Secondary pyelonephritis: diagnosis and treatment

Human body — is the highest stage of evolution. Man breathes, lives and moves thanks to the coordinated work of the main organ systems. Each of them performs a certain role, but not interfere with the functioning of others.

Buds — a unique component of the human body. This paired organ, which is tasked to clean the blood from harmful substances. When a well-oiled mechanism fails, there are a variety of diseases. Among the variety of the most common is secondary pyelonephritis (obstructive). About his methods of diagnosis and treatment will be thoroughly explained in today's article.

Medical reference

Pyelonephritis is the inflammation of the kidney caused by the infection. While in the pathological process involved the renal calyx, pelvis and parenchyma. It may be due to the activity of pathogenic flora. The causative agent of the disease usually enters the kidneys via the blood of the infected area. Essentially “easier” this process is the violation of the mechanism of excretion of urine.

Pyelonephritis — this is a fairly common ailment that is found in people of all ages. In children it is one of the three diseases along with respiratory infections. The inflammatory process in the kidneys and is diagnosed in pregnant women. Adult they suffer almost every third. It is noteworthy that women more often seek medical attention. This is due to anatomical features of the urethra: it is short and located near the vagina.

Despite the infectious nature, often one of the pathogen-bacteria is not enough for the development of pathology. Should the effect of several precipitating factors to create a favorable environment for the growth of pathogenic flora. Therefore, in medical practice it is accepted to allocate the primary (inflammation develops in a perfectly healthy kidney) and secondary pyelonephritis, when the disease occurs on the background of concomitant diseases (prostate adenoma, urolithiasis, etc.).

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The Last option pathology is widespread and often requires more attention from doctors. His therapy is associated with many complications, since you need to be treated and the pyelonephritis, and concomitant disease.

Main reasons

The primary form of pyelonephritis is lose healthy body. In this case, the cause of the disease are microbes. They can live in the human body or penetrate the body from outside. As a rule, in studies in the urine E. coli, Staphylococcus, Klebsiella or Enterococcus.

Some other etiology of secondary pyelonephritis. Against the background of already existing pathologies and deviations in the work on developing this form of the disease. We are talking primarily about the following disorders:

1. Urolithiasis. The concretion with a diameter greater than 5 mm may exacerbate the outflow of urine any of the parts of the urinary system.
2. Cystitis. In 50% of cases the inflammation of the bladder causing pyelonephritis. Infection of the bladder easily pass up the ureters into the pelvis of the kidney tissue.
3. Benign prostatic hyperplasia. An enlarged prostate squeezes the urethra, thereby provoking the delay of urine.
4. Pregnancy. Women in the position most common chronic secondary pyelonephritis. History is often ignored, so the patient later find out about existing pathology.
5. The Narrowing (stenosis) of the ureter. This violation may be either congenital or acquired.
6. Anomalies in the structure of bodies (horseshoe kidney, prolapse of the organ, etc.). Almost 100% of cases, birth defects occur during the development of pyelonephritis.

Clinical picture

Disease, by definition, is a secondary character. Therefore, its appearance is often preceded by signs of primary disease. We are talking about the so-called triad of symptoms:

• Temp;
• Discomfort in the lumbar region;
• Changes in the urine.

In some cases, has secondary pyelonephritis latent period. The chronic form of the disease has a somewhat different clinical picture, which will be discussed below. First you need to understand the triad of symptoms characteristic of the acute course of the disease.

Temperature in the case of pyelonephritis always occurs suddenly and persists at high levels for several days. The patient's condition deteriorates. He may complain of headache, fatigue, chills, and excessive sweating.

Pain in the lumbar region is always present on the part of the affected organ. Sometimes there is another characteristic of the disease symptom — renal colic. It is accompanied by paroxysmal severe pain, which literally blocks the person. He loses the ability to change body position. In some patients the pain is so bad that they even lose consciousness. To remove the attack is possible only with the help of strong antispasmodics.

“standard” for the disease is possible to observe changes in the urine. It becomes dark and muddy, sometimes it begins to foam. In the case of subsequentmicroscopic examination of the fluid will be determined by the bacteria and leukocytes. However, secondary to acute pyelonephritis such changes rarely occur. This is due to the fact that the obstruction of the ureter allows urine from the patient's kidneys to get into the bubble. It will receive urine from a healthy body. As a result, standard urine analysis will be the “clean”. That's why for confirmation of diagnosis always also recommended an ultrasound.

Course of the disease in young patients

Secondary pyelonephritis in children is usually manifested by symptoms that resemble a fever. The attack begins with the appearance of chills. While the baby's moving too much, may increase the temperature to high levels. Sometimes it reaches 41 degrees. General malaise accompanied by nausea and vomiting. Profuse sweating leads to a decrease in temperature, strong weaknesses.

In children with chronic secondary pyelonephritis develops much more often than adults. This is due to anatomic-physiological features of kidneys of the child, which have underdeveloped adipose capsule. Therefore, the hypothermia comes on very quickly, especially in the winter time. On the other hand, the circulatory system still isn't very long. For this reason, infection is much easier to get to the kidney, because the immune system does not manage to destroy it.

The appearance of chronic forms of the disease

Developed after suffering a primary acute pyelonephritis, secondary form often ironiziruya. This situation may occur if the treatment was not effective enough. Secondary chronic pyelonephritis is characterized by the following clinical picture:

• Headache,
• Fever;
• Weakness;
• Mild lower back pain, and it can be on the side of healthy kidneys;
• Low temperature (not more than 38 degrees).

To detect this form of disease very difficult. Weakness throughout the body, lethargy, and lumbar spinal pain — these symptoms may indicate not only the secondary chronic pyelonephritis. They are characteristic of many disorders, including and inflammation in the body and undergoing stress, and even the common cold. That is why you should not try to self-diagnose myself, to start treatment. It is better to seek the assistance of the expert.

Medical examination

Diagnosis of the disease is carried out exclusively in the clinical setting. Timely access to a physician allows not only the correct diagnosis and start of therapy, but also to avoid the development of serious complications.

To confirm secondary (obstructive) pyelonephritis conduct a comprehensive survey consisting of the following events:

1. A urine test. With the active inflammatory process, it will show leukocyturia and bacteriuria. Also in the urine protein may be present.
2. Blood. The increase in leukocytes and lymphocytes, ESR acceleration up to 45 mm/h indicates pyelonephritis.
3. Comparative leukocytosis is necessary to determine which kidney is involved in the pathological process. To this end, the blood is from the fingers of both hands.
4. Plain radiography. Helps to determine the presence of stones or tumors in organs, which often are the cause of the disease.
5. The Study of blood serum for urea.
6. Ultrasound of the pelvic organs.
7. Programma with the use of contrast agents. Conducted to assess the condition of the excretory system. The study should be repeated three times at intervals of 30 minutes.

Required is a physical examination of the patient with palpation of the affected area. In the course of such examination the doctor checks the appearance of the initial symptoms of the disorder, possible causes. In detail we study history, the disease of the kidneys.

Conservative treatment

Treatment of secondary pyelonephritis, especially with the attacks of renal colic, is performed in a hospital. To achieve recovery at home is possible only in exceptional cases and in mild form of the disease.

First case of pyelonephritis patient is prescribed therapeutic diet. It implies exclusion of acute and fried foods, spices, rich meat and fish broths. Fall under the ban of alcoholic drinks and coffee. The diet should mainly consist of vegetables and fruits. Resolved lean fish. Special attention is recommended to be given to drinking regime. For example, the day should drink at least 3 liters of fluid. This amount must not include fruit drinks, milk and liquid food.

«Gold standard" treatment of secondary pyelonephritis consider antibiotics. Originally prescribed drugs broad-spectrum intravenously or intramuscularly. All patients without exception, a diagnostic is assigned a urine culture on the flora with subsequent determination of susceptibility to antibiotics. The results of this analysis do not come earlier than 7 days. After that, previously prescribed antibiotics cancel and leaveonly those that shows the sensitivity of the causative agent of the disease.

Symptomatic therapy involves the application of antispasmodics (“no-Spa”, “Drotaverine”), anti-inflammatory (“Ketorol”, “Substance”) and antipyretics.

Surgery

Surgical operation with secondary pyelonephritis is assigned in case of occlusion of the ureter by calculi. The amount of interference is determined by the severity of the pathology, the size of foreign objects in the genitourinary system.

If the stone is small, the ureter catheter is placed. Another condition for the procedure is the duration of the disease. Catheterization is possible only in the first 3 days exacerbation of chronic pyelonephritis.

When the pathology is complicated by calculi of large size, the patient is assigned a series of sequential operations. First performed puncture nephrostomy-drainage of the kidney under the control of the ultrasound machine. This procedure allows to get rid of the internal pressure, and the patient gets the opportunity to eat and drink.

Examined the kidney itself for its functionality. If the body is healthy and has a positive Outlook for recovery, assigns an operation to remove the stone. Often resort to laparoscopic intervention. A more progressive method is crushing stone via ultrasound. The remaining sand and debris are removed from the body in a natural way.

Sometimes the patient is too late to ask for help. In such cases, for secondary pyelonephritis can be complicated pyonephrosis, by purulent fusion parenchyma. Such unpleasant consequences are the indications for nephrectomy — resection of organ. Operation allows you to avoid subsequent necrosis and infection of the blood. It is performed under General anesthesia, and in the future the patient is given a group of disability.

The Help of medicine

For the treatment of acute inflammatory process recipes of traditional healers show low efficiency. To their aid is usually resorted to in the chronic course of the pathology and only as a Supplement to the main therapy.

For Example, for the relief of pain and reduce swelling helps herbal. It is made using chamomile, celandine, burdock and elderberry. All the ingredients must be mixed in equal proportions, pour a glass of 2 liters of boiling water and take the infusion several times a day.

Before applying this or other prescription it is necessary to consult with your doctor. Some advice of folk healers can do more harm than the potential benefits for the body.

Methods of prevention

Prevention of secondary pyelonephritis is reduced to treatment of the underlying disease. For example, if kidney stones have to follow a strict diet to prevent the recurrence of stones. In the case of cystitis — to monitor the hygiene of the genital organs, not SuperCool the body. Anomalies in the structure of organs of the urogenital system, we recommend that timely surgical intervention.

Also for the prevention of the disease should be twice a year to undergo a comprehensive medical examination with mandatory urine samples. Men are encouraged to promptly treat “profile” of the disease. We are talking about prostatitis, adenoma and prostate cancer.

The fair sex the inflammatory processes in the kidney arise mainly in the second half of pregnancy. At this time the fetus begins especially much pressure on the pelvic organs. Prevention of secondary pyelonephritis doctors advise several times a day to take the position of the body, excluding the increased pressure on the ureters. In addition, you should regularly visit the gynecologist and take time recommended a specialist examination.