home Auditorium 7 What is chronic pyelonephritis? Chronic pyelonephritis, symptoms, treatment, exacerbation How chronic pyelonephritis is treated

What is chronic pyelonephritis? Chronic pyelonephritis, symptoms, treatment, exacerbation How chronic pyelonephritis is treated

Pyelonephritis is a nonspecific inflammatory disease of the kidneys of bacterial etiology, characterized by damage to the renal pelvis (pyelitis), calyces and kidney parenchyma. Due to the structural characteristics of the female body, pyelonephritis is 6 times more common in women than in men.

The most common causative agents of the inflammatory process in the kidney are Escherichia coli (E. coli), Proteus (Proteus), Enterococcus (Enterococcus), Pseudomonas aeruginosa (Pseudomonas aeruginosa) and staphylococcus (Staphylococcus).

Penetration of the pathogen into the kidney is most often associated with the reflux of urine into the kidneys (vesicoureteral reflux - VUR) due to obstructed urine outflow, bladder overflow, increased intravesical pressure due to hypertonicity, structural abnormalities, stones or enlarged prostate gland.

Why is pyelonephritis dangerous?

Each new exacerbation of pyelonephritis involves more and more new areas of kidney tissue in the inflammatory process. Over time, normal kidney tissue dies at this site and a scar forms. As a result of a long course of chronic pyelonephritis, a gradual decrease in the functional tissue (parenchyma) of the kidney occurs. Eventually, the kidney shrinks and stops functioning. With bilateral kidney damage, this leads to chronic renal failure. In this case, in order to maintain the vital functions of the body, kidney function must be replaced with an “artificial kidney” device, that is, hemodialysis is regularly performed - artificial blood purification by passing it through a filter.

Forms of pyelonephritis

Diagnosis of pyelonephritis

Pyelonephritis is manifested by dull pain in the lower back, aching in nature, of low or medium intensity, an increase in body temperature to 38-40°C, chills, general weakness, loss of appetite and nausea (all symptoms may occur at once, or only some of them). Typically, with reflux, there is an expansion of the collecting-pelvic system (PSS), which is observed on ultrasound.

Pyelonephritis is characterized by an increase in leukocytes, the presence of bacteria, protein, red blood cells, salts and epithelium in the urine, its opacity, turbidity and sediment. The presence of protein indicates an inflammatory process in the kidneys and a disruption of the blood filtration mechanism. The same can be said about the presence of salts: blood is salty, isn’t it? Consumption of salty foods increases the load on the kidneys, but does not cause the presence of salts in the urine. When the kidneys do not filter well enough, salts appear in the urine, but instead of looking for the cause of pyelonephritis, our favorite urologists with the letter X (don’t think that they are good) recommend reducing the amount of salt consumed in food - is this normal?

Urologists also like to say that with pyelonephritis you need to consume as much fluid as possible, 2-3 liters per day, uroseptics, cranberries, lingonberries, etc. That’s how it is, but not quite. If the cause of pyelonephritis is not eliminated, then with an increase in the amount of fluid consumed, reflux becomes even more intense, therefore, the kidneys become even more inflamed. First you need to ensure normal passage of urine, exclude the possibility of overflow (no more than 250-350 ml depending on the size of the bladder), and only then consume a lot of fluid, only in this case will fluid consumption be beneficial, but for some reason very often this is forgotten.

Treatment of pyelonephritis

Treatment of pyelonephritis should be comprehensive, and should include not just antibacterial therapy, but also, more importantly, measures aimed at eliminating the very cause of pyelonephritis.

With the help of antibiotics, inflammation is relieved in the shortest possible time, but if the cause itself is not eliminated, then after some time, after stopping the antibiotics, pyelonephritis will worsen again and after a certain number of such relapses, the bacteria will acquire resistance (resistance) to this antibacterial drug. Therefore, subsequent suppression of bacterial growth with this drug will be difficult or even impossible.

Antibacterial therapy

It is desirable that the antibiotic be selected based on the results of bacteriological urine culture with determination of the sensitivity of the pathogen to various drugs. In the case of acute pyelonephritis, immediately after taking a culture, a broad-spectrum antibiotic from the fluoroquinol group, for example, Tsiprolet, can be prescribed and adjusted based on the culture results. Antibacterial therapy should continue for at least 2-3 weeks.

Causes of pyelonephritis

The most likely causes of the development of pyelonephritis include reflux caused by difficulty urinating, bladder overflow, increased intravesical pressure, complications of cystitis, as well as anatomical abnormalities in the structure of the ureters, disruption of the sphincters.

Urinary disorders can be caused by hypertonicity of the sphincter of the bladder and the bladder itself, obstructed outflow of urine due to inflammatory disease of the prostate gland (prostatitis), spasms, which may be caused by cystitis, structural changes in the ureteral sphincters and anomalies, impaired neuromuscular conduction, and at the least degree - weakness of the smooth muscles of the bladder. Despite this, most urologists begin treatment by stimulating the force of detrusor contractions, which further aggravates the situation, although in combination with antibacterial therapy, in most cases, this gives visible but short-term improvements. If there is difficulty in the passage (outflow) of urine, in order to prevent reflexes, it is necessary to resort to periodic catheterization of the bladder, or installation of a Foley catheter with a change every 4-5 days.

In the case of hypertonicity of the bladder sphincter or itself, it is necessary to look for the cause of hypertonicity or spasms and eliminate it, thereby restoring the normal outflow of urine. If you are diagnosed with cystitis, you need to treat it, since pyelonephritis can be a complication of cystitis.

For inflammatory diseases of the prostate gland, you need to undergo a course of treatment for prostatitis (read the article on prostatitis).

If there are structural abnormalities of the bladder, urethra, or ureters, you need to consult with doctors and take measures to eliminate the defects, possibly surgically.

There are many drugs and techniques for the treatment of neuromuscular conduction disorders; qualified doctors must select tactics.

Before “stupidly” stimulating the force of contractions of the bladder muscles, you need to exclude the presence of all the disorders described above, be vigilant and control the treatment prescribed to you.

Exacerbations of pyelonephritis inevitably lead to thinning of the functional part of the kidney and death of nephrons, therefore, in order to preserve as much of the kidney as possible in working condition, it is extremely important to eliminate the cause of pyelonephritis in the shortest possible time. Ask to measure the thickness of the renal parenchyma during an ultrasound scan. The thickness of the parenchyma of healthy kidneys is on average 18 mm.

About 2/3 of all urological diseases occur due to acute or chronic pyelonephritis. This pathology is infectious in nature and is accompanied by damage to one or two kidneys. Their inflammation is provoked by various bacteria, although sometimes the disease develops against the background of other diseases of the internal organs. Women are more prone to pyelonephritis, which is explained by the individual characteristics of the anatomical structure of the vagina and urethra. Treatment of the disease is carried out comprehensively by taking medications and following a number of rules.

What is pyelonephritis

The disease is an infectious-inflammatory process in the kidneys caused by the action of pathogenic bacteria. They affect several parts of these paired organs at once:

interstitial tissue - the fibrous base of the kidney;
parenchyma - functionally active epithelial cells of these paired organs;
pelvis - cavities in the kidney, similar to a funnel;
renal tubules.

In addition to the pyelocaliceal system, damage can also affect the glomerular apparatus with blood vessels. At an early stage, the disease disrupts the main function of the kidney membrane - urine filtration. A characteristic sign of the onset of inflammation is aching pain in the lumbar region. The disease can be acute or chronic. If you suspect pyelonephritis, you should contact a nephrologist. If diagnosis is not made in a timely manner and treatment is not started, the following complications may develop:

Spicy

Acute pyelonephritis develops as a result of the influence of exogenous or endogenous microorganisms that penetrate the kidney tissue. More often, right-sided localization of inflammation is noted, which is explained by the structural features of the right kidney, which causes its tendency to stagnation. In general, the following signs indicate the acute stage of this pathology:

With bilateral inflammation of the kidneys, the patient complains of pain throughout the back and abdomen. The purulent form of the disease causes pain similar to renal colic. Impaired urine flow is manifested by an increased urge to urinate. In addition, nocturnal diuresis predominates over daytime diuresis. These symptoms may cause swelling and increased blood pressure.

Chronic

In most cases, chronic pyelonephritis is a continuation of its acute form. The most common cause is improperly selected or missing treatment. Also at risk are patients who have impaired urine passage through the upper urinary tract. A third of patients suffer from this disease since childhood due to low-grade inflammation of the parenchyma of the renal collecting apparatus.

Chronic pyelonephritis has a wave-like character: remissions are replaced by periods of exacerbation. This is the reason for the change in the clinical picture. During an exacerbation, the symptoms are similar to the acute form of the pathology. During the period of remission, the signs are weakly expressed. Patients complain of periodic throbbing or aching pain, which often occurs at rest. Against their background appear:

asthenia – episodic weakness;
rapid fatigue;
slight increase in pressure or temperature.

Causes

The common cause of the development of the disease is bacteria: staphylococci, enterococci, chlamydia, Klebsiella, salmonella, Pseudomonas aeruginosa. They reach the kidneys in different ways. With cystitis, this occurs by the urinogenic (ascending) route: microorganisms penetrate into the pyelocaliceal system from the urethra in the following pathologies:

cystitis;
colpitis;
prostate adenoma;
urolithiasis disease;
abnormalities in the structure of the urinary system.

Bacteria are introduced during manipulation of catheters. Another route of infection is hematogenous, when microbes enter the kidneys through the bloodstream from another source of inflammation in the following diseases:

angina;
pneumonia;
ear infection;
pulpitis;
flu.

At-risk groups

Doctors identify several risk groups, which include patients prone to developing pyelonephritis. The first group consists of people with abnormalities in the structure of the urinary tract, such as:

Congenital anomalies. They are formed under the influence of hereditary or negative (smoking, drugs, alcohol) factors during pregnancy. The result is that malformations develop: narrowing of the ureter, underdeveloped or prolapsed kidney.
Anatomical structure of the genitourinary system in women. They have a shorter urethra compared to men.

Women more often suffer from this disease not only because of the special structure of the genitourinary organs. The reason for their development of this disease may be hormonal and other changes during pregnancy:

The hormone progesterone reduces the tone of the muscles of the genitourinary system to prevent miscarriage, but at the same time disrupts the outflow of urine.
The growing fetus enlarges the uterine cavity, which compresses the ureter, which also disrupts the process of urine outflow.

The last risk group consists of patients with reduced immunity. In this condition, the body cannot fully protect itself from all foreign microorganisms. A weakened immune system is typical for the following categories of patients:

children under 5 years old;
pregnant women;
people with autoimmune diseases such as HIV infection and AIDS.

Provoking factors

Pyelonephritis is secondary when it develops against the background of other diseases. These include diabetes mellitus, frequent hypothermia, poor hygiene, and chronic inflammatory infections. The general list of factors provoking pyelonephritis includes:

Tumors or stones in the urinary tract, chronic prostatitis. Cause stagnation and disruption of urine outflow.
Chronic cystitis. This is an inflammation of the bladder in which the infection can spread up the urinary tract and cause kidney damage.
Chronic foci of inflammation in the body. These include bronchitis, furunculosis, intestinal infections, and amygdalitis.
Sexually transmitted diseases. Trichomonas and chlamydia can penetrate through the urethra into the kidneys, which will lead to their inflammation.

Treatment of pyelonephritis at home

The disease is treated with conservative methods, but the approach must be comprehensive. Therapy, in addition to taking medications, includes adherence to a special regime. The rules concern correction of the patient’s lifestyle and nutrition. The goal of therapy is to eliminate the causative agent of pyelonephritis. Additionally, measures are being taken to normalize urine flow and strengthen the immune system. Treatment of pyelonephritis in women and men is carried out according to the same scheme, including:

Compliance with a special regime. Involves avoiding intense physical activity and avoiding hypothermia.
Drink plenty of fluids. Prescribed if the patient does not have edema.
Medical nutrition. A balanced diet helps reduce the load on the kidneys, reduce the level of creatinine and urea in the blood.
Taking non-hormonal medications. They are part of etiotropic and symptomatic therapy. The first one eliminates the cause of the disease, the second one copes with its symptoms.
Physiotherapy. It is used to speed up recovery and relieve unpleasant symptoms of pathology.

Compliance with the regime

Taking into account the severity of the disease, the doctor determines where pyelonephritis will be treated. Uncomplicated forms are treated at home, and the first days must be kept in bed. The patient should not overcool and play sports. In case of exacerbation, only visiting the toilet and kitchen to eat is allowed. In case of intoxication and complications, the patient needs treatment in a hospital under the supervision of a doctor. Indications for hospitalization are:

progression of chronic pyelonephritis;
severe exacerbation of the disease;
disturbance of urodynamics, in which it is necessary to restore the passage of urine;
development of uncontrolled arterial hypertension.

Drink plenty of fluids

For pyelonephritis, it is necessary to increase fluid intake to 3 liters per day, but only if there is no edema. Water flushes the urinary canals, removes toxins and restores normal water-salt balance. You need to drink 6-8 glasses at regular intervals. In addition to water, to ensure an anti-inflammatory effect and normalize metabolic processes, it is useful to consume:

rosehip decoction;
dried fruits compote;
mineral water with alkalis;
weak green tea with milk or lemon;
lingonberry and cranberry fruit drinks.

Medical nutrition

A strict diet is not required. The patient is advised to avoid salty, spicy and fatty foods, smoked foods and alcoholic beverages. Preference is given to products with vitamins B, C, P. You need to eat more vegetables and fruits, especially those that have a diuretic effect: watermelon, melon. The list of recommended products additionally includes the following products:

Drug therapy

It is divided into two types: etiotropic and symptomatic. The first is necessary to eliminate the cause that caused the disturbance of renal circulation, especially venous circulation, or urine passage. Surgical interventions help restore the flow of urine. Taking into account the cause of the disease, the following is carried out:

removal of prostate adenoma;
nephropexy for nephroptosis;
plastic surgery of the urethra;
removal of stones from the urinary tract or kidneys;
plastic surgery of the ureteropelvic segment.

Etiotropic treatment additionally includes anti-infective therapy - taking antibiotics depending on the causative agent of the disease. This method is used for primary and secondary pyelonephritis. Symptomatic therapy helps eliminate signs of the disease and restore the body after treatment. To perform these tasks, the following groups of drugs are prescribed:

diuretics – eliminate swelling;
non-steroidal anti-inflammatory drugs – provide relief of inflammation;
improving renal blood flow - effective for chronic pyelonephritis;
immunomodulators, adaptogens – strengthen the immune system.

Physiotherapy

In medicine, physiotherapy is understood as the study of the influence of natural factors on the body. The use of the latter helps reduce the number of medications a person takes. The indication for physiotherapy is chronic pyelonephritis. The procedures increase blood supply to the kidney, improve the delivery of antibiotics to the kidneys, and eliminate spasms of these paired organs. This makes it easier for mucus, bacteria and urinary crystals to pass away. These effects have:

Electrophoresis of furadonin on the kidney area. The solution for this procedure includes: 100 ml of distilled water, 2.5 g of sodium hydroxide, 1 g of furadonin. To achieve results, 8-10 procedures are performed.
Ultrasound at a dose of 0.2-0.4 W/cm2 in pulsed mode. An ultrasound therapy session lasts 10-15 minutes. Contraindication: urolithiasis.
Electrophoresis of erythromycin on the kidney area. Using an electric current, a solution of 100 g of ethyl alcohol and 100 thousand units of erythromycin is delivered to the organs.
Thermal procedures. These include ozokerite and paraffin applications, diathermo mud, therapeutic mud, diathermy.

Drugs for the treatment of pyelonephritis

The selection of drugs for etiotropic treatment is carried out on the basis of general and biochemical blood and urine tests, during which the causative agent of the disease is identified. Only under this condition will therapy bring a positive result. Different antibiotics are effective against certain bacteria:

Names of bacteria	Names of antibiotics and uroantiseptics
Escherichia coli	Carbenicillin; Gentamicin; Levomycetin; phosphacine; nitrofuran compounds; Nalidixic acid; Ampicillin.
Enterobacter	Levomycetin; Ciprofloxacin; Nitrofurans; Tetracycline; Gentamicin.
	Ampicillin; Nalidixic acid; Carbenicillin; Cephalosporins; Levomycetin; Gentamicin; nitrofurans; sulfonamides.
Enterococcus	Gentamicin; Ampicillin; tetracyclines; Carbenicillin; Nitrofurans.
Pseudomonas aeruginosa	Gentamicin; Carbenicillin.
Staphylococcus aureus	Gentamicin; Oxacillin; Methicillin; Tetracyclines; Cephalosporins; nitrofurans.
Streptococcus	Penicillin; Carbenicillin; Tetracyclines; Gentamicin; Ampicillin; sulfonamides; nitrofurans; cephalosporins.
Mycoplasmas	Erythromycin; Tetracycline.

Antibacterial therapy based on the results of bacteriological examination of urine

The condition for the success of antibacterial therapy is that the drug corresponds to the sensitivity of the pathogen to it, which is identified during bacterial testing. If the antibiotic does not work within 2-3 days, which is confirmed by a high level of leukocytes in the blood, then it is replaced with another drug. Indications for use are determined by the type of pathogen. In general, the following groups of drugs are used:

Name of antibiotic group	Examples of drugs	Method of administration	Daily dosage
Penicillins	Ampicillin	Intramuscularly	1 g every 6 hours.
	Amoxicillin		0.5 g every 8 hours.
	Augmentin	Intramuscularly	1.2 g every 4 hours.
Aminoglycosides	Garamycin (Gentamicin)	Intravenous, intramuscular	3.5 mg/kg in 2-3 dilutions.
	Amikacin		15 mg/kg in 2 doses.
	Tobramycin		3-5 mg/kg in 2-3 injections.
Tetracyclines	Doxycycline	Intravenously, orally	0.1 g up to 2 times.
	Metacycline		0.3 g up to 2 times
	Vibramycin		0.2 g 1 time at the initial stage of treatment, then in a maintenance dosage of 0.1 g.
Levomycetins	Levomycetin succinate	Intramuscular, intravenous	0.5-1 g up to 3 times.
Levomycetins	Chloramphenicol		0.5 g up to 3-4 times.
Sulfonamides	Urosulfan		1 g up to 2 times.
	Co-Trimoxazole		480 mg 2 times.
	Biseptol	Drip	960 mg 2 times.
Nitrofurans			0.2 g 3 times.
	Furadonin		0.1-0.15 g three times.
	Furazidin		50-100 mg three times.
Quinolones	Nitroxoline		0.1 g 4 times.
			2 tablets 4 times.
	Ofloxacin		100-300 mg 2 times.
Cephalosporins	Cephalothin	Intravenously or intramuscularly	1-2 g every 4-6 hours.
	Ceftriaxone	Intravenously or intramuscularly	0.5-1 g up to 1-2 times.
	Cephalexin		0.5 g up to 4 times.

Diuretics

In the presence of edema and high blood pressure, it is necessary not only to limit the amount of fluid consumed. Additionally, the patient is prescribed diuretics. They are used only for prolonged pyelonephritis to relieve swelling. The most common diuretic is Furosemide:

composition: substance of the same name – furosemide;
release forms: capsules and solution for injection;
therapeutic effect: short-term but pronounced diuretic effect;
dosage for adults: 0.5-1 tablet or 20-40 mg by slow intravenous administration;
effectiveness: 20-30 minutes after taking the tablets, 10-15 minutes after infusion into a vein.

Furosemide has a very long list of side effects, so herbal preparations are often used as an alternative. Examples of such drugs are:

Canephron. It has antispasmodic and anti-inflammatory effects. The composition contains centaury, rosemary, and lovage. The dose is determined by the disease, on average 2 tablets three times a day. The advantage is that it is well tolerated. Contraindications include only individual intolerance to the drug.
Phytolysin. It is a paste from which a suspension is prepared. Contains parsley root and lovage, birch leaves, goldenrod, sage and peppermint oils. Dosage – 1 tsp. paste in half a glass of water 3 times every day. Contraindications: pregnancy, renal failure.

Nonsteroidal anti-inflammatory drugs

The need to use non-steroidal anti-inflammatory drugs (NSAIDs) is because they help reduce inflammation in the kidneys. They inhibit cyclooxygenase, which is a key enzyme in triggering responses. As a result of taking NSAIDs, the production of inflammatory proteins slows down and cell proliferation (proliferation) is prevented. This helps to increase the effectiveness of etiotropic treatment, i.e. taking antibiotics. When taking NSAIDs, they penetrate into the inflammation site more easily.

For this reason, such drugs are used in conjunction with antibiotics. NSAIDs are not used without etiotropic therapy. The drug Indomethacin is also not used, since it leads to necrosis of the renal papillae. Among the effective NSAIDs are:

Voltaren. The basis is diclofenac, which has anti-inflammatory, antipyretic, antirheumatic and antiaggregation effects. Contraindications and side effects should be studied in the instructions, they are numerous. The average dosage of tablets is 100-150 mg in several doses, the injection solution is 75 mg (3 ml ampoule). The advantage is that in case of kidney pathologies, diclofenac accumulation is not observed.
Movalis. Based on meloxicam, a substance with antipyretic and anti-inflammatory activity. Contraindications: severe renal failure, chronic pyelonephritis in patients undergoing hemodialysis. Dosage of different release forms: 1 tablet per day, 15 mcg intramuscularly once. The advantage is high bioavailability. Side effects are presented in a large list, so it is better to study them in the detailed instructions for Movalis.
Nurofen. Contains ibuprofen - an analgesic and anti-inflammatory substance. Used for fever in patients with infectious and inflammatory diseases. The dosage of tablets is 200 mg up to 3-4 times daily. The advantage is that it can be used in the 1st-2nd trimester of pregnancy. The disadvantages of Nurofen include a large list of contraindications and adverse reactions.

Drugs to improve renal blood flow

With a long-term course of the chronic form of pyelonephritis, the blood supply to the kidney tissue deteriorates. Antiaggregation and angioprojective drugs help improve microcirculation, dilate blood vessels and increase the amount of oxygen delivered to the kidneys. The main indication for their use is the treatment of chronic pyelonephritis. Commonly used antiplatelet agents include:

Trental. Based on pentoxifylline, it has a vasodilating effect, increases the elasticity of red blood cells. Dose for different release forms: tablets - 100 mg 3 times a day, ampoules - 200-300 mg in the morning and evening.
Venoruton. Includes rutoside, has phlebotonic and angioprotective effects. Reduces capillary permeability and swelling. The average dosage is 300 mg three times a day. Troxevasin has a similar effect.
Chimes. Contains dipyridamole, a substance with immunomodulatory and antiaggregation effects. Taken in a daily dose range of 75-225 mg (1-3 tablets).
Heparin. Anticoagulant based on sodium heparin. Has an antithrombotic effect, reduces platelet aggregation. The dose for intravenous administration is 15 IU/kg/hour.

Immunomodulators and adaptogens

The cause of pyelonephritis is often a deficiency of the T-suppressor function of lymphocytes. In this regard, patients with this diagnosis need to take immunomodulators and adaptogens. These drugs accelerate the formation of protective antibodies. Indication for use: treatment of chronic pyelonephritis in the acute stage. Examples of immunomodulators and adaptogens are:

Timalin. Normalizes the function of B and T lymphocytes. It is administered intramuscularly at 10-20 mg daily. The duration of treatment is 5-6 days.
Levamisole (Decaris). Stabilizes the function of T- and B-lymphocytes, stimulates phagocytosis, thereby increasing the interferon-producing ability of the body. Prescribed in a course of 2-3 weeks. Dose – 150 mg every 3 days.
T-activin. Dosage – 100 mcg daily for intramuscular administration.
Methyluracil. Take 1 g up to 4 times a day for a course of 15 days.
Tincture of Chinese lemongrass or ginseng (adaptogens). The recommended dose per day is 30-40 drops up to 3 times. Take adaptogens until the end of treatment of the disease.
Multivitamin complexes Duovit, Vitrum or Supradin. Replenishes the lack of vitamins and minerals in the body. Dosage is: 1 tablet per day.

Treatment of pyelonephritis with folk remedies

Herbal medicine is not used as the main method of treatment; it is indicated as a complement to medications and physical procedures. Herbal treatment is considered safer, but products based on them should still be used under the supervision of a doctor. The plants used should have mild diuretic and antiseptic effects. These include:

Bearberry (bear ears)

This plant contains a unique substance - arbutin, which is oxidized in the body to glucose and hydroquinone. The latter is a natural antiseptic that exhibits an antibacterial effect. Use bearberry according to the following instructions:

Pour about 30 g of dry herb into 500 ml of boiling water.
Boil over low heat for a couple of minutes, then let it brew for about half an hour.
Drink 2 tbsp daily. l. up to 5-6 times. Bearberry is effective in an alkaline environment, so it is additionally necessary to drink Borjomi mineral water, soda solutions and eat more raspberries, apples, and pears.

Lingonberry leaves

Lingonberry leaves have choleretic and antimicrobial effects. These properties are due to the presence in the composition of the same substance that is found in bearberry - hydroquinone. The instructions for preparing and taking a decoction of these two herbs are also the same. It’s better to infuse the lingonberry remedy for about 2 hours. In addition, after a 3-week course of therapy, it is necessary to take a break of 7 days and repeat the treatment cycle.

Cranberry or lingonberry juice

These drinks have antipyretic, anti-inflammatory, healing and antibacterial properties. The high acidity of cranberries and lingonberries makes them effective against urinary tract and kidney infections, but they should not be used for stomach or duodenal ulcers. Instructions for preparing and using fruit juice:

Take 500 g of cranberries or lingonberries, rinse.
Grind them until smooth.
Through several layers of gauze, squeeze the juice out of the berries, add 2.5 liters of clean water.
Take 4 glasses of fruit drink daily.

Medicinal preparations for oral administration or external procedures

In herbal medicine, herbal infusions are also effective against this disease. The combination of several components helps reduce the number of side effects and dosage. The following recipes are effective:

Recipe number	Ingredients, quantity tsp.	Method of preparation and use
	St. John's wort – 5; bearberry leaf – 5; fennel fruits – 2; elderberry flowers – 4; lemon balm – 3; knotweed – 5; calamus root – 2; kidney tea leaf – 2; flax seeds – 3.	Pour 2-3 tbsp. l. collecting 500 ml of boiling water. Pour into a thermos and leave for 6 hours. Use during the day in 3 doses half an hour before meals.
	Veronica grass – 5; wild rosemary shoots – 5; St. John's wort – 5; horsetail grass – 4; corn silks – 3; pine buds – 3; corn silks – 3; mint leaf – 3.	Brew 2-3 tbsp. l. herbal mixture 0.5 liters of boiling water. Leave in a thermos for 6 hours. Drink the infusion in 3 doses throughout the day, consuming 20-30 minutes before meals.
	chicory roots – 4; dandelion roots – 4; chamomile grass – 4; corn silks – 3; juniper shoots – 3; heather grass – 3; celandine – 4; calamus leaves – 3; cudweed grass – 5; birch leaves – 3.	Pour 100 g of herbal mixture with a liter of boiling water. Leave for 2 hours, then strain. Add to a bath with water at a temperature of 32-36 degrees. Lie in it for about 10-15 minutes. Dry your body with a towel. Go to bed. Course – 10-15 procedures, 1 per day.

Spa treatment

Complex therapy of pyelonephritis, especially chronic, involves sanatorium-resort treatment. It helps patients cope with exacerbations and recover faster. Although this type of treatment also has contraindications: chronic renal failure, high blood pressure, anemia. The following procedures are recommended for other patients with pyelonephritis:

drinking treatment with mineral waters in the sanatoriums of Zheleznovodsk, Jermuk, Slavyanovsky and Smirnovsky mineral springs;
diet therapy;
heat therapy;
hardening;
mud applications;
balneotherapy through vibration, radon, aromatic, mineral baths and Charcot shower (massage with jet water).

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An inflammatory disease called chronic pyelonephritis is localized in the pyelocaliceal region of the kidneys. Its development is possible at any age in both women and men. Chronic pyelonephritis occurs as a consequence of infectious diseases or as an independent disease.

Main features

Chronic pyelonephritis symptoms have the following:

Lumbar aching pain, not very strong and asymmetrical. Moreover, it can hurt on the side opposite to the affected kidney;
Heaviness appears in the lower back, especially after standing for a long time;
Young children and adults with a loose or low-lying kidney may experience abdominal pain;
In the evening, for no reason, the temperature may rise to 38 C;
At night, urination becomes more frequent;
Blood pressure rises;
Painful feeling of fatigue, especially in the morning;
Headaches and worsening mood;
In the morning, swelling of the face and hands may form, and in the evening - swelling of the feet and legs.

It often happens that in this state the patient feels cold in the lower back and begins to dress warmer.

When analyzing the patient’s urine and blood, the following signs of chronic pyelonephritis are revealed:

decreased hemoglobin;
increased number of leukocytes in the urine;
a large number of pathogenic bacteria in the urine;
increased number of red blood cells.

Chronic pyelonephritis - treatment

To eliminate pathogens, antibiotics and uroseptic agents are used. The drugs used must be non-toxic to the kidneys and effectively combat the most common infectious pathogens: staphylococcus, Klebsiella, E. coli, Pseudomonas aeruginosa, Proteus, etc. Before starting treatment, the sensitivity of bacteria to antibiotics is determined by testing the patient's urine.

Most often, the doctor prescribes penicillin antibiotics (amoxicillin, azlocillin, carbenicillin). Their spectrum of action is wide, and nephrotoxicity is minimal.
For hospital treatment, both 2nd and 3rd generation cephalosporins are used. Their effectiveness is no different from previous drugs, but most of them are used in the form of injections. Suprax or Cedex is prescribed on an outpatient basis.

Fluoroquinolones have a good effect. They effectively destroy infection in the urinary tract, but are not recommended for use in pediatrics, lactating women and pregnant women. These drugs also have a side effect - photosensitivity appears after taking them. Therefore, you should not stay in the sun for a long time during the treatment period.

Nitrofurans also treat pyelonephritis well. These include furadonin and furamag. But some patients do not tolerate them well due to nausea, bitterness in the mouth or vomiting.

Hydroxyquinolines have normal tolerance. From this series we can name nitroxoline and 5-Nock.

The amount of liquid you drink should be increased to approximately 3 liters during the day. If the symptoms of intoxication are severe and there is a high temperature, it is recommended to take pharmaceutical rehydron or citroglucosolan.

If it is not possible to determine the origin of the pathogen that caused pyelonephritis, or the antibiogram is not yet ready, then broad-spectrum antibiotics are prescribed. Such, for example, as carbenicillin, nitroxoline, ampiox, cephalosporins, quinolones.

Chronic renal failure (CKD for short) may develop. In this case, reduce the dose of uroantiseptics and increase the intervals between their administration.
There are 4 groups of antibiotics that are used differently in case of chronic renal failure:

drugs used in usual doses: chloramphenicol, dicloxacillin, erythromycin, oleandomycin;
antibiotics with a dose reduced by 30% due to their accumulation in the body during chronic renal failure: ampicillin, methicillin and oxacillin;
agents with mandatory dose adjustment and interval of use: streptomycin, biseptol, gentamicin, kanamycin, carbenicillin;
drugs that are not recommended for use in chronic renal failure: nitrofurans, nevigramon and tetracyclines (except doxycycline).

Chronic pyelonephritis treatment takes a long time. The first course of treatment lasts 6-8 weeks. During this time, infection activity is suppressed and inflammation decreases. If the inflammatory process is severe and does not go away for a long time, then antibacterial agents are used in combinations. For example, drugs based on nalidixic acid are combined with cephalosporins, aminoglycosides or carbenicillin. The drug 5-Nok combines well with antibiotics. With the simultaneous use of bactericidal antibiotics such as penicillins and aminoglycosides or penicillins and cephalosporins, they further enhance their effect.

When the patient enters remission, treatment is intermittent. Antibacterial therapy should be repeated 3-5 days before the next exacerbation is expected to begin. The duration of the courses is 8-10 days, using the same drugs that provided relief at the beginning of treatment.

Phytotherapy

Herbal remedies as an addition to antibiotic therapy are very effective, but cannot completely replace it and are not recommended for use during periods of exacerbations. They are used for prophylaxis during remission periods or after a course of antibiotics.

The table below lists all the herbs used in the complex therapy of chronic pyelonephritis.

Medicinal plants used for pyelonephritis (including chronic)

Plant name	Action
Plant name	bactericidal	diuretic	astringent	hemostatic
Althaea officinalis	++	_	_	_
Cowberry	++	++	–	–
Black elderberry	+	++	+	–
Cornflower (flowers)	++	++	–	–
Elecampane tall	+	++	–	+
Angelica (root)	–	++	–	–
Strawberry (leaf)	–	+	–	++
St. John's wort	+++	+	++	+
Cranberry	+	+	–	–
Stinging nettle	++	_	+	+++
Birch leaves	–	++	–	–
Wheatgrass (grass and roots)	_	++	_	_
Kidney tea	–	+++	–	–
Chamomile officinalis	++	_	_	_
Red rowan	+	++	+	++
Corn silks	++	++	+	+
Bearberry	++	+++	+	–
Horsetail	+	+++	+	++

For example, bearberry, or as it is also called bear's ears, contains a substance that is broken down in the body into the antiseptic hydroquinone and glucose. Bearberry is used in the form of decoctions. Its action is best demonstrated in an alkaline environment. Therefore, it is recommended to drink the decoction with alkaline mineral waters. Raspberries, pears, and apples alkalize urine well.

The antimicrobial and diuretic properties of lingonberry leaves are used similarly to bearberry. The reception is the same, a decoction together with an alkaline mineral water.

Treatment with physiotherapeutic procedures

Physiotherapeutic methods are used in combination with basic treatment. This method works as follows:

increases blood flow to the kidneys, which allows antibacterial agents to enhance their effect;
the discharge of harmful substances from the renal pelvis improves due to the relief of muscle spasms.

The physiotherapy procedures used are listed below:

erythromycin electrophoresis;
electrophoresis of furadonin;
calcium chloride electrophoresis;
ultrasound (in the absence of kidney stones);
microwave;
thermal procedures (paraffin and ozokerite applications, therapeutic mud, diathermy).

All physiotherapy procedures are applied to the kidney area.

Treatment at mineral water resorts

The use of mineral waters in the treatment of chronic pyelonephritis has a positive effect on the patient’s condition. Mineral waters, with their alkaline composition, help relieve inflammation, increase the alkalinity of urine, and wash out salts and harmful bacteria.

For chronic pyelonephritis, the following mineral water resorts are useful: Truskavets, Zheleznovodsk, Sairme, Jermuk. As well as mineral springs Slavyanovsky and Smirnovsky.

Spa treatment includes, in addition to drinking mineral waters, physiotherapeutic procedures.

There are contraindications for spa treatment:

high blood pressure;
anemia;

Anti-relapse treatment

To prevent periods of exacerbation of chronic pyelonephritis, several methods are used. One of them involves treating with antibiotics several times a year in combination with antiseptics and medicinal plants.

The following technique involves the use of the following drugs for 4 weeks:

In the first week - biseptol (1 or 2 tablets at night);
In the second week - a herbal uroantiseptic;
In the third week - 5-NOK (2 tablets at night);
In the fourth week - chloramphenicol (1 tablet at night).

In the future, they do the same, but with other drugs of similar action. If an exacerbation has not been observed for more than 3 months, plant-based antiseptics can be used. They are used 2 weeks a month. The cycle can be repeated, and if there is no exacerbation, take a break for 1-2 weeks.

Another version of the technique involves drinking rosehip infusions, vitamins and cranberry juice for one week. Use medicinal preparations for the second and third weeks. In the fourth week, an antibiotic is used, which should be changed monthly.

Pyelonephritis- a violation of the structure and functioning of the kidneys as a result of inflammation. Today, pyelonephritis is one of the most common diseases in nephrology - according to statistics, more than half of all inflammatory diseases of the genitourinary system.

The occurrence of an infectious-inflammatory process in the kidneys occurs as a result of the entry of pathogenic microorganisms either from the organs of the urinary system, or along with blood from any infected organ.

Causes of chronic pyelonephritis

The causative agents of pyelonephritis can be staphylococcus, Proteus, Escherichia coli, Pseudomonas aeruginosa, etc. Pyelonephritis often occurs against the background of diabetes mellitus, reduced immunity and any chronic diseases.

Chronic pyelonephritis, as a rule, occurs as a consequence of advanced acute or primary chronic pyelonephritis. Most patients develop chronic pyelonephritis in childhood, this is especially true for girls.

A simple examination fails to identify obvious symptoms of pyelonephritis in about a third of patients, and only attacks of causeless fever may indicate an exacerbation of the disease. Recently, the frequency of cases of a combination of chronic pyelonephritis and glomerulonephritis has been increasing.

Symptoms of chronic pyelonephritis

A symptom of unilateral chronic pyelonephritis is dull, constant pain in the lower back on the side of the affected kidney. Most patients do not have urinary problems. During the period of exacerbation of the disease, only 20% of patients experience an increase in body temperature.

The urine sediment reveals a predominance of leukocytes over other formed elements of urine. However, as the pyelonephritic kidney shrinks, the severity of urinary syndrome decreases. The relative density of urine remains normal. One of the symptoms of chronic pyelonephritis in most patients is bacteriuria.

If the number of bacteria in 1 ml of urine exceeds 100,000, then their sensitivity to antibiotics and chemotherapy must be determined. Arterial hypertension is a fairly common symptom of chronic pyelonephritis, especially bilateral.

Diagnosis of chronic pyelonephritis

For the diagnosis of chronic pyelonephritis, it is essential to detect active leukocytes in the urine. In case of latent pyelonephritis, it is advisable to carry out a pyrogenal or prednisolone test (30 mg of prednisolone, dissolved in 10 ml of isotonic sodium chloride solution, administered intravenously over 5 minutes; after 1, 2, 3 hours, and 24 hours after this, urine is collected for examination) .

The prednisolone test is positive if, after administration of prednisolone, more than 400,000 leukocytes are excreted in the urine within 1 hour, a significant portion of which are active. The detection of Sternheimer-Malbin cells in the urine only indicates the course of an inflammatory process in the urinary system, but does not yet prove the presence of pyelonephritis.

Infusion urography initially reveals a decrease in the concentrating ability of the kidneys, delayed release of a radiopaque substance, local spasms and deformations of the calyces and pelvis. Over time, the spastic phase gives way to atony, the calyces and pelvis expand. Then the edges of the cups take on a mushroom shape, and the cups themselves move closer together.

Infusion urography is informative only in patients with a blood urea concentration below 1 g/l. In diagnostically uncertain cases, kidney biopsy is used. However, with focal lesions of the kidney due to pyelonephritis, the absence of positive biopsy results does not exclude the current process, since it is possible that healthy tissue may be included in the biopsy sample.

With increasing renal failure, symptoms of chronic pyelonephritis appear: pale and dry skin, nausea and vomiting, nosebleeds. Patients lose weight and anemia worsens. Pathological elements disappear from urine. Possible complications of pyelonephritis: pyonephrosis, nephrolithiasis, necrosis of the renal papillae.

The functional state of the kidneys is examined by chromocystoscopy, radionuclide methods, excretory urography and clearance methods. In chronic pyelonephritis, the concentrating ability of the kidneys is quickly impaired, in contrast to the nitrogen excretory function, which persists for a long time. Acidosis resulting from tubular dysfunction, as well as loss of calcium and phosphate, in some cases lead to secondary parathyroidism with renal osteodystrophy.

Diagnosis of chronic pyelonephritis is a difficult task. In the differential diagnosis of chronic glomerulonephritis, the following are of great importance: data from excretory urography, radionuclide renography and the nature of the urinary syndrome. Nephrotic syndrome confirms the presence of glomerulonephritis.

In case of arterial hypertension, it is necessary to carry out a differential diagnosis between pyelonephritis, vasorenal hypertension and hypertension. A specific history that is characteristic of pyelonephritis, the results of X-ray and radionuclide studies, urinary syndrome, and the asymmetry of dye excretion detected during chromocystoscopy in most cases help to correctly identify the disease. The presence of renovascular hypertension is detected by radionuclide renography, intravenous urography and aortoarteriophaphy.

Treatment of chronic pyelonephritis

Treatment of chronic pyelonephritis is very long and can last several years. It is necessary to start treatment with the appointment of nalidix, 5-NOC, sulfonamides, alternating them. At the same time, it is reasonable to use cranberry extract in treatment.

If these drugs do not produce results, then broad-spectrum antibiotics are used during exacerbations of the disease. The use of an antibiotic should begin with determining the sensitivity of the microflora to it. For most patients, monthly 10-day courses of treatment are sufficient.

With such therapeutic tactics, in some patients, virulent microflora continues to be sown from the urine. In these cases, long-term antibiotic therapy is necessary, replacing the drugs used every 5-7 days.

As renal failure increases, the effectiveness of antibacterial therapy decreases. When the concentration of residual nitrogen in the blood serum is more than 0.7 g/l, it is usually not possible to achieve therapeutically effective levels of antibacterial drugs in the urine.

In the absence of renal failure, spa treatment is indicated.

Questions and answers on the topic "Chronic pyelonephritis"

Question:Hello! An ultrasound was diagnosed with chronic pyelonephritis, but I don’t observe any symptoms. In the evening the temperature rises to 37, maybe because of this diagnosis?

Answer: Hello. You would be able to “feel” it only during an exacerbation. An increase in temperature is possible.

Question:Hello! I have chronic pyelonephritis, cystitis. I’m planning a pregnancy, tell me what can be done for prevention so that there is no exacerbation during pregnancy. Now I am worried about nagging pain in the lower back.

Answer: You can take the herbal preparation Canephron 2 tablets 3 times a day throughout your pregnancy. It is well tolerated and provides prevention against urinary tract inflammation.

Question:Please tell me I’m now 18 years old, I got sick at the age of 13, I started with cystitis and then I was diagnosed with acute pyelonephritis. Over the course of a year, I could end up in the hospital three times, just like with an exacerbation. Now I’m diagnosed with secondary chronic pyelonephritis and I’m on " e;D"e; accounting. Tell me, is it possible to cure this disease?

Answer: If this is secondary pyelonephritis, then you probably have a certain congenital pathology of the structure of the urinary tract. It is impossible to be completely cured until the cause is eliminated.

Question:Exacerbation of chronic pyelonephritis, urine contains sand, ketone, fresh erythrocytes, 5-6 leukocytes, tank culture was not performed. Do you need an antibiotic?

Answer: With exacerbation of chronic pyelonephritis, especially in the presence of inflammatory changes in the urine, antibiotic therapy, unfortunately, is mandatory.

Question:5 years ago I was diagnosed with chronic pyelonephritis. I was treated for half a year with courses of antibiotics for 10 days a month. 3 years ago I gave birth to another child and now there are constant exacerbations. The pressure rises to 170 over 110. When using medications to lower the pressure, nothing helps. They even gave me intravenous magnesium and severe headaches. I took the antibiotics Bessiptol, Trichopolum, the antimicrobial drug Tseprolet several times, and I drink phytolysin almost constantly. Now I take Augmentin, but still my blood pressure rises again, does not decrease after taking pills for high blood pressure, and even if it drops a little, then it rises again. I get tested and show that there is nothing. I did an ultrasound, and the doctor also said everything was fine. But then why is this happening to me? Please tell me, I’m so tired of being on pills. Thank you very much.

Answer: You need to consult with a nephrologist and conduct a comprehensive examination: general blood and urine analysis, urine according to Nechiporenko, uroculture, vaginal smear, biochemical blood test, ultrasound of internal organs, and, if necessary, additional examination urography. Only after receiving the results of the examination will the specialist doctor prescribe the correct treatment and identify the exact cause of the increase in pressure.

Question:Hello, I am 20 years old, 1st pregnancy. I took tests the other day and found a lot of leukocytes and bacteria in my urine. High blood pressure 140 over 100, swelling of the legs. Please tell me that I must go to bed for treatment, and how will I be treated?

Answer: Most likely, such symptoms, together with laboratory data, indicate the presence of pyelonephritis. Treatment in this situation in a hospital setting is mandatory. The treatment regimen will be selected individually by the attending physician, after an accurate diagnosis has been established.

Question:Hello, I have been suffering from chronic pyelonephritis for three years. I was treated with medications, but I don’t see any results. Not long ago I began to be treated with herbs (Collection of herbs: tansy, calendula, wormwood, St. John's wort, mint, shepherd's purse, rose hips, burdock, buckthorn, oregano, datura) I brew 1 teaspoon per 200 grams. boiling water and drink 2 times a day, before meals. How correct is this? Now I’m taking the 3rd course (24 days each, 6 days rest). But my kidneys still hurt. Can I drink cystone with this collection? If I’m not being treated correctly, how should I treat it?

Answer: Herbal medicine is only an adjunct in the treatment of inflammatory kidney disease. To carry out adequate treatment, you need to seek a personal consultation with a urologist. Only after a general urine and blood test and clinical examination will a urologist be able to prescribe treatment appropriate to the stage of the disease and the severity of your condition.

Question:I'm 17 weeks pregnant. Diagnosis of chronic pyelonephritis. Please tell me which antipyotics are safer for the fetus during pregnancy.

Answer: The decision on prescribing antibiotics during pregnancy remains with the attending gynecologist-nephrologist. In case of exacerbation of pyelonephritis, it is possible to use drugs from the group of semisynthetic penicillins, 2nd and 3rd generation cephalosporins; these drugs can be used during pregnancy.

Question:Hello, I was recently admitted to the hospital with suspected gestational pyelonephritis, but I did not finish treatment - I feel great! The other day I went for a walk and my right side started to hurt sharply, but after some time the pain went away, then it happened again, and so on periodically throughout the night. My lower back doesn’t hurt, I don’t have a fever, please tell me what to do, thank you.

Answer: You need to go to the hospital where you were treated as soon as possible. It will be necessary to repeat a general blood test, a general urinalysis and, possibly, a repeat ultrasound of the kidneys. Most likely, you have a repeated exacerbation of pyelonephritis, due to insufficient treatment for the previous exacerbation.

Question:A month ago I was in the hospital with acute pyelonephritis. Now blood and urine tests are normal, but periodically in the evening the temperature rises to 37-1 and I constantly feel the presence of a kidney (not pain, but as if it is slightly enlarged). Is this a transition to the stage of chronic pyelonephritis or just normal consequences of an acute attack? If you follow a diet and drink kidney teas, will everything go away? Or see a doctor?

Answer: In such a situation, you should definitely consult a doctor for personal advice; perhaps the inflammation in the renal tubules has not been completely stopped, and its presence causes an increase in temperature and pain.

Question:Hello! Almost two weeks ago I went to the doctor with pain in my kidneys, and the doctor sent me for an ultrasound. The ultrasound showed nothing, and a urine test showed uric acid crystals. I am also worried about frequent urination with delay and a small amount of urine, sometimes there is pain. The doctor diagnosed: dysuria and uric acid diathesis. What kind of diseases are these? And how can pyelonephritis and right-sided nephroptosis affect these diseases? Now I’m taking Canifron, a urological preparation.

Answer: It is recommended to take a daily urine test for salts and a biochemical blood test, as well as conduct a bacteriological urine culture; only after receiving these examination results will it be possible to make an accurate diagnosis. Dysuria is a violation of urination, there can be many reasons (neurological disorders, compression of the bladder by a tumor, which leads to difficulty in the outflow of urine, blockage of the duct with a stone, inflammation of the bladder, etc.). Uric acid diathesis is an increased amount of salts in the urine, which can lead to the formation of stones. Chronic pyelonephritis and nephroptosis aggravate the course of the disease.

How does the disease affect the fetus?

A child can become infected in utero from the mother. Babies are often born with conjunctivitis, and in some it is more serious - the infection affects vital organs. In addition, pregnant women may develop intrauterine hypoxia. The fetus will not have enough oxygen. Subsequently, the child will be born with low birth weight.

How can a pregnant woman be treated?

If renal inflammation is detected, the doctor prescribes antibacterial therapy. But!!! During pregnancy, you should not get carried away with antibiotics, so the urologist selects safe drugs that will not affect the fetus and will help get rid of the exacerbation. It is impossible to refuse treatment while carrying a baby.

A pregnant woman must take antispasmodics, painkillers, and vitamins. The doctor prescribes uroantiseptics, sedatives, and additionally requires physiotherapeutic procedures, ureteral catheterization, detoxification and positional therapy.

Chronic pyelonephritis in pregnant women is treated in a hospital setting. The woman is observed by a nephrologist and obstetrician-gynecologist. Positional therapy is considered especially effective for pregnant women, as it restores impaired urine flow. What is the point of such therapy? The woman is placed on her side (where the healthy kidney is), her legs should be higher than her head (so the uterus will not put pressure on the ureter). If the woman does not feel better after a day, catheterization is performed.

What is the danger of the chronic form for pregnant women?

If you start the pathology, everything will end in suppuration. It can only be treated with renal decapsulation; sometimes the fibrous capsule is removed. In advanced cases, you will have to lose a kidney, so pregnancy is out of the question here.

When a woman becomes ill, she must be observed by a local doctor. After she is discharged from the maternity hospital, she is registered. Why is this? To control the patient's condition.

Pregnant lifestyle

A special diet is very important here. In case of acute pyelonephritis, you need to drink as much water as possible. You will have to cross out spicy, fried, and fatty foods from the menu, but be sure to include fresh vegetables and fruits.

For chronic pyelonephritis, it is important to adhere to the following diet:

Consume as little rich broth as possible and avoid various seasonings.
Drink as much water as possible - up to 2 liters per day.
Avoid salt (no more than 8 grams per day).
Include as many vitamin-rich foods as possible.

In the acute stage of the disease, if severe pain appears, the temperature rises sharply, signs of intoxication appear, you need to adhere to bed rest. Then you can’t lie still, you need to walk as much as possible, this will improve the flow of urine.

Attention! To prevent the development of renal inflammation, it is necessary to treat the disease in a timely manner.

Prevention during pregnancy

During such an important period, a woman should take her health especially seriously. Do not forget about personal hygiene, empty yourself in a timely manner, you cannot tolerate it. In addition, it is very important to dress warmly; often hypothermia not only causes kidney disease, but also leads to miscarriage.

It is also very important not to give up gynecological registration. It is necessary to attend a consultation as scheduled, take all tests, and undergo an ultrasound. The sooner the doctor learns about the pathology, the easier it will be to get rid of it. Listen to your doctor in everything, follow the basic recommendations.

Treatment of chronic pyelonephritis

Antibacterial therapy

The goal of treatment is to eliminate bacterial microflora. In this case, uroseptics and antibiotics are prescribed. The main thing is that the drugs have maximum effectiveness and minimal nephrotoxicity and are suitable for destruction:

Proteas.
Klebsiella.
Pseudomonas aeruginosa.
Staphylococcus.

We note that it is often prescribed Penicillin– Azlocillin, Carbenicillin, Amoxicillin. They are non-toxic and do their job perfectly.

Cephalosporins the second and third generations are also effective, but are used as injections in hospital settings, and only Cedex and Suprax are used at home.

Fluoroquinolones – Ofloxacin, Levofloxacin, Norfloxacin, Ciprofloxacin. The drugs destroy most pathogens, but they cannot be used by children, during pregnancy and the lactation period. Side effect is photosensitivity. During treatment with the drug you will have to forget about visiting the solarium and going to the beach.

Attention! Sulfonamide drugs (Biseptol) were previously used to treat various infections; now bacteria are practically insensitive to this group of drugs.

Nitrofurans (Furamag, Furadonin) are quite effective for pyelonephritis, but have a number of side effects - bitterness in the mouth, severe nausea, vomiting, so patients should not be treated with them.

Hydroxyquinolines (Nitoxoline, 5-NOK) are well tolerated, but in recent years the sensitivity of bacteria has also decreased. It is recommended to treat chronic pyelonephritis for two weeks. If complaints persist for a long time, treatment is extended for a month.

Detoxification of the body

If blood pressure does not increase and there is no swelling, you need to drink about three liters of clean water per day. In addition to water, you are allowed to drink fruit drinks and juice. Has your temperature risen and are you worried about symptoms of intoxication? It is necessary to take Tsitroglucosolan and Regidron.

Phytotherapy

An additional type of treatment is the use of traditional methods of treatment. We note that herbal preparations must be taken for a long time, with a course of therapy of one month. For preventive purposes, it is good to do this twice a year. Of course, you cannot use traditional recipes if you are prone to an allergic reaction or hay fever.

What fees are best?

Licorice + cornflower + bearberry. Take a tablespoon of the mixture and pour boiling water (250 ml). You need to wait half an hour and take everything inside.
Horsetail + + birch leaves - take everything one part at a time, add rose hips. Everything must be poured with boiling water (500 ml).

To improve renal blood flow you need to take:

Antiplatelet agents – Curantil, Trental.
Drugs to improve venous outflow - Troxevasin, Trental.

Features of the treatment of chronic pyelonephritis in children

It is important to say that in children, pathology is treated only in a hospital setting. At the first symptoms, the child is hospitalized in the urological, nephrological department. In an inpatient setting, you can evaluate the dynamics of blood and urine tests, conduct other examinations, and select safe therapy.

Treatment procedures include:

Compliance with the regime. If a child has a fever or complains of pain in the abdomen or lower back, it is necessary to adhere to bed rest. When the fever and severe pain go away, the child can move around the ward. Then a general regime is required - every day you can walk with your child on the hospital grounds for an hour.
Diet. Helps reduce the load on the kidneys and adjust metabolism. It is recommended to adhere to diet No. 5, in which there is no need to limit salt, but it is important to expand the drinking regime. If the child's condition is too serious, you will have to give up liquid and salt. A protein-vegetable diet has proven itself very well, but it is important to exclude any irritating foods - smoked foods, spices, rich broths, fatty foods, spicy foods.
Antibiotics. More detailed information about antibacterial drugs was provided above; it is only worth adding that the child is prescribed treatment for one month.
Medications. Additionally, it is necessary to take antispasmodics, antipyretic drugs that have antioxidant activity - beta-carotene, unithiol, vitamin E. Non-steroidal anti-inflammatory drugs are also prescribed - Voltaren, Ortofen. For 2 months, uroseptics and herbal medicines are prescribed - Canephron, lingonberry leaves,.

Important! After the child is discharged, you cannot relax; it is important to monitor him every month with a nephrologist - donate urine, undergo an ultrasound. A child is removed from the register only after 5 years, if during this time there were no complaints, symptoms and a normal urine test.

It is worth noting that chronic pyelonephritis in children cannot be completely cured. As a rule, during the active period, the child is hospitalized, carefully examined, and therapy is prescribed. It is very important to identify the cause of the development of the chronic form; this determines how often the disease will bother the child. Depending on the cause of the infection, the necessary procedures are selected:

The operation is performed for anomalies with obstructive processes, vesicoureteral reflux.
Diet in case of dysmetabolic nephropathy.
Psychotherapeutic and drug treatment if neurogenic bladder dysfunction is detected.

In the chronic form, during remission, a course of antibiotics in small doses is prescribed for prevention purposes. In addition, uroseptics are prescribed as a course of therapy for one month and phytotherapeutic agents are prescribed every month for a week.

So, chronic pyelonephritis is a rather insidious and dangerous disease, which over time leads to serious consequences. If you notice an exacerbation at least once, it is important to get examined and find out if you have a chronic form. You need to take the health of children especially seriously; their illness is more complicated than that of adults. The same goes for pregnant women. For them, the disease can cause miscarriage and other complications during pregnancy. Be careful, pay attention to your well-being and health, and do not trigger various diseases!