Pyelonephritis

Pyelonephritis's disease overview

Pyelonephritis (renal nephritis) includes acute pyelonephritis and chronic pyelonephritis.

What is pyelonephritis

Acute pyelonephritis is an acute bacterial infection of renal, pyelonephrosis, ureter and renal parenchyma, also known as the upper urinary tract infection. Acute bacterial infections caused by bacteria in the upstream line from the bladder to the ureter and then the renal pelvis, or due to the blood sugar takes until the infection is available.

Chronic pyelonephritis is a chronic lesions in the parenchyma, in the interstitial tissue of the kidneys, as a result of the process of infection from the kidneys into the kidneys for prolonged prolonged kidneys. Many times, ruining kidney fibrosis leading to kidney failure.

Acute pyelonephritis recurrence many times, or acute renal failure is not satisfactory treatment will lead to chronic pyelonephritis and chronic kidney failure.

Acute pyelonephritis is an acute disease, with manifestations of infection, the disease responds quite well with antibiotic treatment, if diagnosed and treated promptly, the disease can cure after 10 Up to 14 days. If not treated properly, the disease can cause dangerous complications such as kidney abscess and around the kidneys, blood infections, acute kidney failure, kidney necrosis, kidney inflammation- chronic pyelonephritis, chronic kidney failure . Whatever complications, it can be life -threatening if not treated properly, may fall and infection shock, multi -organ failure, acute kidney failure or gradually impaired kidney function and finally. is chronic kidney failure. Therefore, the elimination of risk factors, treatment according to the cause, thoroughly compliance with treatment is extremely important, significantly reducing the rate of transition from acute pyelonephritis into chronic pyelonephritis. The full knowledge of causes, symptoms, and principles of treatment is essential for early diagnosis and propose effective treatments to reduce the complications of pyelonephritis. P>

Causes of Pyelonephritis's disease

The cause of the disease is usually caused by gram -negative bacteria: The most common is E. coli, then Klebsiella, Proteus Mirabilis, Enterobacter

Gram (+) bacteria: less common less than 10%: Enterococcus, Staphylococcus ...

Causes in the entrance:

Reverse bacterial infections: due to bacteria that follow the urinary tract going back to the kidneys, causing chronic pyelonephritis; The disease encounters both men and women due to unsafe hygiene, or due to intervention of examination procedures such as bladder, urethra ... in men over 60 years old, due to prostate enlargement, urine Stagnant in the bladder is a favorable factor that causes chronic kidney inflammation.

Bloody infection: The rate of bacterial infections by blood sugar is much lower than that of reverse bacterial infection but very important, when in the blood there is microscopic Bacteria (derived from any bacterial foci of the body) can easily cause infections in the kidneys, especially when the urinary tract has obstruction and damage.

Lymphatic infections : less common than blood sugar infections, bacteria in the colon can follow the lymphatic system into the secretion system The urine and the kidneys.

Symptoms of Pyelonephritis's disease

Early stage pyelonephritis has the following manifestations:

Sudden high fever, chilling, rapid collapse, dry chapped lips, dirty tongue ...

Pain on the back of one or both sides, sometimes dull pain continuously in the lumbar area. Or there is pain in urinary -style kidney stones: severe pain in the lumbar area, spreading to the genitals, increasing pain when changing posture or after severe labor.

The back of the patient's back ribs, pain, ie

Bladder syndrome: Manifestations of urination disorders: Pying, urination (moony urination, constant push), hematuria, opaque urination, pus

Anorexia, not eating well, nausea, vomiting, abdominal distention, body fatigue

If treated late or not in accordance with science, the disease is easy to relapse, turn into chronic, kidney failure, nipple necrosis, kidney stasis, blood pressure, hypertension ... these complications can kill patients.

Diagnosis of chronic pyelonephritis includes the above symptoms repeated many times, may be accompanied by the following symptoms

Hypertension due to long -term progression, re -recurring leads to renal function impairment

Anemia: Blue skin is pale, dizzy due to kidneys participating in the hematoma process.

There may be edema in case of kidney failure

There may be a large kidney to water or pus signs of kidney touch (+), kidney (+)

Prehistoric exploitation: History of recurrent urinary tract bacteria, a history of stones, polycystic kidneys, urinary tract deformities, prostate tumors ...

People at risk for Pyelonephritis's disease

In case of bladder reflux, the ureter, after the bladder - ureter, reverse kidney shooting.

After the urinary system surgery

obstruction of urinary tract due to stones in the renal pelvis, ureteral stones, bladder stones, urinary tract tumors, peritoneal tumors, prostate enlargement, fibroids supply, narrowing of the ureter and pregnancy ...

Hoc localized inflammation: Cystitis, prostatitis, rectal inflammation, appendicitis, appendix ... kidney

Demons of urinary tract causing stagnant urine at the top of the urethra-bladder, ureter- pyelonephrosis with conditional and upstream bacteria, upstream

When the body's resistance is poor or there are prolonged chronic diseases, chronic nephritis is likely to occur. Especially in pregnant people, people with metabolic disease (diabetes, gout, oxalate); Malignant blood disease caused by cancer cells entering the kidney area can also cause chronic nephritis.

Prevention of Pyelonephritis's disease

Thoroughly treat the favorable factors: stones, prostate fibroids ... to eliminate the cause of urine.

Periodic examination, detection of potential infections for definitive treatment.

Avoid tips: urine, bladder when not needed.

must drink enough water every day 2-2.5 liters. Ensure urine from 1.5-2 liters/ day.

Hygiene of the genitals, especially for women to pay attention to hygiene during menstruation, after sex, ....

Especially those who have a history of pissing or being suffering from kidney stones-Ureter must pay attention to a diet of water and diet to reduce foods containing calcium ( bones, cartilage, crabs ...).

Urinary infections must be treated properly and thoroughly from the beginning.

Diagnostic measures for Pyelonephritis's disease

Clinical

The disease usually appears with the following manifestations:

Infection syndrome: high fever, can become 39 - 40 degrees Celsius, accompanied by headaches and fatigue, dirty lips, dirty tongue, which can be dehydrated due to high fever.

Acute bladder syndrome: urination, urination, difficulty urinating, hematuria, opaque, pus are early signs before manifestation of pyelonephritis. P>

Pain: back pain, a lot of ribs, touch when touched, often pain on one side, rarely the two sides. Kidney pain may appear.

Kidney to the kidney (+/-), can be touched.

Diagnosis of chronic pyelonephritis needs to be carefully exploited: History of acute pyelonephritis, recurrence many times, a history of urinary infection, recurrence Many times, there are stones, with tumors, or have an urinary deformity accompanied by symptoms such as hypertension, anemia, etc.Subclinical

Blood formula: The number of white blood cells increases significantly, especially neutrophils.

Acute blood cultivation: When high fever> 39 –40 degrees Celsius accompanied by tremor. The common bacteria can be found in the urinary tract like the Gram-Mam bacteria are typically E. Coli

Testing for kidney function assessment (glomerular filtration level) to help adjust the appropriate antibiotic dose.

proteinuria <1g/24h.

Referred urine tests: Pus cells, many white blood cells, red blood cells, nitrite, ..

VKuria (+) transplant to determine diagnosis and antibiotics for treatment. However, negative implants also do not allow the diagnostic exclusion

ultrasound: Easy detection of signs of pyelonephrosis, ureteral stretching, kidney - urinary stones, compression tumors ... is the cause of inflammation of the radio Renal pelvis

Incellular abdominal scan: If suspected to have urinary tract kidney stones, orientation

CT or MRI scan in cases where it is difficult to find the cause of pyelonephritis

Radiography of renal function is a modern method, high accuracy to assess kidney function to diagnose early and treat the causes of pyelonephritis. >

Radio function is usually applied at the nuclear medical unit at Vinmec Hospital. Radioma function to assess kidney function by using modern measurement devices with high accuracy. With good quality images, functional renal radiography has become an indispensable technique to explore kidney function, contributing to improving the effectiveness of diagnosis of the urinary system.

Pyelonephritis's disease treatments

Principles of treatment of pyelonephritis

Severe cases need to be inpatient treatment, urinary bacteria transplant or blood culture before taking antibiotics. Use antibiotics early without waiting for antibiotic results. Use antibiotics according to experience. If after 3-5 days of treatment, clinical symptoms do not need to adjust antibiotics according to bacterial and antibiotic implants.

Timely resolve factors that facilitate infections such as: obstruction due to stones or other causes must be determined.

Clinical symptoms do not mean from all the pathogenic bacteria, so the transplant must be monitored for 2 to 4 weeks after stopping antibiotics to evaluate successful or ventricular treatment. defeat.

Recurrent urinary infections need to be classified to determine the same strain or due to different strains. If relapse early occurs within 2 weeks from the end of treatment is the same strain. If relapse after 2 weeks is usually infection due to a new strain. Specific treatments

Antibiotic treatment to kill pathogenic bacteria to avoid complications, can use oral or injection antibiotics depending on each specific case:

Oral antibiotics: indicated in cases of uncomplicated pyelonephritis in 7-14 days if symptoms are not severe. Combining anti -spasms. If the clinical condition does not progress well (clear infection syndrome, still fever, opaque, pain, dehydration ...) should be transferred to inpatient treatment.

Injecting antibiotics: indicated in cases of severe infections

Collaborative drugs

Compensate for oral and/or intravenous roads: Ensure urine> 50 ml/hour.

Pain relief, smooth muscle relaxation when pain:

Some cases should be noted:

Acute pyelonephritis in pregnant people:

Common in the last 3 months.

Be cautious when using antibiotics.

No X-ray.

All other morphological exploration only after giving birth.

Acute pyelonephritis recurrent many times:

Each recurrence will deform the kidney, recurrent many times will cause fibrosis and kidney shrinking.

should treat antibiotics for a long time to prevent recurrence and find the cause.

monitoring after treatment: as if it was.

If not responded well, after 2 weeks of necessary treatment: X-ray, re-implant urine to consider gravel intervention and abscess around the kidneys if any.

If there is no abnormalities in the urinary system: Treatment with other antibiotics combined for 2 weeks.

If the patient recurs with the same bacteria: Continue 6 weeks of treatment.

See also:

Radiology Review kidney function

complications of acute pyelonephritis - Chronic

How dangerous acute pyelonephritis?

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