headaches and frequent urination. Some patients have dull, aching pains in the lumbar region that are worse in cold, damp weather. Symptoms indicating an exacerbation coincide with the clinical picture of an acute process.

Complications

Bilateral acute pyelonephritis can cause acute kidney failure. Sepsis and bacterial shock are among the most formidable complications. In some cases, the acute form of the disease is complicated by paranephritis. Perhaps the development of apostenomatous pyelonephritis (the formation of multiple small pustules on the surface of the kidney and in its cortical substance), carbuncle of the kidney (often occurs due to the fusion of pustules, is characterized by the presence of purulent-inflammatory, necrotic and ischemic processes) kidney abscess (melting of the renal parenchyma) and necrosis of the renal papillae .

If treatment is not carried out, terminal stage purulent-destructive acute process. Pyonephrosis develops, in which the kidney is completely subjected to purulent fusion and is a focus consisting of cavities filled with urine, pus and tissue decay products. With the progression of chronic bilateral pyelonephritis, kidney function is gradually impaired, which leads to a decrease in the specific gravity of urine, arterial hypertension and the development of chronic renal failure.

Diagnostics

Diagnosis is usually not difficult for a nephrologist due to the presence of pronounced clinical symptoms. The history often includes chronic diseases or recent acute purulent processes. clinical picture forms a characteristic combination of severe hyperthermia with lower back pain (usually unilateral), painful urination and urine changes. Urine is cloudy or reddish in color and has a pronounced fetid odor.

Laboratory confirmation of the diagnosis is the detection of bacteria and small amounts of protein in the urine. To determine the pathogen, a urine culture is performed. About availability acute inflammation evidenced by leukocytosis and an increase in ESR in the general blood test. With the help of special test kits, the microflora that caused inflammation is identified. Diagnostics structural changes with pyelonephritis, it is carried out with the help of ultrasound of the kidneys. The concentration ability of the kidneys is assessed using the Zimntsky test. To exclude urolithiasis and anatomical abnormalities, CT of the kidneys is performed.

Plain urography revealed an increase in the volume of one kidney. Excretory urography indicates a sharp limitation of kidney mobility during orthoprobe. With apostematous pyelonephritis, there is a decrease in the excretory function on the side of the lesion (the shadow of the urinary tract appears late or is absent). With a carbuncle or abscess on the excretory urogram, the bulging of the contour of the kidney, compression and deformation of the calyces and pelvis are determined.

Treatment of pyelonephritis

An uncomplicated acute process is treated conservatively in a hospital setting. Antibacterial therapy is carried out. Medicines are selected taking into account the sensitivity of the bacteria found in the urine. In order to eliminate inflammation as quickly as possible, preventing the transition of pyelonephritis to a purulent-destructive form, treatment begins with the most effective drug.

Conducted detoxification therapy, correction of immunity. In case of fever, a diet with a low protein content is prescribed, after normalization of the patient's temperature, the patient is transferred to good nutrition with high content liquids. At the first stage of therapy for secondary acute pyelonephritis, obstacles that impede the normal outflow of urine should be eliminated. The appointment of antibacterial drugs in case of impaired passage of urine does not give the desired effect and can lead to the development of serious complications.

Treatment of chronic pyelonephritis is carried out according to the same principles as the treatment of an acute process, but is more time consuming and laborious. The therapeutic program provides for the elimination of the causes that led to difficulty in the outflow of urine or caused renal circulation disorders, antibiotic therapy and the normalization of general immunity.

In the presence of obstructions, it is necessary to restore the normal passage of urine. Restoration of urine outflow is performed promptly (nephropexy for nephroptosis, removal of stones from the kidneys and urinary tract, removal of prostate adenoma, etc.). The elimination of obstacles that interfere with the passage of urine, in many cases, allows to achieve stable long-term remission. Antibacterial drugs are prescribed taking into account the data of the antibiogram. Before determining the sensitivity of microorganisms, therapy with antibacterial drugs is carried out. a wide range actions.

Patients with chronic pyelonephritis require long-term systematic therapy for at least a year. Treatment begins with a continuous course of antibiotic therapy lasting 6-8 weeks. This technique allows you to eliminate the purulent process in the kidney without the development of complications and the formation of scar tissue. If renal function is impaired, constant monitoring of the pharmacokinetics of nephrotoxic antibacterial drugs is required. To correct immunity, if necessary, use immunostimulants and immunomodulators. After achieving remission, intermittent courses of antibiotic therapy are prescribed.

During remission, patients are shown Spa treatment(Jermuk, Zheleznovodsk, Truskavets, etc.). It should be remembered about the mandatory continuity of therapy. Antibacterial treatment started in the hospital should be continued on an outpatient basis. The treatment regimen prescribed by the doctor of the sanatorium should include taking antibacterial drugs recommended by the doctor who constantly monitors the patient. Phytotherapy is used as an additional method of treatment.


is an infectious and inflammatory disease of the kidneys. The disease develops as a result of the spread pathogenic microorganisms penetrating into the kidneys from the lower parts of the urinary system. The most common cause of pyelonephritis is Escherichia coli - E. Coli. It is found when performing a urine test in sick women in large numbers. Less commonly, the causative agents of the disease are other gram-negative bacteria, staphylococci and enterococci. In 20% of cases, pyelonephritis occurs as a result of a mixed infection.

Pyelonephritis is a serious disease characterized by a severe course. Patients suffer from severe pain, general well-being is disturbed. Experts are unanimous in the opinion that the disease is much easier to prevent than to get rid of it.

Pyelonephritis refers to infections of the urinary system. If pathogenic bacteria capture its lower sections, and therapy antibacterial agents is selected incorrectly or is completely absent, then microorganisms begin to multiply rapidly with spread to the kidneys. This leads to the symptoms of pyelonephritis. The nephrologist deals with the diagnosis and treatment of the disease.

Facts and statistics about pyelonephritis

    It has been established that female representatives suffer from pyelonephritis more often than men by 5 times. The acute form of the disease is diagnosed more often in women. reproductive age leading an active sexual life.

    In the United States of America, 1 in 7,000 people gets sick every year. 192,000 patients need and receive hospitalization every year.

    With adequate treatment, up to 95% of all patients notice a significant improvement in the first two days.

    Pyelonephritis affects children, both girls (in 3% of cases) and boys (in 1% of cases). In childhood, the disease is dangerous for its complications. So, cicatricial changes kidney parenchyma is diagnosed in 17% of recovered children, hypertension in 10-20% of children.

    Abundant fluid intake is an essential condition for the treatment of the disease. For drinking it is necessary to use clean water, which normalizes the balance in the body, thins the blood, promotes the speedy removal of pathogenic microorganisms and toxic products of their vital activity. The effect is achieved by increasing the number of urination as a result of heavy drinking.

    You should not refuse to drink plenty of water due to pain during emptying Bladder, as this is the only way to remove bacteria from the body. You should urinate as often as possible so that there is no such serious complication as blood poisoning, as a result of which a person may die.

    Alcoholic drinks, coffee, carbonated water - all this is prohibited in pyelonephritis. It is believed that cranberry juice can help in the fight against the disease. It is consumed in its pure form, or diluted with water.

Symptoms of acute pyelonephritis are as follows:

    The occurrence of a feeling of nausea, which may be accompanied by vomiting.

    High body temperature with chills. Sweating increases, appetite disappears, headaches occur.

    Increased fatigue, malaise and weakness.

    Painful sensations with localization in that side from which the kidney is damaged. Pain can also be girdle in nature with predominant localization in the lower back. "Spillage" of pain occurs with a bilateral inflammatory process. An exacerbation of the disease is characterized by Pasternatsky's symptom, which boils down to the appearance of pain when tapping in the lumbar region and, for a short time, an increase in erythrocyturia. When changing the position of the body, the intensity of pain does not change, but they increase during deep breathing and palpation of the abdomen.

    An increase in the number of urination, regardless of the sex of the patient.

    Minor swelling.

    Laboratory tests of urine and blood indicate inflammation. Pathogenic bacteria and leukocytes are found in the urine.

    If pyelonephritis is purulent, then the body temperature can manifest itself abruptly - rise to high values ​​​​and fall to subfebrile levels several times a day. Most often, the fever lasts for a week.

    Bacterial shock is typical for 10% of patients.

There are also non-specific symptoms for acute pyelonephritis that may indicate the disease:

    An increase in body temperature to high values, up to the development of a feverish state.

    Tachycardia.

    Dehydration of the body.

If the disease has become chronic (which often occurs with an untreated acute stage of the disease, although sometimes chronicization of the process without a previous exacerbation is possible), then the symptoms of pyelonephritis may be less pronounced, but they persist for a long time period. When donating blood for analysis, signs of inflammation may not be detected. Leukocytes are present in the urine, but the bacterial component may be absent. When remission of pyelonephritis occurs, then all laboratory parameters will be normal.

In addition, every third patient notes the following symptoms (characteristic of inflammation of the lower urinary system):

    Pain during emptying of the bladder of the type of pain.

    The presence of blood impurities in the urine.

    Constant desire to empty the bladder even when it is not full.

    Darkening of urine, the presence of turbidity in it, the presence of an unpleasant fishy smell.

Ascending entry of bacteria into the kidneys

The development of the disease is provoked by bacteria. They, through the urethra, enter the urinary system and inseminate the bladder. If the infection is not eliminated, then gradually it will rise higher and higher, capturing the organs located in its path and eventually affecting the kidneys. In 90% of cases, the disease occurs due to the penetration of Escherichia coli into the bladder. She, having begun her vital activity in the intestines, penetrates into the urethra from the anus. Most often this happens during the emptying process. Due to the fact that the urethra and anus in women it is located nearby, and the main source of infection is E. coli, they suffer from pyelonephritis much more often.

In addition, the urethra in women is short, and the anatomy of the external genital organs is such that it is not difficult for E. coli to penetrate the bladder and then the kidneys. Therefore, the ascending route of infection is the most common cause of infection, resulting in acute pyelonephritis.

However, not always only E. coli leads to inflammation of the kidneys.

Other causes of pyelonephritis include:

    Enterococci;

    Mycotic microorganisms;

  • Enterobacter.

Vesiculourethral reflux (vesicoureteral reflux)

This pathology is characterized by the fact that from the bladder, urine flows back into the ureters and is partially thrown into the renal pelvis. When the disease remains undetected at an early stage, it leads to regular stagnation of urine, reflux and reproduction of pathogenic agents in the tissues of the kidney, which leads to an inflammatory process.

The more exacerbations of pyelonephritis the child suffers, the more the structure of the kidneys is disturbed. As a result, normal tissue is replaced by scar tissue and the organ is unable to perform its functions in the same volume. This development of the disease is typical mainly for young children who have not reached the age of five. However, scarring of the tissues of the kidneys and in adolescence against the background of the disease.

It is children's kidneys that are more prone to scarring, since:

    reverse current or reflux in childhood occurs under less pressure than in adults.

    The immune system of children is more vulnerable to the pathogenic influence of bacterial agents than in adulthood. This is especially true for children under one year old.

    Pyelonephritis is more difficult to detect at a younger age, especially in infancy.

Vesico-dream reflux is found in most children under six years of age suffering from pyelonephritis (from 20 to 50% of all patients), while in adults this pathology is diagnosed only in 4% of cases.

Pyelonephritis transferred to early age, leads to irreversible changes kidney tissues. So of all patients on hemodialysis, 12% were sick with acute pyelonephritis in childhood.

As for other causes of pyelonephritis, they are of low prevalence. It is possible for the pathogen to penetrate not from the bladder, but through the blood flow from other organs.

Risk factors

There are risk factors that increase the likelihood of developing the disease, among them:

    Deposition of stones in the kidneys.

    Pathologies of the development of the organs of the urinary system of a congenital nature.

    Changes in the urinary system due to age.

    Neurogenic dysfunction of the bladder, which is observed with diabetes. This condition requires re-insertion of the catheter, which increases the risk of developing the disease.

    Damage spinal cord as a result of injuries.

    The period of bearing a child, which can lead to a decrease in tone and a decrease in ureteral perilstatics. This is due to their compression by the growing uterus, with polyhydramnios, with a narrow pelvis, with a large fetus, or against the background of existing insufficiency of the vesicoureteral valves.

    Full or partial displacement of the uterus outside the vagina.

    The introduction of a catheter into the bladder, which leads to its obstruction.

    Sexual activity of a young woman. During intercourse, the muscles of the urogenital diaphragm contract as a result of massaging the urethra, which increases the risk of infection along the ascending pathway.

    Operations on the organs of the urinary system.

Diagnosis in a typical case is not difficult. The patient's complaints about pain in the lumbar region, intoxication syndrome become the basis for taking tests and undergoing an instrumental examination, which makes it possible to diagnose pyelonephritis.

Instrumental Research come down to:

    Ultrasound of the kidneys, which allows you to detect the presence of stones in them, provides information about the size of the organs, about changes in their density. In the chronic course of the disease, the echogenicity of the parenchyma increases, and with acute course decreases unevenly.

    CT makes it possible to assess not only the density of the parenchyma, but also the state of the perirenal tissue, vascular pedicle and pelvis.

    Excretory urography provides information about the limitation of the mobility of the affected kidney, the tone of the urinary tract, the condition of the cups, etc.

    Cystography is performed to detect intravesical obstruction and vesicoureteral reflux.

    Angiography of the arteries of the kidneys is used more often with the already diagnosed chronic pyelonephritis, since this method is not routine for detecting the acute stage of the disease.

    Women should definitely undergo a gynecological examination.

What tests are given for pyelonephritis?

With pyelonephritis, it is necessary to pass the following tests:

    Urinalysis according to Nechiporenko.

    Zimnitsky test.

    Bacteriological examination of urine.

    It is possible to perform a prednisolone test, which allows you to identify the latent course of the disease. Why is it given intravenously? special drug(Prednisolone with Sodium chloride), after which, after an hour, after two and after three hours, and then, after a day, urine is collected and analyzed.

Is it possible to cure pyelonephritis at home and what to take for recovery? The answers to these and many other questions concern people suffering from kidney inflammation. According to experts, self-treatment of pyelonephritis on initial stages can be very effective, but extreme caution must be exercised. By reading this article, you will general information about treatment methods for the disease and find out in which cases you may need urgent medical attention.

Causes of the disease

The first thing you need to pay attention to when starting the fight against a particular disease is the etiology. Pyelonephritis develops when a mixed infection or pathogens enter the bloodstream of a person (these can be coli, all kinds of cocci, etc.). Before you learn how to cure pyelonephritis, check out the list of factors associated with infection:

  • chronic states of overwork/weakness/stress;
  • decreased immunity;
  • lack of vitamins;
  • passage of urine;
  • urolithiasis disease;
  • kidney tumor;
  • narrowing of the ureters.

How to treat pyelonephritis in adults

It is known that the treatment of pyelonephritis in mature women and men is a complex set of medicinal measures aimed at normalizing the condition of the kidneys. The disease control program includes the use of drugs and procedures aimed at eliminating foci of inflammation. Features of kidney treatment depend on the age of the person, general condition health and the current form of the disease.

diet therapy

The first thing you should take care of is the diet, because the body receives all the nutrients along with food. When choosing a diet, the nature of the disease and the individual characteristics of the patient's body must be taken into account. If we are talking about acute pyelonephritis, it is necessary to exclude from the diet following products:

  • snacks, canned food, smoked meats, pickles;
  • hot spices / seasonings;
  • coffee;
  • broths with broth;
  • legumes;
  • cakes/creams;
  • mushrooms;
  • sparkling water;
  • alcoholic drinks.
  • dairy;
  • fruits with a high content of potassium (dried apricots, apricots, raisins);
  • White bread(salt-free);
  • butter (in moderation);
  • boiled and grated vegetables;
  • cereals;
  • sugar.

  • herbal decoctions;
  • compotes / fruit drinks / kissels / juices;
  • teas (green, weak black);
  • mineral soda water without gas.

In the process of treating chronic pyelonephritis, the list of products to be excluded remains unchanged. The basis diet food includes the following products:

  • lean varieties of fish / meat / poultry (minced meat or boiled meat);
  • vegetarian and milk soups (fruit/vegetable);
  • dairy and dairy products;
  • flour products;
  • chicken eggs;
  • pasta (well boiled);
  • cereals;
  • puddings;
  • raw / boiled vegetables (except radish, cauliflower, garlic and onions);
  • fruits and berries of all kinds;
  • gourds;
  • jam, honey, sugar and some other harmless sweets.

The nuances of the diet for pyelonephritis (kidney disease) must be agreed with the attending physician, otherwise digestive disorders may occur. You will have to forget about the products recommended for exclusion from the diet until the kidneys are completely recovered, otherwise the effectiveness of therapeutic measures will decrease significantly. The sooner the patient provides a balance of substances in the body, the less chance there will be for pyelonephritis.

Medical therapy

Treatment of the acute form of pyelonephritis with drugs is aimed at quickly eliminating foci of inflammation in the kidneys and preventing the strengthening of the disease. The average course duration is 12-16 days. The general complex of therapeutic measures is based on the following principles:

  • elimination of factors that cause infection in the kidneys;
  • antibiotic therapy after sampling for culture;
  • strengthening the immune system to prevent relapses in the future;
  • pathogenic/symptomatic treatment.

To alleviate the condition of a patient with a diagnosis of "acute pyelonephritis", antispasmodics ("Drotaverin", "No-Shpa", "Spasmalgon") are prescribed. In the course of direct treatment of inflammation of the kidneys, specialists conduct a number of laboratory tests and prescribe complex treatment with drugs from several pharmacological groups:

  1. Antibiotics: Cefalexin, Cefaclor, Amikacin, Gentamicin. Highly effective, but at the same time low-toxic antibacterial drugs for the treatment of acute forms of pyelonephritis. Depending on the form of release, they are used orally and intravenously.
  2. Non-steroidal anti-inflammatory drugs (NSAIDs): Nimesulide, Voltaren, Movalis. The acute form of pyelonephritis is often accompanied by fever. To reduce body temperature and block inflammation in the kidneys during the treatment of this disease, NPS tablets are prescribed.
  3. Probiotics: Ecoflor, Trilact, Bifidum BAG. These drugs are prescribed to restore the intestinal microflora affected by the treatment of acute pyelonephritis with antibiotics. Probiotics contain beneficial microorganisms that reduce the level of intoxication and remove toxins.
  4. Anticoagulants: "Dipiridamolm", "Heparin", "Troxevasin". Drugs in this category normalize blood flow in the kidneys, which significantly increases the effectiveness of treatment.

Treatment of the chronic form of pyelonephritis requires a long methodical approach. After the examination, doctors prescribe long-term treatment drugs of the following pharmacological groups:

  1. Penicillins: "Carbenicillin", "Azocillin", "Amoxicillin". They are prescribed for the treatment of chronic pyelonephritis (kidney disease) with a minimum level of nefortoxicity.
  2. Fluoroquinols: "Ofloxacin", "Ciprofloxacin", "Levofloxacin". They are given in the form of injections. The powerful antibacterial effect of these drugs significantly increases the effectiveness of the fight against pyelonephritis (kidney disease).
  3. Cephalosporins 2, 3 generations: "Cefaclor", "Cefalexin". Low-toxic drugs to combat inflammatory processes. Active ingredients These cephalosporins break down the cell walls of bacteria that cause pyelonephritis (kidney disease) and kill them, restoring normal work tubular system.
  4. Nitrofurans: Furagin, Furazolidone, Furadonin. Effective in the fight against chronic pyelonephritis, however, due to the high degree of toxicity, they are prescribed in the most extreme cases of kidney disease.
  5. Oxyquinolines: Nitroxoline, 5-Nock. Drugs in this category are well tolerated by the body, but their effectiveness in the treatment of chronic pyelonephritis (kidney disease) has noticeably deteriorated due to a decrease in the sensitivity of bacterial microorganisms.

Surgical intervention

Surgical treatment for pyelonephritis is prescribed in the most extreme cases, when inflammatory processes that affect the internal tissues of the kidneys do not respond to antibiotics and NPS drugs. Surgical intervention carried out to prevent neforsclerosis and pyonephrosis. Advanced stages of pyelonephritis lead to unilateral wrinkling of the kidney.

To prevent further inflammation of the organs of the urinary system, a nephrectomy is prescribed - an operation to remove the kidney (under general anesthesia, the patient's retroperitoneal space is opened and the affected organ is cut off). In rare cases, when there is destruction of one of the halves double kidney, surgeons resort to resection. This operation involves the removal of part of the kidney tissue affected by purulent inflammatory processes.

Folk remedies for treatment at home

Traditional Methods the fight against pyelonephritis (kidney disease) involves the use of medications in a hospital hospital, but is there really no way to do without doctors. Connoisseurs of home recipes say: early stages effective treatment of pyelonephritis with folk remedies at home is quite possible. Write down a few grandma's recipes for yourself to be ready if there is a threat of inflammation of the kidney:

  1. Propolis with butter. Melt 60-70 grams of butter, add 15 grams of propolis and mix. Use the resulting slurry of 5-7 grams with an interval of 7-8 hours.
  2. . An excellent remedy for the treatment of acute and chronic forms of pyelonephritis (kidney disease). Cook 170 grams of oats in a liter of milk. You need to boil for a long time, until half of the liquid has evaporated. Cool the resulting jelly and drink it at intervals of 5-6 hours. After 2-3 weeks, kidney disease will recede.
  3. Salt dressing. Pour 230 grams of salt onto a thick large towel and soak it with water. Before going to bed, tie around the waist and go to bed. Performing this procedure every night, you can remove the exacerbation of pyelonephritis (kidney disease) in less than two weeks.

Phytotherapy

Increase efficiency drug treatment inflammation of the kidneys will help natural herbal decoctions. Natural components contribute to the normalization of the balance of substances and cleanse the body of toxins. Official medicine recognizes most of the existing methods of herbal treatment. Folk decoctions provide a whole range beneficial effects:

  • uroseptic;
  • diuretic;
  • detoxification;
  • restorative.

Below are some phytotherapeutic recipes that have repeatedly demonstrated their effectiveness in the treatment of acute infectious pyelonephritis (kidney disease):

  1. Meadowsweet, yarrow and budra. In a large metal container, mix these herbs in equal proportions, add a small amount of agrimony, immortelle, celery and marshmallow. Pour a liter of boiling water and let it brew for 1.5-2 hours. For effective treatment acute form of pyelonephritis (kidney disease), drink a decoction at intervals of 12 hours, 30-40 ml.
  2. Fireweed, chamomile, birch. An incredibly effective remedy for the treatment of chronic pyelonephritis (kidney disease). Mix the components in equal quantities and pour three cups of boiling water. The scheme of application is extremely simple: drink 50-60 ml of decoction every 8 hours, and after 2-3 weeks, kidney disease will recede forever.

Features of the treatment of the disease

The main task of the doctor prescribing drugs for the treatment of acute / chronic pyelonephritis is to correctly assess the current situation and take into account all the nuances. Most people admitted to hospital with kidney inflammation are treated according to the standard regimen, but there are separate categories people for whom treatment measures are selected taking into account additional factors.

In children

By definition, the child's body cannot normally absorb potent drugs, so doctors are especially careful about which antibiotics to treat the baby with so as not to damage the organs of the gastrointestinal tract. At the age of 12 years, it is not recommended to get involved in folk remedies, it is better to immediately contact specialists. Homemade decoctions and tinctures are not contraindicated, but if they do not help cure pyelonephritis (kidney disease) within 2-3 days, seeking medical help should not be postponed.

In pregnant women

Potent antibacterial drugs for the treatment of acute pyelonephritis during pregnancy are used only after a complete examination and only as prescribed by the attending physician. Any self-activity in such situations should be excluded. The exhausted body of a pregnant woman may not respond adequately to medications, so she always needs to be under the supervision of specialists.

Is it possible to cure chronic pyelonephritis completely

Treatment of chronic pyelonephritis is aimed at blocking inflammatory processes and normalizing the functioning of the kidney. With a successful outcome, all symptoms disappear, the state of human health returns to normal, but the disease itself remains. Under the influence of negative external / internal factors, whether it is a decrease in immunity, hypothermia, stress, or something else, the disease will manifest itself again, and then repeated treatment will be required.

Video about the symptoms and treatment of acute pyelonephritis

The video below contains recommendations from experts on how to behave when a kidney infection is suspected. After watching this video, you will get a lot of valuable information about the identification and treatment of acute pyelonephritis. Take the received information into service so that a dangerous infectious disease does not bring you to a hospital bed!

Pyelonephritis is a bacterial inflammation of the kidneys, resulting from the spread of bacteria from the bladder. The symptoms of kidney inflammation are kidney pain and high temperature. Inflammation of the kidneys can lead to complications, which are serious illness such as urosepsis (when bacteria enter the bloodstream) or kidney failure. What is pyelonephritis, and how to treat kidney pyelonephritis?

Pyelonephritis is an inflammatory disease of the kidneys that is caused by bacteria. Acute inflammatory process in the kidneys is one of the most serious illnesses. Purulent necrosis is characteristic of this disease. Abscesses may form in the kidneys. In the acute course of the disease, purulent exudate accumulates in the kidneys. This condition is called pyonephrosis. To prevent the development of the inflammatory process, antibiotic treatment should be started immediately. How to recognize the typical symptoms of pyelonephritis?

The disease develops in children and adults as a result of bacterial infection. The most common pathogens are Gram-negative Escherichia coli. These bacteria are present in the normal physiological flora of the human large intestine. They perform an important function in the body - they take part in the destruction of nutrient residues and the synthesis of certain vitamins. But if microorganisms enter the urinary system, they can cause many diseases. Pyelonephritis often occurs in individuals with congenital or acquired anomalies of the urinary system. Conditions associated with a decrease in the functions of the immune system contribute to the development of pathogenic microorganisms not only in the urinary system, but throughout the body as a whole.

Chronic pyelonephritis

This is an inflammatory process in the kidneys, during which scarring occurs. In case no sudden pain(as in the acute course of the disease). The illness often accompanies arterial hypertension. The most common reason patients seek medical advice is poor laboratory results. If the patient is observed, polyuria and nocturia (nighttime urination) occur, associated with impaired urine concentration.

Chronic pyelonephritis is associated with a violation of the outflow of urine. Violation of the outflow of urine causes the occurrence of a certain amount of urine in the bladder, despite frequent urination. This condition contributes to the development of infection. If left untreated, complications can occur, such as kidney failure.

Causes of pathology

The causes of pyelonephritis of the kidneys are enterobacteria and staphylococcus aureus. Infection occurs when the immune system person is weakened. People who have taken antibiotics or immunosuppressants for a long time, as well as those who have undergone surgical procedures on the urinary tract, are at risk of infection. For inflammation of the urinary tract, sexually transmitted microorganisms are also responsible - chlamydia, mycoplasma, gonococcus and viruses. Most often they develop in women who have an active sex life. more common in women than in men. This happens because the urinary tract of a woman is arranged differently: in women, the urethra is shorter, and it is easier for bacteria to enter it.

The risk of developing the disease increases due to:

  • weakening of the body's immunity;
  • gout;
  • kidney stones;
  • anomalies in the structure of the urinary tract;
  • diabetes mellitus.

Inflammation of the urinary tract is especially susceptible to women during pregnancy and the elderly.

The mouth of the urethra is inhabited by some types of bacteria, the presence of which is not associated with the occurrence of an inflammatory process. Strains of bacteria begin to multiply when favorable conditions arise for them in the body (decreased immunity), and cause inflammation in the urinary tract.

Microorganisms that cause inflammation of the kidney include:

  • staphylococci;
  • streptococci;
  • bacteria E. coli;
  • gonococci;
  • less often bacteria of the species Proteus mirrabilis and Klebsiella pneumoniae.

Pyelonephritis can also be caused by fungi or viruses, so a preliminary visit to the doctor is required before starting antibiotic treatment to rule out other etiological factors.

Factors in the development of inflammation of the kidneys

There are factors that contribute to bacterial inflammation of the kidneys. First of all, you should list all the conditions associated with stagnation of urine or difficulties in its passage. These states include:

  • narrowing or injury of the urethra;
  • nephrolithiasis;
  • prostate hypertrophy in men.

A natural defense against the entry of pathogens into the upper urinary tract is the correct peristalsis of the ureters and their structure.

The very act of urination, that is, emptying the bladder, contributes to the physical cleansing of the urinary tract.

Other conditions for the onset of the disease

Risk factors for developing a urinary tract infection are:

  • elderly age;
  • pregnancy;
  • postpartum period;
  • any anatomical abnormalities of the urinary tract;
  • other instrumental procedures within the urinary system;
  • diabetes;
  • decrease in immunity.

The most common cases are when bacteria enter the kidneys from the urinary tract. In rare cases (about 2%), bacteria enter the kidneys through the blood.

Main symptoms

There are many symptoms of a urinary tract infection. The most common signs of inflammation in patients are:

  • pain or burning during urination;
  • frequent urination that makes it necessary to wake up at night (nocturia);
  • constant pain in the suprapubic region and lower back.

It happens that the patient loses all or part of the control over the process of urination. In addition, general signs of inflammation may be present, such as:

  • heat;
  • nausea;
  • vomit;
  • stomach ache;
  • headache.

There may be discharge from the urethra, and the excreted urine becomes cloudy, may contain blood, and have a fetid odor.

At the first examination of the patient, the doctor most often prescribes a general urinalysis and tests that confirm the presence of bacteria and leukocytes in the urine and other signs of the inflammatory process.

After analyzing a urethral swab or urine culture, the etiology of the infection can be accurately determined, which greatly speeds up treatment with the most appropriate antibiotic.

In case of recurrent urinary tract infections, additional diagnostics aimed at explaining this condition. Anatomical defects within the urinary tract are searched using:

  • computed tomography;
  • Ultrasound of the pelvic organs;
  • urography.

If the infection passes to the kidneys, pyelonephritis occurs. :

  • fever;
  • malaise;
  • severe pain in the lumbar region, which is defined as;
  • chills;
  • vomit.

You need to know what is dangerous pyelonephritis. In the worst case, urosepsis develops, that is, sepsis of the urethra. Then treatment in the hospital is necessary, because the bacteria enter the bloodstream, which is a real threat to the patient's life. Careful monitoring of vital signs is required important functions and intensive antibiotic treatment.

Treatment Methods

In the vast majority of cases, the inflammatory process of the urinary system is uncomplicated and ends with a quick and complete recovery after short-term antibiotic therapy. This does not require control examinations, but only proper hygiene urinary system.

However, if the inflammatory process becomes complicated and pyelonephritis is diagnosed, it may be necessary to refer the patient to the hospital.

Treatment with antibiotics usually begins with intravenous administration, and then their oral administration is prescribed. Choice medicinal product depends on the results of the analysis for culture of urine and blood, which allow you to accurately determine the etiological factor.

In the treatment of bacterial inflammation of the kidneys, symptomatic therapy is also necessary, so the patient is recommended:

  • relaxation;
  • reception a large number liquids;
  • taking drugs with antipyretic, analgesic, and sometimes with antiemetic action.

After the disappearance high temperature and improve the patient's clinical condition, the doctor prescribes treatment with oral antibiotics. It usually requires 10-14 days of outpatient therapy.

How to treat pyelonephritis? The most commonly used groups of antibiotics include fluoroquinolones, aminoglycosides, and third-generation cephalosporins.

Dietary restrictions are often necessary in treatment. The diet consists of limiting the amount of salt and protein consumed and consuming an appropriate amount of calories.

In case of complications of the disease and the development of renal failure, treatment in the form of hemodialysis or kidney transplantation is necessary.

Prevention

It is worth mentioning ways to prevent conditions with severe inflammation of the kidneys. The main ones are the following:

  • proper hygiene of the urinary system;
  • appropriate fluid intake;
  • avoiding dehydration;
  • avoiding the use of excess drugs that damage the kidneys;
  • prevention of exposure to environmental toxins;
  • prevention of bacterial and viral infections;
  • vaccination;
  • systematic supervision by a doctor.

Prevention is based on strengthening the immune system, timely treatment infectious and inflammatory diseases and referral to doctors if a disease is suspected. Be healthy!

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