Secondary pyelonephritis in children. Causes of development and treatment of pyelonephritis in children. Can be used at home

Pyelonephritis– inflammatory process in the kidneys and renal pelvis– the most common disease among children, second in frequency only to inflammatory diseases of the upper respiratory tract. Widespread incidence among young children childhood, transition to a chronic form and the possibility of irreversible consequences make it possible to consider this disease a very serious pathology that requires a careful approach to treatment, both from the doctor and from the parents.

Aware means armed! Suspecting the disease in time is already half the success of recovery!

Pyelonephritis in children, like any inflammatory disease, are caused by microorganisms (bacteria) that in various ways enter the kidney and begin to actively reproduce. According to the etiology and pathogenesis of pyelonephritis, in the vast majority of cases the disease is caused by Escherichia coli, which is carried into the kidney through the bloodstream from a source of chronic infection, the role of which is most often played by carious teeth, chronic tonsillitis(sore throat) and otitis media (ear inflammation). In more in rare cases the infection comes from the bladder or external genitalia. This is precisely the reason for the fact that girls, due to their short urethra, suffer from pyelonephritis and cystitis 3 times more often than boys.

However, in normal conditions The child’s body is able to cope with microorganisms. The main reason The development of inflammation is considered to be a decrease in immunity when the body's defenses are unable to fight infection.

There are many reasons leading to a decrease in immunity, the main of which are:

• Complications during pregnancy and childbirth
• Short-lived breast-feeding, early introduction complementary foods
• Lack of vitamins
• Chronic inflammatory diseases of the respiratory tract and ENT organs
• Hereditary predisposition

There are so-called critical periods of child development when the body is most vulnerable to the effects of infectious agents:

• From birth to 2 years
• From 4-5 to 7 years
• Teenage years

Classification of pyelonephritis

Based on the causes of the disease, pyelonephritis is divided into primary and secondary. Primary pyelonephritis develops in almost healthy child against the background of complete well-being, secondary, in turn, occurs with congenital anatomical anomalies of the kidneys, bladder and urethra, when stagnation of urine provides the prerequisites for the active proliferation of bacteria.

There are two forms of pyelonephritis: acute and chronic. Acute pyelonephritis in children occurs more violently with symptoms of severe intoxication, but with proper treatment most often ends in complete recovery. In some cases acute form can become chronic, which is characterized by periodic exacerbations, lasts a very long time (up to old age) and leads to irreversible complications.

The main symptoms of pyelonephritis in children

The peculiarity of pyelonephritis in children is that, depending on age, the symptoms of the disease manifest themselves differently. It is not difficult to suspect signs of pyelonephritis in a child; usually the disease occurs with characteristic manifestations, the only exception is children younger age.

Children under 1 year

Pyelonephritis in children under one year of age usually has the following symptoms:

• Increase in temperature to 39-40 without signs of inflammation of the respiratory tract
• Anxiety and sleep disturbance
• Decreased appetite

An increase in temperature to high levels without any reason should immediately alert both parents and the doctor to the presence of pyelonephritis in the child. The temperature with pyelonephritis is difficult to treat with antipyretic drugs and can remain at high levels for several days.

Children from 1 year to 5 years

In children under 5 years of age, along with high temperature abdominal pain appears without specific localization, nausea, sometimes vomiting. The child is restless and cannot clearly indicate the place where it hurts.

Over 5 years old

Typical symptoms from the urinary system appear only after 5-6 years of age, when the child begins to be bothered It's a dull pain in the lumbar and suprapubic region and pain when urinating.

Thus, the “typical” set of symptoms of acute pyelonephritis in children over 5 years of age includes the following:

• Acute increase in body temperature to 39-40C. It's important to remember that distinctive feature kidney inflammation from colds the absence of inflammation of the respiratory tract is considered (runny nose, cough, sore throat, sore throat, ear pain). The temperature is rising in the background full health immediately to high levels.
• Symptoms of general intoxication - the child becomes lethargic, capricious, refuses food. Attacks of chills are replaced by attacks of fever. Often, against the background of temperature, it appears headache.
• Symptoms from the urinary system - as a rule, on the second day after the temperature rises, a constant aching pain appears in the lumbar region(usually all on one side), pain in the suprapubic region, pain when urinating. With concomitant cystitis, the urge to urinate becomes frequent up to 20 or more times a day.
• Urine with pyelonephritis in a child is visually dark, cloudy, foamy, sometimes with a reddish tint (due to the presence of blood in it).

Despite the severe course of acute pyelonephritis, with timely treatment medical care and proper treatment, the disease has a favorable outcome. However, often the acute form becomes chronic.

Chronic pyelonephritis

Pyelonephritis is considered chronic if it lasts more than 1 year and has 2 or more episodes of exacerbation over a period of time. this period. This form is an alternation of periodically recurring exacerbations (especially in the spring-autumn period) and asymptomatic periods. The manifestations of the chronic form are the same as those of the acute form, only most often less pronounced. The course of chronic pyelonephritis is slow and long-lasting. At frequent exacerbations, improper treatment and lack of prevention, the disease can lead to such a serious complication as renal failure.

Set of diagnostic measures

It is not difficult for an experienced doctor to diagnose “Pyelonephritis,” especially if there have already been episodes of the disease in the medical history. Usually, diagnosis of pyelonephritis in children necessarily includes general analysis urine, general blood test, urine culture for microflora and ultrasound of the kidneys. If there are bacteria and leukocytes in the urine, and with a corresponding ultrasound picture, the doctor can already make an appropriate diagnosis.

Video lecture. Pyelonephritis in children. "Medical Bulletin":

Treatment of pyelonephritis in children

Basic principles of treatment

It is important to understand that the treatment of any disease, especially something as serious as pyelonephritis, is not limited to medications. Treatment is a wide range of measures aimed not only at eliminating the cause of the disease, but at preventing subsequent relapses (exacerbations).

Treatment of any inflammatory kidney diseases is complex and consists of the following components:

1. Mode
2. Diet
3. Drug therapy
4. Physiotherapy and physiotherapy

You should always strictly follow all doctor’s recommendations for get well soon and relapse prevention.

Mode

During pronounced manifestations diseases recommended bed or floor bed rest. About studying, walking and, especially, sports training need to forget for a while. In the second week of the illness, when the temperature drops significantly and the lower back pain goes away, the regimen can be expanded, but it will be much better if the child spends the entire period of the illness at home.

Diet

Diet for pyelonephritis in children, as well as in adults, is an integral attribute of successful recovery. Spicy, salty, fried foods should be excluded from the child’s diet, and foods high in protein should be limited. On days 7-10 of the acute form, it is necessary to switch to a lactic acid diet with incomplete restriction of salt and protein. Also recommended drinking plenty of fluids(compotes, fruit drinks, weak tea), and in case of chronic pyelonephritis (during periods of remission), it is mandatory to drink slightly alkaline mineral waters.

Drug therapy

a) Antibiotics

All inflammatory diseases are treated with special antimicrobials(antibiotics), and childhood pyelonephritis- not an exception. However, under no circumstances should you engage in self-treatment child - antibiotics are prescribed only by a doctor(!), who is able to take into account all the criteria for selecting a drug, based on the severity of the disease, age and individual characteristics child. Treatment of acute and treatment of chronic pyelonephritis in children is carried out according to the same principles.

Antibiotics for pyelonephritis in children are represented by a relatively small range, since many antibiotics are contraindicated under 12 or 18 years of age, so specialists usually prescribe the following groups of drugs:

• Protected penicillins (Augmentin, Amoxiclav). In addition to the usual tablets, these antibiotics are available in the form of a sweet suspension for young children, and the dosage is done using a special measuring syringe or spoon.
• Antibiotics of the cephalosporin group, which most often come only in injections, so they are used for inpatient treatment(Cefotaxime, Cefuroxin, Ceftriaxone). However, some also exist in the form of suspension, capsules and soluble tablets(Cedex, Suprax).
• Aminoglycosides (Sumamed, Gentamicin) and carbapenems also occur in rare cases, but most often they are used as an alternative and as part of combination therapy.

In severe cases, the doctor may use several antibiotics at once. different groups (combination therapy) to get rid of the infectious pathogen as soon as possible. Sometimes one antibiotic has to be replaced with another, and this happens in the following cases:

• If 2-3 days after taking the drug the condition has not improved or, on the contrary, has worsened, and the temperature continues to remain at the same levels
• At long-term treatment more than 10-14 days. In this case, the doctor must replace the antibiotic to prevent the child’s body from developing an addiction to this drug.

b) Uroseptics

Drug therapy is not limited only to antibiotics - there are other important groups of drugs, for example, uroantiseptics (nalidixic acid). They are prescribed after a course of antibiotics for children over 2 years of age.

c) Vitamins and immunomodulators

Having completed the course of basic treatment, it is imperative to restore weakened immunity after illness. For this purpose, immunomodulators (Viferon, Reaferon) and a complex of multivitamins are usually prescribed according to the child’s age.

d) Herbal treatment

Herbal medicine for kidney diseases has long proven its effectiveness, but it can only be carried out in combination with basic medications. Well proven bear ears, bearberry, Birch buds, horsetail. These plants have anti-inflammatory and antiseptic effect, however, they need to be taken over a long period of time.

Features of inpatient treatment

Treatment of pyelonephritis in children under one year of age is carried out only(!) in a hospital under close supervision medical personnel. Older children with moderate or severe cases are also required to be hospitalized. It is advisable to always treat acute pyelonephritis in children over 10 years of age in a hospital (even if mild degree gravity) in order to carry out the complex on time diagnostic procedures and identify the cause of the disease.

In the hospital the child will receive everything necessary help in full

Nursing care for pyelonephritis in children includes measures to monitor adherence to the regime during fever (especially important for children 3-10 years old), monitoring diet, carrying out timely hygiene and other measures that ensure the creation comfortable conditions for a speedy recovery of the child.

Often the choice of treatment is made together with a pediatric urologist surgeon to timely resolve the issue of eliminating anatomical abnormalities if secondary acute or secondary chronic pyelonephritis in children.

Physiotherapy and exercise therapy

Physiotherapy depends on the severity of the disease, and is most often prescribed by a physiotherapist after the course of primary treatment, when the child’s condition returns to normal. Well proven ultrasonic methods, UHF therapy, magnetic therapy. Also when subsiding inflammatory process Physical therapy is indicated in a lying or sitting position, depending on the age and condition of the child.

Preventive actions

Prevention of pyelonephritis in children plays an important role in both acute and chronic form diseases. It is divided into primary and secondary.

Primary prevention (preventing the development of the disease) includes timely elimination of foci of chronic infection (carious teeth, chronic otitis media and tonsillitis), strengthening the immune system and avoiding hypothermia, personal hygiene (especially careful hygiene of the external genitalia).

Secondary implies the prevention of exacerbations and includes the doctor’s recommendations: compliance with anti-relapse therapy, systematic observation, as well as all of the above primary prevention measures.

Dynamic observation

Both acute and chronic pyelonephritis in children are suspected dynamic observation at pediatric urologist, nephrologist or pediatrician with periodic urine examination and kidney ultrasound:

— After an acute episode or an episode of exacerbation of a chronic one – once every 10 days

— During remission — once a month

— In the first 3 years after treatment – ​​once every 3 months

– Up to 15 years – 1 or 2 times a year

Systematic observation will help avoid long-term complications of the disease: chronic renal failure, arterial hypertension, urolithiasis.

Pyelonephritis in children is an inflammatory process of the kidneys caused by infection. Pathology is one of the four most common childhood diseases (together with infectious diseases, digestive and respiratory system). Children under 7 years of age are most susceptible to pyelonephritis. Moreover, girls get sick 3 times more often than boys. This fact is related to the features female body. Urethra in girls it is wider, which allows bacteria to enter the bladder and kidneys.

There are two forms of pathology: chronic and acute. Acute pyelonephritis is accompanied elevated temperature, chills, headache, nausea. Pyelonephritis in older children often occurs with pain in the lumbar region, which appears constantly or periodically, sometimes radiating to the groin area. The chronic form is an untreated acute process; it occurs with periodic exacerbations (symptoms are the same as for an acute disease) and asymptomatic periods.

There are two types of pyelonephritis:

• Secondary. Occurs as a result of stagnation of urine caused by pathological changes genitourinary system(congenital anomalies of the structure of the kidneys or bladder).
• Primary. Its appearance is not associated with residual fluid in bladder, but is caused by other reasons (infection entering through the urethra or along with the blood).

Reasons for the development of the disease

The baby's body is not able to resist many bacteria. In addition, children under 4 years of age are physiologically unable to completely empty their bladder. Residual fluid in the bladder favors the growth of bacteria. Often the source of infection becomes some chronic lesion: tonsillitis, caries, etc.

What can cause pyelonephritis in children:

• Intrauterine infection.
• An infection that has entered the kidneys along with blood from other areas of inflammation.
• An ascending infection that has ascended to the kidneys through the urethra.
• Weak immunity.
• Long-term use of antibiotics.
• Chronic diseases.
• Diseases of the urinary system.

Symptoms of the disease

Acute pyelonephritis usually begins with sharp jump temperature, chills, sweating, headache, nausea. Insidiousness acute process is that young children do not always experience pain when urinating and heaviness in the back. These symptoms characteristic of pathology are observed only in patients over 5 years of age. Signs of pyelonephritis in children are very diverse.

For example, at infants the only manifestation of the pathology may be prolonged jaundice.

Most probable signs illnesses in children, symptoms of intoxication appear:

• Temperature 38-40°C.
• Lethargy.
• Poor appetite.
• Nausea.
• Restless sleep.

The chronic form occurs in the form of exacerbations, recurring 1-2 times a year. Exacerbations are replaced by asymptomatic or sluggish periods. During relapses, symptoms of an acute process are observed. Often chronic course The disease is accompanied by infectious asthenia (irritability, fatigue, deterioration in school performance).

Diagnosis of the disease

A full range of examinations is carried out. To identify the activity of inflammatory processes, a general blood and urine test and urine culture are prescribed. In addition, urine culture is performed to determine the presence and quantity of bacteria. General tests are done at least once a week.

Other studies:

• Ultrasound of the kidneys and urinary tract.
• X-ray of the kidneys.
• Excretory urography (a type of radiography that allows you to get a more detailed picture of the changes).
• Measuring the volume of urine excreted.

Recently, there has been a tendency towards pathology with a latent (hidden) or mildly symptomatic course. This makes it difficult to recognize not only chronic, but also acute pyelonephritis.

As a result, the disease can be discovered by chance, when going to the hospital for another reason.

Possible complications

Complications of the disease in children begin only with incorrectly selected treatment. Inflammation can progress to purulent form with the formation of multiple abscesses in the kidney or one large carbuncle. The disease is accompanied by dehydration and refusal to eat. Without emergency treatment, renal dysfunction begins.

Other complications:

• Kidney failure.
• Urolithiasis disease.
• Increased pressure.

Treatment

Pathology begins to be treated by suppressing the pathogen. Antibiotics, uroseptics, and herbal medicine are actively used. Antibacterial drugs are used individually, taking into account the sensitivity of bacteria. At the first stage of treatment, before the results of the urine bacteriogram appear, effective antibiotics general action. If the disease is caused by a disturbance in the flow of urine, it is necessary to restore it (catheterization, surgery in case of urolithiasis).

After a course of antibiotics, treatment is continued with uroseptics. At severe forms diseases, mixed therapy is practiced (several different antibacterial drugs). At severe pain antispasmodics are prescribed. Since antibiotics inhibit the intestinal microflora, after each course of antibiotics restorative therapy is carried out to prevent dysbiosis.

Diet for pyelonephritis in children:

• A large amount of liquid, in addition to water, it is recommended to drink fruit drinks and juices from sour berries (currants, cranberries).
• Dairy products.
• Fruits, vegetables, cereals.
• During an exacerbation, it is necessary to reduce the consumption of protein foods and completely eliminate meat from the diet.
• It is forbidden to eat salty, spicy and pickled foods.

Prevention

Prevention of pyelonephritis in children mainly consists of measures aimed at improving the health of frequently ill and weak children. It should be borne in mind that pyelonephritis most often occurs in children with chronic infections in organism. The cause of the pathology can be tonsillitis, adenoids, sinusitis, inflammation internal organs(gallbladder, stomach, etc.).

Flu and caries can also cause pyelonephritis. Therefore, parents should monitor the child’s health and promptly treat chronic diseases.

Stagnant urine is a favorable environment for reproduction pathogenic bacteria. Parents need to monitor the normal flow of urine in a young patient. To do this, the child must empty the bladder regularly (every 2-3 hours) and drink more fluids. In addition to water, you can give your child juices and fruit drinks made from sour berries, such as cranberries. Acidic environment prevents the growth of bacteria. In addition, cranberries are a powerful natural antiseptic.

Undeveloped the immune system child is the reason for penetration various infections into the body. The site of infection is often the genitourinary organs.

Pyelonephritis (PN) is an inflammatory kidney disease caused by bacterial infections.

Spa treatment helps to completely restore kidney function. It is carried out in specialized sanatoriums - Essentuki, Zheleznovodsk and others no less than 3 months after recovery.

Conclusion and complications

Treatment of relapses is carried out in the same way as acute illness. The most important thing is to determine the cause of infection and identify problems in the structure of the kidneys. During the period of remission, control tests and planned courses of anti-relapse therapy are necessary.

The course includes admission small doses antibiotics and uroseptics, drugs to maintain immunity, herbal medicine courses. Children are registered with a pediatrician or nephrologist before transferring to an adult clinic.

This is why doctors often insist on hospitalization. This promotes timely compliance with bed rest and diet.

Teenagers sometimes ignore taking pills at home, and the dose they receive turns out to be insufficient to eliminate inflammation and destroy pathogens. A complication of PN can be purulent inflammation of the kidney tissue, in severe cases renal failure develops.

Disease Prevention

For babies, regular diaper changes are necessary. Reducing exposure to urine will reduce the risk of developing PI.

Measures to prevent PN and the development of exacerbations include:

• regular urination and bowel movements, prevention of constipation;
• genital hygiene;
• fight against dysbacteriosis;
• timely treatment of inflammatory processes;
• compliance with the drinking regime;
• strengthening the immune system;
• compliance with the vaccination schedule.

Dietary requirements

The diet for PN is aimed at reducing the load on the kidneys and getting the right amount of fluid.

Healthy foods:

• dairy and fermented milk, cottage cheese;
• vegetables and fruits;
• lean meats, fish;
• vegetable oil.

Prohibited foods include many of the things children love: carbonated drinks, fast food, sweets confectionery, sweets, salty, spicy, smoked foods, canned food.

It is necessary to reduce the consumption of salt and sugar.

Parents need to think about how to replace their favorite sweets. Children will enjoy fruit drinks made from natural or frozen berries and baked apples.

The menu is designed so that the sick child eats with pleasure and receives all the substances necessary for growth and development.

Prognosis for recovery

The vast majority of children (80%) recover without any consequences for the body. However, parents need to closely monitor the health of their children, undergo examinations, take tests and do an ultrasound of the kidneys.

Pyelonephritis can occur in a child at any stage of development. Having promptly paid attention to several important symptoms, you can cure the baby and protect him from many problems that this disease leads to in the future.

Consulting a doctor in this case is extremely necessary, since any disease can lead to complications affecting the kidneys. To avoid childhood pyelonephritis, there is no need to allow the child to become hypothermic, which can lead to colds, and it is also necessary to observe the rules of personal hygiene. Doctors say that the presence of an infection in a child, for example, caries, sore throat, runny nose, carries harmful effects on general state human and kidneys as well. Diseases of the genitourinary system in children are not uncommon. It is in children, especially in infancy, that they tend to develop rapidly.

Reasons contributing to the development of pyelonephritis

In order to understand the principle of the development of a disease such as pyelonephritis, it is necessary to delve into the anatomy and find out the structure of the vulnerable organ.

The kidneys are located on both sides of the lumbar vertebrae behind the peritoneum. Right kidney located slightly below the left, as it borders the liver. The size of the organ depends on the age of the child. The kidneys of newborns reach a length of 4 cm, and in adolescence their size exceeds 12 cm in length and 6 in thickness. The kidneys perform a very important function for the body - they remove metabolic products along with urine, thereby regulating water-salt balance in the body and maintain homeostasis.

In addition, it is the kidneys that are responsible for the production of vitamin D and substances necessary to maintain normal level hemoglobin in the blood and regulation blood pressure. They are needed to provide proper operation heart, brain and other organs. The kidneys are responsible for the balance of calcium and phosphorus and contribute to the formation of bone tissue.

Types of pyelonephritis characteristic of children

According to symptoms and therapeutic methods treatment, pyelonephritis can be divided into two types.

Primary pyelonephritis

It develops in children when the internal intestinal microflora changes from normal to pathogenic. Often dysbiosis can occur against the background of certain diseases, namely ARVI or intestinal infections. Dysbacteriosis is a common cause of pyelonephritis in children. An equally common cause of the disease is coccal infections; these can be a variety of diseases, from skin diseases to sore throat or colds. The basis for primary disease kidneys can become diseases of the genitourinary system, due to which bacteria enter the body, and then through the bladder, ureters and pelvis they penetrate to the kidneys.

Secondary pyelonephritis

Secondary kidney disease occurs for completely different reasons. In children, this is usually associated with the presence of congenital abnormalities of the urinary system, such as incorrect position kidneys, bladder, ureters. This leads to poor urine flow or backflow to the kidneys from lower paths. Along with urine, bacteria are often introduced into the kidney, which cause inflammation.

In some children, the kidneys do not have time to develop. Too much small size kidneys affects the productivity of their work. At birth this is not too noticeable, but the weight of the body grows over time, and at the same time the load on the body also increases. kidney tissue, which can no longer cope with the load. Such anatomical deviations appear already in the first months of a baby’s life. To identify the problem in a timely manner, doctors advise ultrasound examination child to make sure that the kidneys normal size and do not have pathologies, and if abnormalities are detected, this will allow immediate treatment to begin.

Signs and symptoms of pyelonephritis

The following symptoms may indicate the presence of an inflammatory process in the child’s kidneys:

• Heat. An increase in body temperature above 38 °C without symptoms of colds, headache, general malaise, weakness, decreased or complete absence appetite.
• Incontinence or lack of urge to urinate. The baby eats normally and consumes the usual amount of fluid, but does not go to the toilet for too long. At night the child sleeps poorly and suffers from constant urges, the smell of urine has become pungent.
• Complaints during urination. The child complains about painful sensations in the stomach, cries, screams, sits on the potty for a long time and makes efforts before urinating.
• Color of discharge.

Urine in the absence of abnormalities is a clear, light yellow liquid. If the color of the urine has become dark or it has acquired a reddish tint, this may indicate kidney disease, in particular pyelonephritis. But don't panic too early, urine may be colored atypically by foods such as beets, blueberries, rhubarb, carrots, vitamins and medicines. If the child has not eaten such foods, the color of the discharge may have changed due to the presence of red blood cells, which is an alarming signal.

• Liquid stool, vomiting. In infants, signs of pyelonephritis may be similar to intestinal diseases and be accompanied by poor weight gain.
• Small amounts of urine. This symptom should not be ignored. You should immediately consult a doctor to find out the causes, establish a diagnosis and prescribe treatment.
• Pyelonephritis may not be accompanied severe symptoms. Constant fatigue And Bad mood baby is a reason to pay attention to his health.

Diagnosis of pyelonephritis

To confirm the diagnosis, the urologist prescribes tests. First of all, this is a general urine test. If such an analysis does not provide a complete picture, then a urine test is prescribed according to Nechiporenko or Zimnitsky.

The essence of urine analysis according to Nechiporenko is that material is collected only from the middle of the stream, and discharge at the beginning and at the end of urination is considered unusable.

To perform a urine test according to Zimnitsky, you will need to collect all your urine for the day. To do this, you need to prepare containers for urination in advance and promptly offer the child to urinate in them. There is no need to specifically give your baby liquids or limit food intake. Such an analysis is needed to identify an inflammatory process in the kidneys or kidney failure.

When collecting urine for analysis, you must adhere to the following recommendations:

• Do not give your child anything to drink mineral water, it will affect the composition of urine.
• Prepare glass containers in advance. Wash it well and pour boiling water over it to prevent bacteria and fungi from getting inside.
• Before collecting urine, pay attention to the baby’s hygiene, otherwise the tests will give inaccurate results.
• When urinating, do not collect the first portion of urine.

Test results will be ready a couple of days after the urine is sent to the laboratory. Each type of analysis uses its own research method.

Interpretation of urine test results

You can understand the test results yourself. In addition to the color and smell of urine, there are many other indicators.

• Urine should be completely clear. The presence of cloudy impurities and flakes indicates inflammation in the urinary system.
• Urine reaction in healthy body slightly acidic or neutral. This indicator depends on the baby’s nutrition. In babies, the density of discharge is lower than usual, it is in the range of 1005-1020. There should be no protein in the urine at all, but a small amount of it is allowed, not exceeding 0.033 g/l. The content of leukocytes is different in boys and girls. For boys the norm is 0-3-5, for girls - 0-5-7. When researched according to Nechiporenko - up to 2000.
• There should be no red blood cells in the urine, in the study according to Nechiporenko - up to 1000.
• The presence of casts indicates possible kidney disease. The study according to Nechiporenko allows their content, but within 20.
• Fungi and bacteria are indicated in the results with a plus sign. At large values Urine culture needs to be done to determine the type of bacteria.

At the end of the examination, the doctor will explain the urine test to the parents. He also prescribes an ultrasound of the kidneys and pelvic organs.

How to prevent the development of pyelonephritis in a child?

Prevent pyelonephritis in children Simple steps will help.

• Put disposable diapers on your baby, especially before going outside and going to bed. This will reduce the chance of contracting an infection.
• Monitor your child's urination frequency. How longer discharge remain in the bladder, the more microbes accumulate in them. Potty train your child by the age of two.
• The girl needs to be washed properly. Hand movements should go from front to back. Maintain hygiene and daily change of linen.
• You should not give your baby highly carbonated drinks. Preference should be given to table mineral or simple purified water.
• Do not feed your child fatty, spicy and salty foods. Salt should be added in moderation, and it is best to steam the meat.

If you have pyelonephritis and after recovery, you will need to adhere to a special diet prescribed by your doctor.

Standard number of urinations per day for a baby

Healthy babies urinate very often, and in fairly large portions.

Children under 6 months make about 20 urinations per day, up to one year - 15, up to three years - about 10.

Even if the child appears to be absolutely healthy, keep track of how many times a day he goes to the potty. If the baby wears a diaper, then this will be impossible. You need to observe the process of urination itself; the stream should not be interrupted, and the liquid should be light.

Treatment of pyelonephritis

When treating pyelonephritis in children, uroseptics or antibiotics are used, homeopathic remedies and herbal medicine.

The duration of treatment and medications can only be determined by a nephrologist or urologist. Treatment often lasts a couple of months. The disease is curable and after a complete recovery you will no longer have to worry about the baby’s well-being. After treatment with antibiotics, probiotic preparations are prescribed, which are required for recovery. normal microflora in the intestines.

Every six months, the baby should have a kidney examination, tests, and systematically visit a pediatrician and urologist.

Pyelonephritis – infection kidneys, which brings a lot of troubles to the child: frequent painful urination, pain in the lower back and lower abdomen, constant increase body temperature. The disease affects almost all structures of the kidney. Timely diagnosed pyelonephritis in children and its effective treatment will help restore kidney function and relieve babies from suffering.

Children's pyelonephritis in medicine is divided into primary and secondary. The first form is characterized by the absence of any abnormalities in the urinary system. In the secondary form of the disease, pathologies of the urinary tract and kidneys are detected. Against this background, the development of obstructive (urinary function is impaired) or non-obstructive (dysmetabolic disorders) pyelonephritis is possible.

The second classification divides the disease into acute and chronic forms. Acute pyelonephritis in children lasts a couple of months and is cured without further relapses. The chronic form of the disease progresses over six months with constant exacerbations. But there are cases when this form of pathology occurs latently, that is, it does not manifest itself in any way.

Symptoms of the disease

Signs of pyelonephritis depend on the form in which the disease occurs.

Acute form of pathology:

• Intoxication. The child’s body temperature rises to 40 degrees, chills appear, the heartbeat quickens, nausea and vomiting begin, and, as a result, weakening and dehydration of the body, and lack of appetite.
• Painful and frequent bowel movements. The baby often asks to go to the potty, grunts for a long time and only then pees, while writhing in pain and screaming. The urine begins to smell specific. Children under 3 years old often complain of pain in the lower abdomen.
• Regurgitation and bad stool . Symptoms of pyelonephritis in children often resemble gastrointestinal disorders. The baby is losing a fair amount of weight. This is especially dangerous for premature babies.
• Laboratory indicators. In children with pyelonephritis, leukocytes are increased in the urine and erythrocyturia occurs. Blood hemoglobin is low, neutrophils are high (this indicates the development of a bacterial infection).

Chronic form of pathology:

• Sometimes there is a dull, aching pain.
• The temperature does not rise above 37.5 degrees.
• The frequency of urination increases, the volume of urine is large, there is no pain.
• Sweating increases.
• Pyelonephritis in a child causes fatigue, irritability, and absent-minded attention, which causes lag in school.
• A urine test shows the presence of salts.
• There is slight intoxication of the body.

How does the disease manifest itself in newborns?

The causes of the disease in infants are congenital pathologies kidneys and urinary tract. Also, signs of pyelonephritis in a child under one year of age appear as a result of acute respiratory viral infection, bacterial or viral infection.

Symptoms of the disease in an infant:

• The temperature rises sharply to 39-40 degrees, convulsions are possible.
• Urination becomes either too frequent or, conversely, very rare.
• Urine smells bad, changes color, and becomes cloudy. Sometimes blood streaks are observed.
• Diarrhea and vomiting begin.
• The newborn does not sleep well, especially at night.
• During bowel movements, the baby cries or screams.

The pathology occurs in a latent form without manifesting itself in any way. In this form, the disease is recognized by doctors only through tests.

How does the disease affect a child's body?

The causes of pyelonephritis in children are bacteria, viruses, fungi. Their entry into the body and progression leads to inflammation. The main causative agent of the disease in babies is coli. Influenza viruses Staphylococcus aureus, Proteus are in second place in the activity of damaging children's organisms. The sources of infection entering the body are: in girls - the vagina, in boys - foreskin. The conducted route is often the large intestine.

Microorganisms enter the kidneys in the following ways:

1. By blood. This path is typical for infants. The pathogen moves to the kidneys from foci of infection in other organs.
2. Through the lymphatic pathways. This type of entry of microorganisms occurs in the case of constipation, diarrhea, dysbacteriosis and intestinal infections.
3. Ascending path. This type of kidney damage is common in children. over a year old. Bacteria enter the organ through the urethra, anus, and genitals.

Diagnosing the disease in children

The doctor listens to all the patient’s complaints and prescribes a series of special tests to confirm the diagnosis. Diagnosis of pyelonephritis in children includes the following studies:

• general and chemical tests of urine and blood;
• urine testing using Nichiporenko, Zimnitsky and other methods;
• tank culture, sediment analysis, urine enzymes;
• antibiogram;
• diuresis study;
• ultrasound of the urinary tract;
• analysis of fluid excreted by the kidneys for fungi and viruses;
• urine cytology;
• CT (computed tomography);
• study of bladder functions;
• cystography and urography.

After full examination To create a complete picture of the disease, the doctor prescribes treatment for the baby and, if necessary, hospitalization.

How is the disease treated in children?

Treatment of pyelonephritis in children is carried out only after an accurate diagnosis of the disease. After all, the symptoms of pathology are sometimes confused with intestinal infection, chronic cystitis and other diseases. Infancy or an acute form of the disease causes the child to be hospitalized, and immediately.

Treatment of acute pyelonephritis in children is represented by the following measures:

1. Sticking to a diet. It is recommended to eat according to table No. 5 according to Pevzner. Salt is allowed to be consumed in moderation, while increasing daily dose water by 50%. It is necessary to exclude from the diet all spices, fatty, spicy, smoked foods. The consumption of protein and plant foods is encouraged. The diet is part of a large set of procedures used to treat dysmetabolic pyelonephritis.
2. Strict bed rest is indicated for a child with pyelonephritis who has a fever and complains of pain in the abdomen and lower back. If there is no fever or pain, the baby is allowed to move around the ward. Next, doctors will allow short walks around the hospital premises.
3. Antibacterial therapy. This procedure is the most important point in the treatment of pathology. It is carried out in stages. Until the results of the study are received, the most effective drug against the most common pathogens. After a urine test, a drug is prescribed that can defeat the identified virus or bacteria.
4. Uroantiseptics. Pyelonephritis in children is also treated with drugs that kill microbes, stop their growth, thereby disinfecting urinary tract. The product is not an antibiotic.
5. They also get rid of acute pyelonephritis in children by treating with antispasmodics, antipyretics, non-steroidal drugs against inflammation.

The baby is in the hospital for a month, in rare cases a little longer. After discharge, he is referred to a pediatrician for observation. Once a month it is necessary to take a control urine test, and twice a year to do an ultrasound of the kidneys. Herbal medicine is prescribed after the end of taking uroantiseptics. A child is deregistered only after 5 years. This is done provided that the symptoms no longer appear and the urine test is always normal.

Treatment of the chronic form of the disease is carried out according to the same principle as its acute form. How to treat chronic pyelonephritis in children? Doctors conduct an examination and select the necessary medical procedures: diet, medications, surgery and others. During the period of remission, the convalescent must undergo a course of antibiotic treatment and take uroseptics. Children who have been diagnosed with a chronic form of the disease are observed by a pediatrician and nephrologist before being transferred to an adult clinic.

What are the consequences of ignoring treatment for a disease?

Complications of pyelonephritis in children are possible if untimely treatment, incorrect or insufficient course of medications. Severe consequences in the chronic form, pathologies develop due to impaired renal function. At acute pyelonephritis complications arise as a result of purulent inflammation and infections.

Preventive measures for pyelonephritis

If kidney function is restored and there are no causes of pathology, pyelonephritis will no longer bother the baby. But for this it is necessary to observe a number of preventive measures:

• do not let the child become hypothermic;
• watch your urination - it should be frequent;
• baby needs proper nutrition, healthy sleep, sufficient fluids and vitamins;
• strengthen children's immunity: walk more, get stronger, play sports;
• Make sure your child follows the rules of intimate hygiene;
• Follow all doctor’s recommendations, conduct examinations and take all control tests in a timely manner.

Pyelonephritis in children, symptoms and treatment shows how serious and dangerous this disease is.

A well-chosen clinic with professional doctors will help the baby get rid of the disease without complications and without harm to health.