How to treat pyelonephritis with drug therapy. How to treat kidney pyelonephritis

Kidney pyelonephritis – an infectious-inflammatory process of bacterial etymology, mainly starting in the pelvis, calyx or medulla of the kidney. There are two ways of penetration of the pathogen into the organ and they are associated with the filtering and urinary functions of the kidney: hematogenous (through the blood - renal artery); urinogenic (through the urinary canals - ureter).

Symptoms

According to many medical sources, pyelonephritis is the most frequent illness kidney The symptoms of this disease directly depend on the form of the inflammatory process in the affected organ:

Symptoms of acute pyelonephritis

On early stages Acute primary pyelonephritis of the kidneys is characterized by: a sharp rise in temperature (not less than 38 degrees), severe chills, fever, body aches, general malaise, dizziness, nausea, vomiting (intoxication of the body). With the development of inflammation, the following symptoms may also be added: sharp or nagging pain in the lumbar region, change in the color and odor of urine, frequent urge and pain when urinating.

For primary or secondary pyelonephritis caused by difficulty urinating ( urolithiasis disease, tumor, cancer, prostate adenoma, hydronephrosis, abnormalities of the urinary system, pregnancy) is characterized by a gradual onset of symptoms: increasing pain in the lumbar region, a slow increase in body temperature, alternating chills and sweating.

Symptoms of chronic pyelonephritis

According to their specificity, the symptoms of the chronic form appear in waves: during periods of remission, no symptoms are observed; during exacerbations, the inflammatory process affects more and more areas of the organ, which leads to damage and death of healthy kidney tissue.

Periods of exacerbation are similar in symptoms to acute pyelonephritis, but their manifestation may not be as severe. Subsequently, under the influence of the disease, scars, abscesses (small cavities), and pustules appear in place of the affected tissues, which can periodically serve as a reason for: an unreasonable increase in temperature to 37-38 degrees (especially in evening time days); general malaise against a background of decline; the appearance of edema (after sleep);

How is kidney pyelonephritis diagnosed?

Make an accurate diagnosis kidney pyelonephritis independently, without laboratory research, is practically impossible, especially in the early stages of the disease. This is due to the fact that the symptoms of pyelonephritis are similar to. Staging accurate diagnosis requires laboratory and instrumental diagnosis.

To identify the inflammatory process in the kidneys, use:

• Urinalysis: 1. General - reveals an increased content of leukocytes, the presence of bacteria in the urine and the pH value (in the presence of an inflammatory process, it changes to alkaline); 2. According to Necheporenko – determines increased amount leukocytes against the background of the number of red blood cells.

Urinalysis indicators for pyelonephritis

• Urine culture is a urine test for the presence (or sterility) and type of bacteria.
• General blood analysis. According to the results, a decrease in hemoglobin and red blood cells is observed, the erythrocyte sedimentation rate (ESR), and a shift in the leukocyte formula are determined.

To clarify the diagnosis, localize foci of inflammation and determine clinical form pyelonephritis is carried out:

• chromocystoscopy - determination of the excretory functions of the kidney by introducing a contrast agent into the body;
• overview and excretory urography- X-ray examination urinary system with the use of a contrast agent (with normal x-ray examination kidneys and ureters are practically invisible);
• (ultrasound);
• renal arteriography – gives a complete and clear picture of the state of the vessels in the kidneys;
• (CT abdominal cavity);
• Kidney biopsy - taking a fragment of kidney tissue using an instrumental method.

After consulting a nephrologist and conducting all necessary studies, the correct and effective treatment pyelonephritis.

Treatment of pyelonephritis

Medication

Prescribing treatment for of this disease is a nephrologist. It should consist of a set of measures aimed at eliminating the causes of the inflammatory process in the organ and factors that disrupt the outflow of urine, and also include drug and symptomatic therapy. Additionally, they may prescribe a strict diet.

In the acute primary form, immediate antibacterial complex therapy is first prescribed. This complex may include: broad-spectrum antibiotics (penicillin, cephalosporin), antimicrobials, diuretics (if the outflow of urine is not impaired), vitamin-mineral complexes, drugs for plant based. The duration of such therapy depends on the severity of the disease and can last several weeks. In the secondary acute form, first of all, the passage (outflow) of urine is restored, and only then antibacterial therapy is prescribed using antibiotics and chemicals influencing the inflammatory process.

Treatment of secondary chronic pyelonephritis is primarily aimed at the disease that caused the inflammatory process in the kidneys. This is necessary in order to eliminate provoking factors, thereby preventing a possible relapse and completely healing the affected organ.

Regardless of the form of the disease, taking into account the patient’s medical history, anti-inflammatory drugs (paracetamol, nimesil), detoxification agents ( Activated carbon) and drugs that improve microcirculation (heparin, dipyridamole).

Phytotherapy

For kidney inflammation it is used as auxiliary treatment. Prescribed as an addition to drug treatment For:

• treatment during remission
• help in eliminating severe inflammatory processes
• antimicrobial effects
• diuretic, uroseptic effect
• detoxification of the body
• restoration of blood volume
• prevention of recurrent diseases

Surgical

Surgical intervention is resorted to in cases where drug treatment does not have the expected effect and the disease progresses or when the disease is in neglected form and cannot be treated with medication.

In most cases, surgical intervention is used for purulent pyelonephritis to remove developing or already formed carbuncles, apostemes. The operation is performed in order to stop further damage, preserve the organ and its functions, and prevent the spread of inflammation to a healthy kidney (with unilateral pyelonephritis), as well as restore the outflow of urine (if disturbances are observed).

In nephrology and urological practice Doctors often encounter such a disease as. According to statistics, the disease occurs in 20% of the population of different age categories. Treatment of pyelonephritis is a long and labor-intensive process, therefore, when diagnosing this disease, patients need not only to take medications for a long time, but also to follow a diet and refuse bad habits. Medicines for pyelonephritis will help not only eliminate the symptoms of the disease, but also influence the very cause of its development.

Pyelonephritis refers to infectious pathologies of acute or chronic course. The disease can affect either one or both kidneys, causing very serious illnesses. Develops as a result of the penetration of pathogenic pathogens into lower sections genitourinary system, which multiply quite quickly, move through the canals of the genitourinary system, reach the kidneys, after which they provoke an inflammatory process.

Pyelonephritis is included in the group of diseases of the urinary system, the treatment of which should be carried out under the supervision of a doctor and only after the results of laboratory and instrumental diagnostics.

Drug treatment of pyelonephritis is aimed at suppressing and destroying pathogenic pathogens, therefore the first drugs for symptomatic treatment will be antimicrobial and antibacterial agents. The treatment regimen for pyelonephritis always consists of taking several medications with different mechanisms of action, which will help not only suppress the aggressiveness of pathogenic bacteria, but also improve the functioning of the kidneys and urinary system as a whole. In order to successfully cure pyelonephritis, it is important not only to recognize the disease in time, but also to identify and eliminate its main cause.

A disease such as pyelonephritis develops as a result of pathogenic flora entering the genitourinary system. The causative agents of infection are often intestinal microorganisms - coli, enterococci, Proteus, staphylococci, streptococci and other bacteria that can stay in the body for a long time, show their aggressiveness against the background of a number of factors, or penetrate from the external environment.

The disease is diagnosed in women much more often than in men. The reason for this is anatomical structure organs of the genitourinary system. The following factors can be a trigger for the development of pyelonephritis:

1. Hypothermia of the body.
2. Decreased immunity.
3. Concomitant diseases of the genitourinary system.
4. Frequent stress, nervous tension.
5. Failure to comply with personal hygiene rules.
6. Gynecological manipulations.
7. Bladder catheterization.

One of the causes of pyelonephritis is nervous tension and stress

In development inflammatory reaction in the kidneys there is a disruption in the outflow of urine through the ureter, which causes an increase in intrapelvic pressure, disruption of capillary blood flow, and tissue hypoxia. Such pathological changes significantly disrupt kidney function and can have unpleasant consequences.

Pyelonephritis is a fairly complex disease, so many people wonder whether pyelonephritis can be cured?

How to recognize the symptoms of pyelonephritis?

The first symptoms of pyelonephritis may appear several hours after contact with a pathogenic pathogen or after a few days. They can be expressed or erased and directly depend on the degree of the disease, its stage, accompanying symptoms sick. A characteristic symptom The disease is considered to be pain in the lumbar region, which can radiate to the back and lower abdomen. The nature pain syndrome may have different intensity.

With pyelonephritis, patients complain of the following symptoms:

1. Pain when urinating.
2. Copious and frequent urination.
3. Cloudy urine mixed with pus or blood.
4. Elevated leukocytes in the blood test.
5. Increase in body temperature to 39 degrees.
6. Fever.
7. Nausea, urge to vomit.

The clinical picture of the disease is more pronounced in acute period. At chronic form The symptoms of the disease are less pronounced, and the disease itself can be diagnosed accidentally after testing. For kidney pyelonephritis, the doctor prescribes a series of tests, studies the clinic and then prescribes therapeutic therapy.

Principle of drug treatment

Treatment of pyelonephritis in adults, as well as in children, consists of a whole complex therapeutic measures aimed at suppressing infection and its spread to other parts of the urinary system. Features of therapeutic therapy depend on the patient’s age and the degree of damage to the structures of the genitourinary system.

In order to cope with the disease, the doctor prescribes several drugs that not only eliminate pathogenic flora, but also restore kidney function. How to treat pyelonephritis and how to prevent its possible complications is determined by the attending physician after determining the nature of the disease.

Considering that this disease is infectious in nature, before prescribing treatment for pyelonephritis, it is important to determine the strain of the pathogen and select drugs to which the pathogen remains sensitive.

If the nature of the disease is not clear, doctors prescribe antimicrobial drugs that can suppress the aggressive flora. In addition to antibacterial drugs, the patient also takes other medications to relieve pain, improve kidney function, and reduce the risk of exacerbations and complications.

Complex therapy for pyelonephritis often includes the following groups of drugs:

1. antibiotics;
2. diuretics;
3. immunomodulators;
4. antihistamines;
5. antispasmodics;
6. anti-inflammatory drugs;
7. vitamin therapy, immunotherapy;
8. medicines based medicinal herbs.

The main thing in the treatment process is antibiotics, which can eliminate bacteria, relieve inflammation, thereby stopping the disease. Antibacterial therapy consists of taking antimicrobial drugs. The acute period of the disease always requires the use of anti-inflammatory, analgesic and antipyretic drugs, which should be taken for 3 to 7 days. Medicines based on vegetable herbs, which are well tolerated, interact ideally with antibiotics and other symptomatic drugs.

An important place in the treatment of pyelonephritis is occupied by pathogenetic treatment, which is aimed at the mechanisms of development of the disease itself, restoration of general health, and reduction of the risk of complications after an illness.

Statistics show that in approximately 20% of people suffering from pyelonephritis, the disease takes on a chronic form, which is characterized by periods of remission and exacerbation. During the acute period, the doctor will always prescribe antibacterial drugs, and during remission, preventive treatment, which will reduce the frequency of exacerbations.

The acute form of pyelonephritis must be treated in a hospital setting, where the disease will be constantly monitored. With minor inflammation, satisfactory condition of the patient, healing process can be performed on an outpatient basis. Treatment at home must necessarily include taking certain medications, following a diet and all the doctor’s recommendations.

In general, treatment for pyelonephritis lasts at least 2 weeks, so if after several days of treatment the patient feels much better, you need to complete the full treatment course, this will help reduce the risk of the disease becoming chronic.

The main thing in the treatment of pyelonephritis is considered to be antibacterial therapy, but the choice of drug directly depends on the type of pathogen and the age of the patient. Doctors often use medications to treat the symptoms of pyelonephritis with the maximum high efficiency. Therefore, patients must strictly adhere to the recommended doses, course, and frequency of taking them.

Nitrofurans

A common group of drugs used for the treatment of the urinary system are nitrofurans, which have a broad antimicrobial effect against gram-positive and gram-negative bacteria. Taking such medications allows you to suppress the aggressiveness of staphylococci, streptococci, trichomonas, E. coli and other microbes.

Representatives of this group:

1. Furagin.
2. Furadonin
3. Furazolidone.
4. Furamag.

The active components of such drugs quickly penetrate the site of inflammation, block and destroy the cell membranes of pathogenic pathogens, thereby stopping their reproduction. Basically, such drugs are prescribed for the treatment of chronic pyelonephritis. General contraindications to their use include children under 3 months of age, pregnancy and lactation. The course of treatment and dose are determined by the doctor for each patient.

Group representatives:

1. Norfloxacin (Nolitsin).
2. Ciprofloxacin (Ciprinol, Tsiprolet).
3. Ofloxacin.
4. Lomefloxacin (Lomflox).

Taking any medication from the group of fluoroquinolones can influence bacterial cells and disrupt their life cycle. Most often, these medications are used when other medications are ineffective. Taking any medicine from this group can only be prescribed by a doctor after identifying the pathogenic pathogen.

Sulfonamides

A group of drugs used to treat diseases of the genitourinary system caused by pathogenic bacteria. Sulfonamides are often used in combination with nitrofurans, which improves the efficiency and quality of treatment.

This group includes the following representatives:

1. Biseptol.
2. Urosulfan.
3. Nitroxoline.

In the last few years, they have been used quite rarely in the treatment of pyelonephritis, since most pathogenic bacteria are resistant to such drugs, so their use may not bring the desired therapeutic effect.

Phosphonic acid derivatives

The only drug from this group is Monural, which has persistent antimicrobial properties and helps to quickly neutralize bacterial flora. The medicine is well tolerated and can be prescribed to children and even pregnant women.

The basis of the drug Monural is fosfomycin, which is a broad-spectrum antibiotic. As practice shows, the effect after taking this drug may occur within 1–2 days. You can take the medicine only as prescribed by a urologist or nephrologist and only after making a final diagnosis.

Penicillins or cephalosporins

To relieve symptoms of pyelonephritis, treatment often includes taking medications from the group penicillin series or cephalosporin. Taking such medications allows you to suppress and destroy pathogenic flora.

These include:

1. Amoxiclav.
2. Augmentin.
3. Amoxicycline.
4. Cefazolin.
5. Ceftriaxone.
6. Emsef.

The treatment course with penicillin or cephalosporin drugs can take from 5 to 10 days. Such drugs are produced in different forms: tablets, suspension for children, or in ampoules for intramuscular or intravenous administration. Penicillins, as well as cephalosporins, can cause allergies, so before taking them you need to conduct a sensitivity test.

Natural preparations

Particularly popular are natural uroantiseptics for pyelonephritis, which contain medicinal herbs. Such drugs are prescribed in combination with other drugs, including synthetic antibiotics. Preparations based on extracts medicinal plants have pronounced antiseptic and diuretic properties.

1. Urolesan;
2. Phytolysin;
3. Cyston.

The advantage of such drugs is considered to be good tolerability, lack of side effects even with prolonged use. Uroseptics are considered ineffective for pyelonephritis purulent form. Medicines from this group are prescribed for outpatient treatment or prevention of diseases of the kidneys and urinary system.

Other drugs for the treatment of pyelonephritis

In addition to the main drugs for pyelonephritis, treatment includes the use symptomatic therapy, which will eliminate certain symptoms of the disease and improve the general condition of the patient.

Non-steroidal anti-inflammatory drugs (NSAIDs) - Ibuprofen, Nimesulide, Voltaren, Movalis and others. Taking such medications allows you to relieve pain, normalize body temperature, and reduce the inflammatory process.

Probiotics – Linex, Laktovit, Ecoflor, Hilak forte. Used in combination with antibiotics and antimicrobials, protect the intestinal mucosa from dysbacteriosis.

Diuretics (diuretics) – Lasix, Furagin. They stimulate the outflow of urine from the renal tubules, thereby eliminating the occurrence of stagnant processes and reducing the risk of stone formation in the kidneys.

Complex therapy for pyelonephritis often includes taking drugs to stimulate the immune system, or vitamin therapy.

It is important to understand that self-medication of inflammatory processes in the urinary system is not worthwhile. Only a nephrologist or urologist knows how to cure pyelonephritis and eliminate all possible risks of its complications. It is known that preventing the development of pyelonephritis is much easier than treating it, so if a person monitors his health and seeks medical help on time, the risks are minimized.

Many people immediately start searching the Internet for information about what pyelonephritis is after they feel discomfort when urinating or pain in the lumbar region.

Pyelonephritis - what is it? This is a kidney disease that is characterized by acute or chronic inflammation of the kidney tissue. As a rule, the development of the disease is facilitated by infection of the human body with bacterial agents. Kidney pyelonephritis, according to the specific progression and localization of the pathological focus, refers to a disease of the genitourinary system of the human body.

Among the main links in the pathogenesis of pyelonephritis, it is customary to highlight damage to kidney tissue due to exposure to endotoxins, as well as defensive reaction the body in the form of an inflammatory process and response to the penetration of a pathogenic microorganism.

Risk factors for pyelonephritis include:

• blockage of the urinary tract by a stone or spasmodic narrowing of the lumen of the ureter due to contraction muscle fibers in its walls;
• congenital pathologies of development and topographic location of the kidney;
• immunodeficiency states;
• changes in the structure of urinary tract tissues during the aging process;
• complication after surgical interventions on the pelvic organs;
• inflammatory processes of the uterine cavity.

The most common etiological factor is bacterial infection. The development of pyelonephritis can also be caused by viral infections.

Ascending pyelonephritis develops due to the penetration of a bacterial agent into the urinary tract through the urethra. This route of infection is most common, especially among the female population.

At upward path The causative agent of infection is most often Escherichia coli, since infection occurs when bacteria penetrate from the anal sphincter into the urethral opening. Thus, due to the peculiarities of the topographical arrangement of organs in women, the anus is located much closer to the urethra than in men and the risk of infection increases significantly.

It is important to know that the acidic environment of the vagina creates favorable conditions for the growth and reproduction of E. coli.

In addition to intestinal bacteria, staphylococci, streptococci, fungi and even protozoa can provoke symptoms of the disease. These types of infections can enter the urinary tract through medical procedures. For example, bladder catheterization or endoscopic examination.

Cases of movement of an infectious focus from any other are very rarely recorded. anatomical structure to kidney tissue. This route of infection migration occurs through blood or lymph.

In childhood, the cause of the development of pyelonephritis can be the reflux outflow of urine from the ureters back into the renal pelvis. Since the outflow of urine from the kidney suddenly stops or decreases, the concentration of pathogenic bacteria increases due to their effective reproduction.

After endotoxin is produced, inflammation and swelling develop renal tissue. In children, kidney inflammation - pyelonephritis and others bacterial diseases cause severe complications with scarring of damaged tissues and the development of chronic renal failure.

Acute and chronic pyelonephritis can occur regardless of age groups at various diseases kidney Chronic pyelonephritis is distinguished by a protracted inflammatory period and a recurrent course of the disease.

Classification of the disease

By the number of affected organs:

• right- or left-sided pyelonephritis;
• bilateral defeat.

Depending on the condition of infection penetration into the genitourinary organs:

• primary;
• secondary.

Depending on the nature of the disease:

• spicy;
• chronic.

Depending on the form of pyelonephritis:

• serous;
• purulent.

Features of symptomatic signs of pyelonephritis

The clinical picture of pyelonephritis depends on the nature of the disease. The syndromes of pyelonephritis include fever, pain and intoxication.

Acute pyelonephritis symptomatically manifests itself in the form of sharp pain in the lumbar region. The most common complaints of patients are nausea and vomiting, sharp increase body temperature to high levels - about 39 degrees. In advanced conditions and with improper treatment, general intoxication of the body develops, up to a coma.

Acute pyelonephritis is usually divided into obstructive and non-obstructive. The difference is that with the non-obstructive type, the symptoms of pyelonephritis develop much faster.

Sharp pain in acute pyelonephritis of a pulling nature

At the early stage of the disease, the inflammatory process has a serous course, since with prolonged stagnation of urine or the inflammatory process, reversible swelling of the kidney tissue occurs. As the disease progresses, the structural components of the kidney are susceptible to autolysis, thus gradually developing purulent process– abscess. In these cases, the kidney tissue cannot be restored.

At chronic pyelonephritis The clinic is distinguished by its slow course of the disease; as a rule, symptomatic signs can appear suddenly and disappear just as quickly. Often chronic pyelonephritis is accompanied arterial hypertension and insufficient functioning of the kidney itself.

Patients complain of pain in the lumbar region aching character, pain intensifies when performing physical activity. Patients pay attention to the fact that body temperature rises mainly at night, the number of urges to urinate increases, and blood pressure also increases.

Patients complain of poor sleep, headaches in the form of migraine attacks. Patients with a chronic form of the disease are prone to sudden changes emotional state. An objective examination in such patients can reveal swelling in the area lower limbs, rarely, upper limbs and facial area. Tissue swelling appears in the morning after sleep.

Symptoms characterizing urinary disorders:

• burning sensation during urination. This occurs due to an inflammatory process along the ureter;
• urine changes its color to darker and cloudier;
• the smell of urine becomes unpleasant and pungent;
• If there is stagnation of blood along the vessels supplying the urinary tract, red blood cells may appear in the urine.

Pyelonephritis in older people is extremely difficult, since the immune system unable to fight infection. The mortality of such patients is associated with the development of renal coma or septic shock.

Acute pyelonephritis, the symptoms of which develop suddenly and intensely, can be fatal in young people.

Unlike childhood signs of pyelonephritis in adults are more pronounced. In children under 12 years of age, the kidneys are not yet fully fixed in the retroperitoneal space and are topographically located lower, so pain from inflammation of the kidneys is localized in the abdomen and not the lower back.

Diagnosis of the disease

A doctor of urological specialization deals with the problems of treating pyelonephritis. In order to make a final diagnosis, it is necessary to carefully collect an anamnesis of the disease and life, to clarify with the patient whether he has previously suffered infectious diseases, whether surgical operations or medical manipulations on the pelvic organs have recently been performed.

After interviewing the patient, an objective examination is carried out, the condition is assessed skin, subcutaneous fat, muscle and bone apparatus. With pyelonephritis, one can objectively detect pallor of the skin and swelling in the lower extremities and face. On palpation it is noted positive symptom Pasternatsky.

Laboratory diagnostic methods are used to determine the inflammatory process in the human body and prove bacterial etiology diseases.

Laboratory methods include:

1. General clinical analysis urine: When culturing urinary sediment on a glass slide, an increase in the number of leukocytes and bacteria in the field of view is detected. Urine should normally be acidic in nature, but with infectious pathology it becomes alkaline;
2. General clinical blood test: all signs of an inflammatory process appear in the peripheral blood, the erythrocyte sedimentation rate increases and the number of leukocytes in the field of view increases significantly.

Additional laboratory research methods include urine culture for sterility and determination of the daily amount of urine.

Instrumental diagnostics are used to visualize the condition of the kidney tissue and assess the general condition of the abdominal organs. For this purpose the following is used:

1. Ultrasonography kidneys: on the ultrasound screen there is a pronounced expansion of the cavity of the renal pelvis, increased echogenicity of the organ parenchyma, the contours of the kidney become rough and uneven. Ultrasound examination helps determine the extent of damage and the size of the kidneys.
2. Survey urography: by using this method instrumental diagnostics on x-ray stones are visualized in the renal pelvis or ureter, which disrupts the outflow of urine. In the image, you can determine the exact location of the kidney and examine the contours of the organ. After pyelonephritis, scar changes in kidney tissue can be detected.
3. CT scan: this type diagnostics are used only for special medical indications and in case of suspected oncological pathology.
4. Radionuclide diagnostics are used quite rarely in medical practice, since there is a high risk of tissue irradiation and the development of serious complications.

Therapeutic measures

Kidney pyelonephritis should be treated comprehensively, including medications and physiotherapeutic methods. Complete treatment for kidney disease contributes to the patient’s speedy recovery from infectious pathology. The goal of drug treatment is aimed not only at destroying infectious agents and relieving symptomatic signs, but also at restoring the vital functions of the body while the disease pyelonephritis has progressed.

How pyelonephritis is treated has been known since the time Soviet Union, when penicillin was first discovered and the bacterial theory of the development of the disease was proven.

As medicinal method Treatments for pyelonephritis are:

1. Antibacterial drugs: in order to treat kidney pyelonephritis with antibiotics, it is first necessary to check the patient’s individual sensitivity to a certain subgroup of drugs. Medicines this group are intended for complete sanitation of the source of the infectious process, disposal bacterial flora from kidney tissue. This group of drugs may have some anti-inflammatory effect. Antibiotics should be prescribed with caution to women early stages pregnancy and children under 12 years of age. This is due to the fact that some antibacterial drugs have a pronounced teratogenic effect and inhibit the normal development of the fetus.
2. Diuretics are used to improve urine flow and eliminate swelling. The mechanism of action of diuretics is associated with an increase in the rate of release of accumulated metabolic products and microelements from the body. Diuretics are prescribed only for non-obstructive types of the disease, since under the influence of diuretics there is an increase in urine production, the outflow of which is already difficult in the obstructive form.
3. To eliminate the inflammatory process and relieve pain in the area of ​​the kidney projection, non-steroidal anti-inflammatory drugs are used. Drugs that stimulate the immune system can also be used to treat pyelonephritis. With the help of immunostimulants, the body's ability to respond to infectious lesion, the risk of complications such as sepsis is prevented.
4. For general strengthening The body uses drugs containing a complex of vitamins.

The difference in how to treat kidney pyelonephritis in children from how pyelonephritis is treated in adults is the choice of antibacterial drugs. The most dangerous are tetracyclines, as they contribute to abnormal development of the bones of the children's skeleton.

In modern times, treatment methods for kidney pyelonephritis using herbal medicine have been developed. Many medical experts claim that herbal medicine is a key and natural method of eliminating unpleasant symptoms and etiological factor. Use as medicinal substances infusions or decoctions of natural medicinal plants will not only significantly improve your general condition, but also prevent significant financial losses.

Plants such as rowan, plantain, strawberry and lingonberry have a pronounced anti-inflammatory, antibacterial, and diuretic effect. These plants are usually combined and used as an herbal tea.

Reading everything about pyelonephritis is not enough to independently treat the disease. It is important to remember that any drug in the wrong dosage can have an adverse effect on the body.

It should be noted that in childhood and adult pyelonephritis, symptoms and treatment differ due to anatomical features. Before a choice is made: how to treat pyelonephritis, the individual sensitivity of the body to certain drugs is determined. Depending on how long pyelonephritis is treated over time, the outcome of the disease will depend.

Surgical intervention for pyelonephritis

In order for surgery to be performed, special medical indications are required. The operation is performed if drug correction is no longer effective and there is a need to sanitation of the infectious focus and excision of irreversibly changed tissue. I guess surgical intervention A stone or tumor formation may be removed from the kidneys and ureters.

During the operation, the surgeon restores the lumen of the ureter, excises inflammatory tissue and installs drains for the outflow of purulent fluid. If the kidney parenchyma is significantly destroyed, an operation is performed - nephrectomy.

Operation is extreme case medical care for pyelonephritis

Preventive actions

Prevention of pyelonephritis is primarily necessary to prevent acute renal failure, which is often the main cause of death in patients with pyelonephritis. Prevention of pyelonephritis should be carried out using certain rules, compliance with which must be clear and without violations. Compliance with these rules does not require significant work; you just need to pay close attention to your own health and carry out treatment in the early stages of the pathological process.

In order not to lead yourself to pyelonephritis, prevention should be carried out taking into account certain rules:

1. Getting rid of bad habits, since alcohol and smoking significantly reduce the body’s immune properties, which inhibits the ability to respond to the penetration of bacteria and viruses into the body;
2. If pathological process infectious etiology is located in any other organs; it must be sanitized, since bacteria can spread to the kidneys with the help of blood;
3. Persons who are at risk of developing the disease should undergo regular laboratory and instrumental methods studies to prevent pyelonephritis.
4. The body must receive sufficient rest and sleep, since an exhausted body is not able to fight a bacterial infection;
5. The use of medicinal herbs as prophylaxis;

Compliance with these rules does not require significant work; you just need to pay close attention to your own health and carry out treatment in the early stages of the pathological process.

Complications of pyelonephritis

The severity of complications in chronic and acute pyelonephritis depends on how the treatment was carried out. Kidney disease pyelonephritis is a disease in which an inflammatory process occurs in the tissues of the urinary system. The danger to the patient’s life lies in the fact that significant progression of the disease can contribute to complete loss organ and dooming the patient to disability.

How is pyelonephritis dangerous? And the fact that after suffering an illness or during acute course The following complications may develop:

Kidney abscess - pathological condition, which is characterized by the development of a purulent focus inside the organ. People with chronic pathologies pancreas. Abscess formation is considered a life-threatening condition, as the infection can spread throughout the body. This complication can only be corrected with the help of surgical intervention and active drainage.

Pus in the kidneys - abscess

Symptomatic signs of a kidney abscess:

• a sharp increase in body temperature to a feverish state;
• sharp unbearable pain in the lumbar region and when urinating;
• aversion to food.

When palpating the lumbar region, sharp sensitivity and pain are detected, and a sharp enlargement of one kidney is determined compared to the other.

General blood poisoning- exactly this severe complication, which develops for any infectious process in the human body. The consequence of bacterial microorganisms entering the bloodstream is septic shock. To combat septic shock massive doses of antibacterial drugs are used. As a rule, patients in shock require intensive care and resuscitation.

The main symptomatic signs of sepsis:

• a sharp decrease in blood pressure;
• depression of the function of the central nervous system;
• feverish condition;
• inhibition of heart function, development of arrhythmia;
• acute respiratory failure.

Bacteriological shock- a condition that develops against the background of improper treatment, namely, taking antibacterial drugs in combination with diuretics for the obstructive type of acute or chronic pyelonephritis. Under the influence of diuretics, urine production increases, and under the influence of antibiotics, massive death of bacterial microorganisms occurs. As a result of this process, there is a massive release of endotoxins and the inability of the urinary organs to dispose of them in a timely manner.

To help patients:

• restoration of ureteral patency and restoration of urine outflow rate;
• To restore the concentration of blood proteins, patients are given a transfusion of fresh frozen plasma;
• Steroid drugs are used to prevent adrenal insufficiency;
• for improvement rheological properties heparin preparations are used in the blood.

Prognosis for recovery in acute pyelonephritis

With the help of modern methods of treatment, the duration of the infectious state is approximately 2 - 3 weeks. If it was produced incorrect treatment acute form or in an extremely neglected state - in best case scenario a chronic process develops, and in the worst case - sepsis, acute renal failure, abscess, peritonitis, bacteriological shock and death.

The prognosis for a full recovery depends on how promptly the treatment was carried out and when seeking medical help. In the case of the chronic form of the disease, the prognosis for recovery is unsatisfactory, since this form is characterized by periodic relapses of the disease, and subsequently provokes the development of acute renal failure. As a rule, such patients may not expect a full recovery.

According to statistics, acute pyelonephritis as a kidney disease is one of the most common infectious pathologies and today it is successfully amenable to medicinal correction. The only problem in medical practice is the actual lateness of patients seeking medical help.

According to statistics, 20% of the population suffers from pyelonephritis and this number does not include those who ignore the disease and do not seek help from doctors. Such inaction can lead to serious damage to the kidneys, and the disease develops into a chronic disease.

Treatment of pyelonephritis is a long process, which can sometimes last several years, and if it is not completed, it becomes chronic. Chronic pyelonephritis can be treated at home using folk remedies and antibiotics.

Symptoms of exacerbation of chronic pyelonephritis:

• a sharp jump – up or down – in blood pressure;
• feverish condition;
• nausea;
• vomit.

Attention! In this case, you need to immediately contact a medical facility!

Treatment of chronic pyelonephritis

Treatment of chronic pyelonephritis includes a number of comprehensive measures: medications, diets, and the use of folk remedies at home. As doctors note: this is the only way to achieve a significant result and recover.

Treatment with medications

Attention! Treatment with medications at home only after consulting a doctor!

The main task of medications is to eliminate the causative agent of the disease as quickly as possible with minimal nephrotoxicity and maximum efficiency. For this purpose, complex drugs are prescribed: antibiotics and uroseptics. Here is a list of the most common drugs that are still effectively used in medicine:

1. Penicillins: Benzylpenicillin, Methicillin, Ampicillin, Dicloxacillin and others.
2. Cephalosporins: Cefazolin, Cefriaxon, Suprax, Cedex, etc.
3. Fluoroquinolones: Levofloxacin, Gentamicin, Amikacin, Ofloxacin.

Remember that the duration of treatment with one course of medications for chronic pyelonephritis lasts for two weeks, then you need to take tests and find out the result. It is recommended that after each course, the medications be replaced with others in order to select the most suitable medications.

Attention! When taking medications, pay attention to the dosage, side effects, and in the case allergic reaction components, replace them with others.

Treatment with folk remedies at home

Treatment of chronic pyelonephritis at home folk remedies cannot in any way replace the use of medications. On the contrary, folk herbal tinctures only improve their effect and together they effectively fight the causative agent of the disease.

Herbal treatment

Collect a mixture of herbs in a ratio of 3:1:1 - bearberry leaves, cornflower flowers and licorice root, and brew it. For one dose per day, 1 tbsp is enough. l. for 250 ml of boiling water. After the herb has been infused for 30 minutes, you can drink 30 ml three times a day.

Rose hips 20 g, birch leaves, corn silk, horsetail - 10 g each, mix and pour 400 ml of boiling water. Take 100 ml before meals, after leaving for 30 minutes.

Take 100 g of dry cornflower (spreading cornflower) and chop thoroughly, pour boiling water (0.200 ml) and bring to a boil. After the herb has infused well for 30 minutes, strain and can be taken 3 times before meals. It is recommended to continue the course of treatment with this herb for one month, then take a break for a month. In chronic pyelonephritis, the cycle ranges from one to two years. Already after the first appointments, pain and aggravation will be relieved.

Treatment of chronic pyelonephritis in pregnant women and children

Attention! Expectant mothers and children are strictly prohibited from taking medications without the supervision and consultation of the attending physician!

The whole difficulty in identifying pyelonephritis in pregnant women lies in the anatomical feature: the uterus puts pressure on the bladder and kidneys. Kidney disease hurts lumbar region, frequent urination, swelling of the hands or feet, but all these symptoms can accompany pregnancy. Therefore, only a urine test will help identify pyelonephritis in pregnant women.

In children, in addition to the external manifestations of the disease, it is worth paying attention to the urine - in chronic pyelonephritis it is cloudy, with a rich yellow and after a while the sediment settles.

Treatment with folk remedies

Propolis

Take 20 g of propolis and chop well, melt 50 g of butter and mix everything. The resulting pulp should be consumed 3 times daily, half a teaspoon.

Prepare propolis oil. To do this, grind the pre-cooled propolis to a powder and pour it into 100 ml vegetable oil, preheated to 80C. Mix thoroughly and leave for at least one hour. Take 1 tsp an hour before meals.

Oats

It is necessary to cook a glass of oats in one liter of milk over low heat until the amount of liquid is reduced by half. Consume the resulting jelly 1/3 cup after meals.

In the treatment of chronic pyelonephritis, various diuretic herbs are very effective. They not only produce well excess water from the body, but also contribute to the fight against viral infection.

Bird knotweed

Rinse the herb leaves well and grind them in a meat grinder, pour enough water into the resulting mass to make a puree, and leave for 20 minutes. After this, strain and consume 100 g before meals.

Birch buds

Take 50 g of dried birch buds and pour 250 g boiled water, leave for 30 minutes. The tincture works well as a diuretic if taken 100 g in the morning and evening.

Dill

Everyone knows Dill water, which is most often given to young children, has a healing effect on the body's kidneys. It is easy to prepare it at home; to do this, take 100 g of dry herb, pour 500 ml of boiling water and leave in an airtight container for 30-40 minutes. Take 100 g daily on an empty stomach for one month.

No less effective are diuretic tinctures, which can be made from parsley root, corn silk, bear ears.

Herbal collection No. 1

Take the following herbs in equal proportions: calamus, flax, bearberry, mix and pour boiling water at the rate of 50 g of mixture - 500 ml of water. Boil for 5–10 minutes, leave for half an hour and take 100 ml twice a day.

Herbal collection No. 2

To prepare the tincture, you need to take the following set of herbs in the same ratio:

• juniper fruits;
• liquorice root;
• knotweed;
• bearberry leaves;
• yarrow;
• sage;
• oat straw;
• white claret.

Mix all the herbs that you have previously crushed. To prepare a one-time tincture, take 10 g of the mixture, pour a glass of boiling water and leave to steep for at least four hours. Then you should boil the tincture and cook in a water bath for 10 minutes, cool to room temperature and take 100 g after meals.

Collection No. 3

A unique collection known to our grandmothers, which helps well with all inflammatory processes in the kidneys. Acts as a diuretic and anti-inflammatory agent. Take the ingredients in equal parts and mix them well:

• cowberry;
• cornflower flowers;
• nettle;
• flax seeds;
• strawberries;
• coltsfoot.

Grind all the herbs thoroughly into powder; you will need 1 tsp per half liter of water. mixtures. Leave in an airtight container for at least 8 hours, and take 100 ml after meals. Continue the course of treatment with this mixture for one month, then take a break.

Diet

1. Monday: Lenten borscht, pearl barley porridge, cucumber, boiled potatoes, rice, beets.
2. Tuesday: soup buckwheat, tomato, boiled beef, tea, oatmeal.
3. Wednesday: borscht, boiled potatoes, vegetable salad, semolina porridge.
4. Thursday: meat pudding, cottage cheese, sour cream, soup, jelly.
5. Friday: soup wheat porridge, omelette, vegetables, boiled veal.
6. Saturday: cabbage salad, cucumber, borscht, rice porrige, boiled fish.
7. Sunday: tomatoes, soup, pearl barley porridge, boiled potatoes, meatballs.

In conclusion…

I would like to add that treatment of chronic pyelonephritis should be accompanied by diet. Create your menu for the week, from which exclude spicy, bitter, sour foods; fried, fatty foods, as well as chocolate.

Drink more liquid, the norm per day is from 2 liters, in summer period eat more watermelons, melons, fruits. And be healthy!

Pyelonephritis is an acute or chronic kidney disease that develops as a result of the influence of certain causes (factors) on the kidney that lead to inflammation of one of its structures, called the pyelocaliceal system (the structure of the kidney in which urine accumulates and is excreted) and adjacent to this structure, tissue (parenchyma), with subsequent dysfunction of the affected kidney.

The definition of "Pyelonephritis" comes from the Greek words ( pyelos- translated as, pelvis, and nephros-bud). Inflammation of the kidney structures occurs in turn or simultaneously, it depends on the cause of pyelonephritis, it can be unilateral or bilateral. Acute pyelonephritis appears suddenly, with severe symptoms(pain in the lumbar region, fever up to 39 0 C, nausea, vomiting, difficulty urinating), with proper treatment after 10-20 days, the patient fully recovers.

Chronic pyelonephritis is characterized by exacerbations (most often in the cold season) and remissions (symptoms subside). Its symptoms are mild, most often it develops as a complication acute pyelonephritis. Often chronic pyelonephritis is associated with any other disease of the urinary system (chronic cystitis, urolithiasis, abnormalities of the urinary system, prostate adenoma and others).

Women, especially young and middle-aged women, get the disease more often than men, approximately in a ratio of 6:1, this is due to the anatomical features of the genital organs, the onset of sexual activity, and pregnancy. Men more often develop pyelonephritis at an older age; this is most often associated with the presence of prostate adenoma. Children also get sick, more often early age(up to 5-7 years), compared to older children, this is due to the body’s low resistance to various infections.

Kidney anatomy

The kidney is an organ of the urinary system that is involved in removing excess water from the blood and products released by body tissues that are formed as a result of metabolism (urea, creatinine, medications, toxic substances and others). The kidneys remove urine from the body, further along the urinary tract (ureters, bladder, urethra), it is released into the environment.

The kidney is a paired organ, bean-shaped, dark brown, located in the lumbar region, on the sides of the spine.

The weight of one kidney is 120 - 200 g. The tissue of each kidney consists of the medulla (in the shape of pyramids), located in the center, and the cortex, located along the periphery of the kidney. The tops of the pyramids merge in 2-3 pieces, forming renal papillae, which are covered by funnel-shaped formations (small renal calyces, on average 8-9 pieces), which in turn merge in 2-3 pieces, forming large renal calyces (on average 2-4 in one kidney). Subsequently, the large renal calyces pass into one large renal pelvis (a cavity in the kidney, funnel-shaped), which in turn passes into next body urinary system, called the ureter. From the ureter, urine flows into the bladder (a reservoir for collecting urine), and from it through the urethra to the outside.

It is accessible and understandable about how the kidneys develop and work.
Inflammatory processes in the calyces and pelvis of the kidney are called pyelonephritis.

Causes and risk factors in the development of pyelonephritis

Features of the urinary tract
Congenital anomalies (improper development) of the urinary system	R develop as a result of exposure to the fetus during pregnancy unfavorable factors(smoking, alcohol, drugs) or hereditary factors (hereditary nephropathy, resulting from mutation of the gene responsible for the development of the urinary system). Congenital anomalies leading to the development of pyelonephritis include the following malformations: narrowing of the ureter, underdeveloped kidney (small), prolapsed kidney (located in the pelvic region). The presence of at least one of the above defects leads to stagnation of urine in renal pelvis, and disruption of its excretion into the ureter, this is a favorable environment for the development of infection and further inflammation of the structures where urine has accumulated.
Anatomical features structure of the genitourinary system in women	In women, compared to men, the urethra is shorter and larger in diameter, so sexually transmitted infections easily penetrate the urinary tract, rising to the level of the kidney, causing inflammation.
Hormonal changes in the body during pregnancy
The pregnancy hormone, progesterone, has the ability to reduce the tone of the muscles of the genitourinary system, this ability has, positive effect(prevention of miscarriages), and a negative effect (impaired urine outflow). The development of pyelonephritis during pregnancy is caused by impaired outflow of urine (a favorable environment for the proliferation of infection), which develops as a result hormonal changes, and compression of the enlarged (during pregnancy) uterus of the ureter.
Reduced immunity
The task of the immune system is to eliminate all substances and microorganisms foreign to our body; as a result of a decrease in the body's resistance to infections, pyelonephritis can develop. Young children under 5 years old get sick more often because their immune system is not sufficiently developed compared to older children. Pregnant women normally have a decreased immune system; this mechanism is necessary to maintain pregnancy, but is also a favorable factor for the development of infection. Diseases that are accompanied by a decrease in immunity, for example: AIDS, cause the development of various infectious diseases, including pyelonephritis.
Chronic diseases genitourinary system
Urinary tract stones or tumors, chronic prostatitis	lead to impaired urine excretion and stagnation;
Chronic cystitis	(inflammation of the bladder), in case of ineffective treatment or its absence, the infection spreads along the urinary tract upward (to the kidney), and its further inflammation.
Sexually transmitted infections of the genital organs	Infections such as chlamydia, trichomoniasis, when penetrating through the urethra, enter the urinary system, including the kidney.
Chronic foci of infection	Chronic amygdalitis, bronchitis, intestinal infections, furunculosis and other infectious diseases are a risk factor for the development of pyelonephritis . In the presence of a chronic focus of infection, its causative agent (staphylococcus, Escherichia coli, Pseudomonas aeruginosa, candida and others) can enter the kidneys through the bloodstream.

Symptoms of pyelonephritis

• burning and pain during urination, due to inflammation in the urinary tract;
• need in frequent urination than usual, in small portions;
• beer-colored urine (dark and cloudy) is the result of the presence of a large number of bacteria in the urine,
• bad smell urine,
• often the presence of blood in the urine (stagnation of blood in the vessels, and the release of red blood cells from the vessels into the surrounding inflamed tissues).

1. Pasternatsky's symptom is positive - when a light blow is applied to the lumbar region with the edge of the palm, pain appears.
2. Edema occurs in the chronic form of pyelonephritis, in advanced cases(untreated), most often appear on the face (under the eyes), legs, or other parts of the body. Swelling appears in the morning, soft, dough-like consistency, symmetrical (the left and right sides of the body are the same size).

Diagnosis of pyelonephritis

General urine analysis - indicates deviations in the composition of urine, but does not confirm the diagnosis of pyelonephritis, since any of the deviations may be present in other kidney diseases.
Correct urine collection: In the morning, the external genital organs are toileted, only after this the morning, first portion of urine is collected in a clean, dry container (a special plastic cup with a lid). Collected urine can be stored for no more than 1.5-2 hours.

Indicators of general urine analysis for pyelonephritis:

• High level of leukocytes (normally in men there are 0-3 leukocytes in the field of view, in women up to 0-6);
• Bacteria in urine >100,000 per ml; the excreted urine is normal and must be sterile, but when collecting it, hygienic conditions are often not observed, so the presence of bacteria up to 100,000 is allowed;
• Urine density
• Urine pH is alkaline (normally acidic);
• The presence of protein, glucose (normally they are absent).

Urinalysis according to Nechiporenko:

• Leukocytes are elevated (normally up to 2000/ml);
• Red blood cells are elevated (normally up to 1000/ml);
• Presence of cylinders (normally they are absent).

Bacteriological examination of urine: used when there is no effect from the accepted course of antibiotic treatment. A urine culture is performed to identify the causative agent of pyelonephritis, and in order to select an antibiotic sensitive to this flora for effective treatment.

Kidney ultrasound: is the most reliable method for determining the presence of pyelonephritis. Determines different sizes of kidneys, a decrease in the size of the affected kidney, deformation of the collecting system, identification of a stone or tumor if present.

Excretory urography, is also a reliable method for detecting pyelonephritis, but compared to ultrasound, it is possible to visualize the urinary tract (ureter, bladder), and if there is a blockage (stone, tumor), determine its level.

CT scan, is selection method, with Using this method, you can assess the degree of damage to the kidney tissue and identify if complications are present (for example, the spread of the inflammatory process to neighboring organs)

Treatment of pyelonephritis

Drug treatment of pyelonephritis

1. Antibiotics, are prescribed for pyelonephritis; based on the results of a bacteriological examination of urine, the causative agent of pyelonephritis is determined and which antibiotic is sensitive (suitable) against this pathogen.

Therefore, self-medication is not recommended, since only the attending physician can select the optimal medications and the duration of their use, taking into account the severity of the disease and individual characteristics.
Antibiotics and antiseptics in the treatment of pyelonephritis:

• Penicillins(Amoxicillin, Augmentin). Amoxicillin orally, 0.5 g 3 times a day;
• Cephalosporins(Cefuroxime, Ceftriaxone). Ceftriaxone intramuscularly or intravenously, 0.5-1 g 1-2 times a day;
• Aminoglycosides(Gentamicin, Tobramycin). Gentamicin intramuscularly or intravenously, 2 mg/kg 2 times a day;
• Tetracyclines (Doxycycline, 0.1 g orally 2 times a day);
• Levomycetin group(Chloramphenicol, 0.5 g orally 4 times a day).

• Sulfonamides(Urosulfan, 1 g orally 4 times a day);
• Nitrofurans(Furagin, orally 0.2 g 3 times a day);
• Quinolones(Nitroxoline, 0.1 g orally 4 times a day).

1. Diuretics: prescribed for chronic pyelonephritis (to remove excess water from the body and possible edema), and not prescribed for acute pyelonephritis. Furosemide 1 tablet 1 time per week.
2. Immunomodulators: increase the body's reactivity in case of illness, and to prevent exacerbation of chronic pyelonephritis.

• Timalin, intramuscularly 10-20 mg 1 time per day, 5 days;
• T-activin, intramuscularly 100 mcg once a day, 5 days;

1. Multivitamins , (Duovit, 1 tablet 1 time per day), Ginseng tincture – 30 drops 3 times a day, also used to improve immunity.
2. Nonsteroidal anti-inflammatory drugs (Voltaren), have an anti-inflammatory effect. Voltaren orally, 0.25 g 3 times a day, after meals.
3. To improve renal blood flow, these drugs are prescribed for chronic pyelonephritis. Chime, 0.025 g 3 times a day.

Herbal medicine for pyelonephritis

Herbal medicine for pyelonephritis is used as an addition to drug treatment, or to prevent exacerbation of chronic pyelonephritis, and is best used under the supervision of a physician.

Cranberry juice has antimicrobial effect, drink 1 glass 3 times a day.

Bearberry decoction has an antimicrobial effect, take 2 tablespoons 5 times a day.

Boil 200 g of oats in one liter of milk, drink ¼ glass 3 times a day.
Kidney collection No. 1: A decoction of a mixture (rose hips, birch leaves, yarrow, chicory root, hops), drink 100 ml 3 times a day, 20-30 minutes before meals.
It has a diuretic and antimicrobial effect.

Collection No. 2: bearberry, birch, hernia, knotweed, fennel, calendula, chamomile, mint, lingonberry. Finely chop all these herbs, add 2 tablespoons of water and boil for 20 minutes, take half a glass 4 times a day.