Diagnosis and treatment of pyelonephritis
Diagnosis of Pyelonephritis in Adults
Diagnosis is as follows.
History - reveals the presence of chronic infections, colds and diseases of the genitourinary sphere.
Clarification of the symptoms of the disease from the words of the patient. Complaints of back pain, visual changes in urine color and odor, weakness, and general malaise are taken into account. An important finding suggesting pyelonephritis is a temperature above 38.5 to 39° C.
Physical examination of the patient
The main data on which the diagnosis of pyelonephritis is made - tests and samples:
complete blood and urine chemistry tests
urine culture with antibiotic susceptibility test
X-ray methods - excretory urography with intravenous contrast, computed tomography
ULTRASOUND.
Diagnosis of Pyelonephritis in Children
The list of procedures by which pyelonephritis is diagnosed in children is generally similar to "adult" - examination and questioning, blood and urine tests, ultrasound and excretory urography. It should be borne in mind that children are not always able to accurately describe their feelings and complaints, therefore, when making a diagnosis it is better to focus on objective data from tests, x-rays and ultrasonography. Sometimes the hallmark indicating pyelonephritis is a temperature that reaches very high numbers (39 to 40° C) and is poorly tolerated by traditional antipyretics.
Therefore, if a young child has a high fever with no other visible signs of colds, they should be evaluated for inflammation in the kidneys.
Pyelonephritis analyses
Blood and urine tests are important information for diagnosing pyelonephritis. This is what you can see in the lab results.
The blood usually shows changes that are characteristic of bacterial inflammation - an increase in white blood cells and ESR, as well as changes in biochemical composition.
On urinalysis, the specific weight and number of white blood cells change, and sometimes blood and protein appear.
Urine biochemistry shows elevated levels of salts, and culture and antibiotic susceptibility testing show which bacteria is to blame for the ailment and the type of antibiotics that are detrimental to it.
Pyelonephritis urine
Renal inflammation is characterized by appearance changes and abnormalities in urinalysis. The urine may be visibly bloody, foul-smelling, and turbid. However, sometimes the fluid does not appear abnormal, but laboratory tests suggest inflammation. What exactly can be found in the urine analysis in pyelonephritis?
The white blood cell count is higher than normal.
Reduction of specific weight.
Inflammatory processes cause small amounts of protein to be released into the urine.
It is also interesting that the inflammatory phenomena in the kidneys are characterized by an increase in urine acidity. It does not in itself constitute a diagnostic feature, but is taken into account together with other indicators.
Pyelonephritis and fever
A "signature" symptom that always gives acute pyelonephritis - a temperature reaching 39-40 °C. Hyperthermia is associated with active inflammation and can be difficult to control until the infection is suppressed by prescribed antimicrobials. Fever is often accompanied by signs of intoxication such as vomiting, headache, lack of appetite, and nausea. Also, hyperthermia due to renal inflammation is characterized by sweating and a chills.
Treatment of Pyelonephritis in Women
In females, kidney inflammation occurs mainly due to ascending infection, and therefore, when treating pyelonephritis, it is necessary not only to eliminate the current inflammation, but also to avoid recurrences. Without addressing the causes that cause the infection, the disease will repeat itself over and over again. Therefore, it is recommended to examine patients for sexual infections and gynecological diseases, with subsequent treatment of all problems found.
Having a permanent source of infection in women is dangerous because the inflammation quickly turns into a chronic form and subsequently is difficult to cure, developing in the body for a long time and oppressing the patient with exacerbations. Moreover, if the exacerbation is regularly relieved with antimicrobial drugs, over time the bacteria lose sensitivity to the drug, and then the treatment of pyelonephritis will become even more problematic.
Treatment of Pyelonephritis in Men
The course of inflammatory kidney diseases in men does not differ from that of women in general, but it has different causes, and therefore requires a slightly different approach to treatment. Due to anatomical characteristics, men are less susceptible to the development of the acute process, but the chronic form of infection affects them quite actively. This is mainly due to the presence of chronic prostate diseases that develop with age. Benign enlargement of gland tissue makes it difficult for urine to leak from the bladder, and the bladder becomes a breeding ground for bacteria. Therefore, in chronic pyelonephritis, the kidneys in men become infected from the bottom up, from the bladder down the urinary tract.
Treatment of chronic kidney inflammation in men is to eliminate the causes of urine stasis, and this requires timely and adequate treatment of the diseases that caused it - adenoma, prostatitis, urolithiasis. If pyelonephritis is severe, treatment is with the most effective antimicrobial cephalosporins and penicillins.
Treatment of Pyelonephritis in Children
Pyelonephritis in children, as in adults, is chronic or acute. Depending on why it arose and in what form it occurs, there are also differences in the methods of treatment. For example, if kidney inflammation causes congenital reflux that cannot be treated conservatively, the child is given antimicrobial drugs in a prophylactic dose.
Also, prompt treatment should be considered to address the very cause of chronic infection - the backflow of urine.
Treat acute pyelonephritis in a child can be the following methods:
be sure to prescribe antimicrobial (mainly broad-spectrum) and uroantiseptics;
from the fifth day of the onset of the disease, add NSAIDs and vitamins.
In addition to drug treatment, children should stay in bed and eat on a sparing diet.
Antimicrobial disease in pyelonephritis
Antimicrobials for pyelonephritis are the mainstay of treatment. Most cases are caused by Escherichia coli and less commonly by enterococci, Pseudomonas aeruginosa, protei, and Klebsiella. They can be destroyed only by modern antibacterial drugs prescribed by a nephrologist or urologist.
Self-treatment attempts, folk methods, or indiscriminate use of inappropriate antimicrobials for pyelonephritis can be very harmful. If you rely only on folk remedies, there is a risk of launching the disease to a severe stage or chronic pyelonephritis, and self-medication will provoke the resistance of the pathogenic flora to drugs.
What antimicrobial groups are used to treat pyelonephritis? Given that the most common causative agent is Escherichia coli, it is exposed to semi-synthetic drugs in combination with clavulanic acid and 1-3-generation cephalosporins. Other drugs are antimicrobial drugs. To prevent relapses in the chronic course of the disease, antimicrobials are used for the treatment of acute form, they are not universal enough, but they have proven to be a good preventive agent.
Treatment of Chronic Pyelonephritis
Treatment of chronic pyelonephritis is primarily aimed at preventing exacerbations and eliminating their consequences. Patients should try to minimize the number of colds and avoid hypothermia. Nutrition is best organized according to a diet specifically designed for patients with renal diagnoses.
During the period of exacerbation, antimicrobials are used, and at its decline, special anticyclic therapy is switched to the long-term use of prophylactic doses of antimicrobial drugs. Anti-relapse treatment is supplemented with phytopreparations having diuretic, antiseptic and anti-inflammatory effects.
Chronic pyelonephritis requires attention and adherence to all the rules of therapy!
Treatment of Acute Pyelonephritis
The acute form of the inflammatory process is treated simultaneously in three directions:
Repair normal flow of urine from affected kidneys It is done with the help of spasmolytic drugs, and in especially severe cases resort to catheterization of the bladder or ureteral stenting
the second element of therapy is the suppression of the pathogen with the help of modern broad-spectrum antibiotics
management of inflammatory phenomena
Drug treatment is supplemented by the normalization of the drinking regime and a gentle diet.
Diet for pyelonephritis
Diet in pyelonephritis - a special therapeutic diet under a system that implies some restrictions for those suffering from kidney diseases. Diet is about gentle action on diseased organs, improving urination and reducing edema, and lowering blood pressure when needed. The main limitation is the almost complete elimination of salt both during cooking and during eating. In addition, the amount of protein in the daily diet is slightly limited and the amount of fluid permitted is reduced. People should eat small feedings and regularly.
Interestingly, when starting the treatment of pyelonephritis, a temporary three-day transition to monoproducts is recommended: unloading days are practiced with the use of watermelons, potatoes, pumpkins.
These options reflect the needs of patients with different forms and stages of the disease.
1. Atatürk’s kidney disease: pyelonephritis or trench nephritis? A medical and historical analysis
3. Emphysematous pyelonephritis caused by Raoultella ornithinolytica: a case report
4. Diagnostic performance of contrast-enhanced ultrasound for acute pyelonephritis in children