Pyelonephritis is a severe infectious disease that can be caused by various pathogenic microorganisms. Determining the specific pathogen and selecting antibacterial therapy is the main method of treating this pathology. The cause of the development of the disease is often a violation of the passage of urine, nephrolithiasis and other abnormalities in the functioning of the urinary system.

In this regard, treatment of pyelonephritis must also necessarily include measures to eliminate the etiological factor to prevent future relapses of inflammatory processes in the kidneys. The therapeutic methods used are selected taking into account the severity of the disease, the nature of the course, the presence of complications, as well as the characteristics of the patient’s health condition. In acute forms of pyelonephritis or exacerbations of the chronic form, treatment should be carried out under the strict supervision of specialists.

Treatment of acute pyelonephritis

Acute pyelonephritis is a serous or purulent inflammation with predominant damage to the renal interstitial tissue. In most cases, the disease develops in only one kidney. The acute course of the disease is characterized by the sudden appearance of severe symptoms such as chills, fever, high temperature, weakness, etc. To avoid consequences, treatment of pyelonephritis should begin immediately and include a set of measures, including taking antibiotics and other drugs, following a diet and bed rest. If necessary, surgical intervention is also used to eliminate the cause of the disease.

Drug therapy

How to treat pyelonephritis and what medications to take? Treatment of acute pyelonephritis is recommended in a hospital setting. In the first days, strict bed rest and warmth are indicated. The selection of drug therapy is carried out taking into account the data of bacteriological urine culture, the presence or absence of urinary tract obstruction, the functional state of the kidneys and the severity of inflammation. If the patient has a disturbance in the normal outflow of urine, then first of all measures are taken to restore it.

The main drugs used to treat pyelonephritis are antibiotics. A course of antibacterial therapy to completely destroy pathogenic microorganisms and prevent relapses or transition of the disease to a chronic form is recommended for at least 6 weeks. In the first days, patients are usually prescribed injectable dosage forms, and then transferred to tablet forms. Given that urine bacterial culture may take several days, a broad-spectrum antibiotic is first empirically selected and then, based on the results obtained, the drug is changed if necessary. For pyelonephritis, depending on the specific pathogen, the following groups of antibacterial agents are used:

• penicillins;
• sulfonamides;
• cephalosporins;
• fluoroquinolones;
• pipemidic acid derivatives;
• nalidixic acid derivatives;
• nitrofuans.

Antibacterial drugs are widely used to treat acute pyelonephritis.

The main requirements for antibiotics for the treatment of pyelonephritis are:

• high bactericidal activity;
• minimal nephrotoxicity;
• maximum degree of elimination in urine.

The criterion for the effectiveness of antibiotic therapy is the reduction of symptoms, intoxication, improvement of kidney function and the general condition of the patient 2-3 days after the start of treatment. At the end of taking antibiotics, a repeat general and bacteriological urine test is performed to monitor the effectiveness of the prescribed therapy. Additionally, instrumental research methods can be used to assess the condition of the urinary system: excretory urography, ultrasound, cytoscopy, etc.

Important: If symptoms of acute kidney inflammation appear, the patient must submit urine for bacteriological examination. Identifying pathogenic microorganisms and determining their sensitivity to antibiotics will allow you to choose the right treatment.

If the cause of the development of pyelonephritis is some kind of kidney disease or other organs of the urinary system, then the underlying disease must also be treated.

Diet

Proper nutrition during acute pyelonephritis helps the body cope with the infection and reduces the load on the kidneys. In addition, drinking plenty of fluids is recommended. Cranberry and lingonberry fruit drinks or rosehip decoction, which have anti-inflammatory and diuretic effects, will be especially useful. Freshly squeezed vegetable or fruit juices are a valuable source of additional vitamins needed by the body during illness. You are allowed to drink mineral water, compotes, green and herbal teas.

To reduce intoxication in acute pyelonephritis, drinking plenty of fluids is indicated

In acute form of pyelonephritis, you must adhere to the following dietary rules:

• completely eliminate marinades, canned food, spices, and smoked foods;
• limit the consumption of baked goods and sweets;
• exclude alcohol, carbonated water, strong black tea and coffee;
• do not eat fried, fatty, spicy and peppery foods containing pepper, horseradish, garlic;
• exclude difficult-to-digest foods (mushrooms, legumes, etc.);
• increase the amount of foods that have a diuretic effect (melons, watermelons, apples, zucchini, etc.).

The basis of the diet should initially be fruits and vegetables; after acute inflammation has been relieved, boiled lean meat and dairy products can be introduced.

Advice: If kidney inflammation is accompanied by increased blood pressure, it is recommended to significantly limit or completely eliminate salt intake.

Surgical treatment

Surgical treatment of pyelonephritis is carried out in case of severe purulent kidney damage, which is characterized by the formation of carbuncles and apostemes, in case of ineffectiveness of antibacterial therapy and other conservative methods. The purpose of surgical intervention is to stop further progression of the inflammatory process, prevent its spread to a healthy kidney, and remove obstacles to the normal outflow of urine in case of obstruction. In this case, the organ is decapsulated, drained, and the ulcers are opened. If the organ is completely damaged (purulent-destructive stage), surgery is performed to remove the kidney.

Treatment of chronic pyelonephritis

In approximately 20% of patients, acute pyelonephritis becomes chronic, the course of which is characterized by alternating periods of remission and exacerbations. In case of exacerbation, the same therapeutic methods are used as for acute kidney inflammation. During the period of remission, treatment of chronic pyelonephritis is carried out at home under clinical supervision. At this time, it is necessary to follow a diet, drink decoctions of medicinal herbs and, if possible, undergo rehabilitation in a specialized sanatorium. Once every three months, such patients must visit a doctor, undergo examination and tests.

• avoid hypothermia;
• adhere to the correct drinking regime;
• take measures to prevent colds and infectious diseases;
• strengthen immunity;
• follow a diet;
• empty your bladder regularly (every 3-4 hours);
• take prophylactic short courses of antibacterial drugs (in consultation with your doctor);
• observe the rules of intimate hygiene.

In patients with chronic pyelonephritis, hypothermia is fraught with exacerbation of the disease

Advice: If symptoms of exacerbation of chronic pyelonephritis appear, you should immediately consult a doctor.

Traditional methods of treatment

For pyelonephritis, treatment with folk remedies can be used as an additional method of therapy both during exacerbations and during remission. For this purpose, medicinal herbs that have anti-inflammatory, bactericidal, antiseptic and diuretic effects in the form of decoctions or infusions are used individually or as part of collections. The combined use of folk and traditional methods of treating pyelonephritis helps speed up the patient's recovery during exacerbation of the disease. Among the folk remedies used for medicinal purposes for kidney inflammation, the most effective are:

• juice from knotweed leaves;
• propolis oil;
• a decoction of a mixture of bearberry leaves, calamus flaxseed, kidney tea, licorice root, birch buds;
• oat decoction with milk or water;
• infusion of lingonberry leaves, blue cornflower flowers, birch leaves;
• a decoction of aspen bark, bearberry, and Siberian elderberry leaves.

Folk remedies for pyelonephritis are used as part of complex treatment

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

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

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

Why is pyelonephritis dangerous?

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

Forms of pyelonephritis

Diagnosis of pyelonephritis

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

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

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

Treatment of pyelonephritis

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

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

Antibacterial therapy

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

Causes of pyelonephritis

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

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

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

In case of inflammatory diseases of the prostate gland, you need to undergo treatment (read the article on prostatitis).

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

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

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

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

Diseases associated with pyelonephritis

Elena Malysheva talks about the disease pyelonephritis

Classmates

In this article we will talk about treating pyelonephritis at home. If an exacerbation of chronic pyelonephritis is accompanied by a sharp increase or decrease in blood pressure, or high fever and pain suggest a violation of the outflow of urine or a suppurative process, which may require surgical intervention, or the level of toxins in the blood increases, or nausea and vomiting do not allow treatment with tablets, then from It is better not to refuse hospitalization. In other cases, you can be treated at home.

What phases are distinguished during pyelonephritis?

1. Active course: pain in the lower back or abdomen, increased temperature, increased pressure, frequent urination, slight swelling, leukocytes and bacteria in the urine in large quantities, signs of an inflammatory process in blood tests.
2. Latent inflammation: there are no complaints, the blood test is normal, but the number of leukocytes in the urine test is increased. There may be no bacteriuria.
3. Remission: there are no complaints or abnormalities in blood and urine tests.

What regimen should be followed when treating pyelonephritis?

• In the phase of remission or latent inflammation, it is enough to avoid hypothermia; damp cold is especially dangerous: kayaking on a mountain river or fighting with a crop in the autumn rain may well result in a hospital bed.
  It is very good if you can take a lying position for half an hour in the middle of the day. And situations where emptying the bladder occurs too rarely are completely unacceptable. It is optimal to go to the toilet every 3-4 hours.
• The phase of active inflammation, especially in the first few days, involves not just home, but bed, “duvet” mode. You can read, watch TV or play computer games - the main thing is that the conditions are met: warmth and horizontal position.

What diet is needed for exacerbation of pyelonephritis?

• The first and most important thing is more fluid. You need to drink at least one and a half liters a day, and the best drink is cranberry or lingonberry fruit drinks, rosehip decoction, but tea, compote, fruit and vegetable juices, mineral water are also great.
• For hypertension, limit salt and all products with a high content of salt - sausages, marinades, canned food, smoked meats.
• Alcohol, coffee, spices, radishes, horseradish, garlic, mushrooms and legumes should be excluded from the diet during an exacerbation.
• During the season, melons and melons will complement the treatment: watermelons, pumpkins and melons.

What drug treatment is used for pyelonephritis?

Antibiotics. During an exacerbation, you cannot do without them, but it is optimal if a doctor prescribes them, even better if at the same time he explains how to collect and where to donate urine for culture for microflora and sensitivity to antibiotics.

As a rule, the causative agents of pyelonephritis are representatives of the obligate intestinal flora (E.coli, Klebsiella, Proteus), so dysbiosis during treatment is almost inevitable. Therefore, the more carefully an antibiotic is chosen, the faster bacteriuria can be dealt with, and the higher the likelihood that exacerbations will be avoided. Typically, the drug is given empirically for 5–7 days and then changed based on culture results. The duration of the course depends on the results of the examination over time: after normalization of urine tests, treatment is continued for another week, so antibacterial drugs can be prescribed for 2 or 3–4 weeks.

Shortening the course of treatment or irregularly taking pills will lead to a protracted course or relapse, and sensitivity to the antibiotic next time will most likely be reduced. Therefore, pyelonephritis at home requires consciousness and discipline from the patient.

Most often in outpatient practice, protected penicillins (Augmentin), 2nd generation cephalosporins (Ceftibuten, Cefuroxime), fluoroquinolones (Ciprofloxacin, Norfloxacin, Ofloxacin) and nitrofurans (Furadonin, Furamag), as well as Palin, Biseptol and Nitroxoline are used - but there is some sensitivity to them has decreased in recent years.

Herbal medicine in the treatment of pyelonephritis

Of course, if you have allergies, especially hay fever, you will have to refuse such treatment. But in general, this is a pleasant and useful addition - in addition to the antiseptic effect, many herbs can reduce spasms of the urinary tract (oats, orthosiphon), reduce bleeding (nettle, rosehip), reduce swelling (horsetail, bearberry) and ease dyspepsia, which often accompanies taking antibiotics ( chamomile, plantain, strawberry leaf).
There are medicines based on herbs (Canephron, Phytolysin), ready-made preparations are sold at the pharmacy, and those who are not lazy can easily stock up on herbs in the summer and then drink preventive herbal teas - especially in the chilly late autumn and during the spring thaw.

The goal of treatment during an exacerbation is to achieve complete clinical and laboratory remission. Sometimes even 6 weeks of antibiotic treatment does not give the desired result. In these cases, a scheme is practiced where, for six months, an antibacterial drug is prescribed for 10 days every month (each time a different one, but taking into account the spectrum of sensitivity), and the rest of the time - diuretic herbs.

Timely treated teeth, proper clothing that prevents hypothermia, good intimate hygiene, normal drinking regime - all this is the prevention of exacerbations of chronic pyelonephritis. And if an exacerbation could not be avoided, then treatment can and should be done at home - but subject to constant laboratory monitoring, because with pyelonephritis, good health is not always a sign of complete recovery.

Which doctor should I contact?

In case of exacerbation of chronic pyelonephritis, treatment can be prescribed by a nephrologist, therapist, or in children - a pediatrician. You can also contact a urologist. The patient must undergo a urine test to determine the sensitivity of the microflora to antibiotics. In addition, at home you should monitor the amount of urine excreted, monitor blood pressure, temperature and pulse levels.

Pyelonephritis

Pyelonephritis is an inflammatory process in the kidneys due to a bacterial infection. The disease in especially severe forms can lead to death. Each new exacerbation of the disease worsens the condition of the kidney tissue, which degenerates into scar tissue. It is important to recognize the disease in time and begin treatment to prevent the development of a chronic disease.

Treatment of pyelonephritis at home

Forms of pyelonephritis

Signs of acute pyelonephritis:

• - pain in the lumbar region;
• - high temperature;
• - changes in urine color;

Symptoms of concomitant diseases, for example, cystitis (constant urge to urinate, painful urination, pain in the lower abdomen).

Signs of chronic pyelonephritis:

• - weakness and fatigue;
• - headache;
• - lumbar pain.

Symptoms of a chronic disease usually appear during exacerbation, along with other signs of acute pyelonephritis.

Kidneys in the human body

When is it dangerous to treat yourself?

There are especially severe cases when treatment with home remedies is not enough and you must contact a specialist. Signs that you should seek medical help:

• - increase and decrease in blood pressure;
• - fever;
• - severe pain in the bladder area;
• - nausea, vomiting.

The presence of the above symptoms may indicate a violation of the outflow of urine, the presence of a purulent process, or an increase in the concentration of toxins in the blood. In such cases, urgent hospitalization is necessary, as there is a risk of needing surgical intervention. In all other cases, home treatment will be sufficient.

Basic requirements for the mode

It is important to avoid hypothermia; cold and wet weather is especially dangerous. During the day, you need to take a lying position as often as possible and constantly empty your bladder (every 3-4 hours). If there is an active inflammatory process, then the regime should be completely bed rest. A person must constantly be in a horizontal position and warm (warmth improves blood circulation in the kidneys and bladder, which accelerates the resorption of the inflammatory process).

It is important to follow a daily routine during pyelonephritis

If the patient exhibits all the signs of an acute inflammatory process, then for 2-5 days he is prescribed a diet that includes the following aspects:

• - eat fresh fruits and vegetables;
• - drink as much fluid as possible (up to two liters per day). This includes not only water, but also juices, teas, etc.;
• - exclude salt from the diet;
• - food must be boiled, steamed or baked after steaming;
• - meat and fish should be consumed in small quantities and only low-fat;
• - exclude spices, fatty foods, seasonings and sauces;
• - do not drink carbonated drinks;
• - do not eat foods with a high level of acidity.

Diet for pyelonephritis

Treatment of pyelonephritis with medications at home

In case of exacerbation of the disease, prescribing antibiotics is a prerequisite. During treatment, dysbacteriosis may occur. Therefore, it is important to seek help from a professional who will conduct a competent diagnosis and prescribe the most effective treatment.

The more carefully the antibiotic that is suitable for a particular patient is selected, the faster the inflammatory process will be overcome without further exacerbation and side effects. In the first week of treatment, doctors prescribe the drug based on the results of the examination and the information they have. After receiving the results of culture for microflora, treatment is prescribed in a more targeted manner.

The duration of treatment depends on the course of the inflammatory process and the presence of positive dynamics in test results. Irregular use of antibiotics or sudden cessation of their use leads to relapse or delay of the healing process. Repeated use of the drug in the future will lead to decreased sensitivity to its components. Therefore, it is very important, when treating at home, to follow your doctor’s recommendations for taking antibiotics.

The most common drugs for the treatment of pyelonephritis:

1. Augmentin,
2. Norfloxacin,
3. Ofloxacin,
4. Furamag and others.

Phytotherapy

Herbs have an antiseptic effect, reduce the manifestation of urinary tract spasms, reduce bleeding, reduce swelling, and ease digestive problems (which often occur when taking antibiotics). Herbs that are used for pyelonephritis: oats, rose hips, nettle, bearberry, chamomile, strawberries, plantain and a number of others. Medicines are produced based on herbs - Canephron, Vitolysin. There are collections of several herbs that can be purchased in ready-made form in pharmacies. It is also very useful to drink herbal teas, including for preventive purposes.

There is a treatment regimen (for particularly protracted forms of the disease), when the patient regularly takes antibiotics in combination with herbal medicine for several months.

In the treatment of pyelonephritis, taking a decoction of rose hips, St. John's wort, motherwort, violet, and horsetail is especially effective. Having mixed all the ingredients in equal quantities, pour a tablespoon of the mixture into one glass of water, boil for 10 minutes, cool and filter. Take ¼ cup 4-6 times a day. Such decoctions are bitter and stimulate appetite, which is especially useful for patients with pyelonephritis who have difficulty eating. Therefore, it is recommended to drink decoctions half an hour before meals.

Herbal medicine for pyelonephritis

Cranberries have a good diuretic and anti-inflammatory effect. They can be consumed in unlimited quantities. You can make a tincture of the berries: mash a tablespoon of cranberries and pour a glass of boiling water, leave for a couple of hours and take half a glass before meals every three hours.

Prevention of pyelonephritis

Preventive measures include the following:

• maintaining dental health. The infection can enter the kidneys from teeth affected by caries. Bacteria, whose activity led to tooth destruction, “sink” into the kidneys. With a weakened immune system, the body cannot cope with such a process and pyelonephritis occurs;
• wearing warm clothes. Often the cause of pyelonephritis is hypothermia, which occurs due to dressing inappropriately for the weather;
• drinking enough liquid (this is not necessarily water, but also juices, compotes, teas and any other liquid);
• correct treatment with constant laboratory monitoring to exclude relapse or complications;
• taking vitamins. This is especially true during the cold season. The weakened immunity of a person who has a deficiency of vitamins in the body cannot resist all kinds of bacteria. Once in the body, they cause an inflammatory process;
• eating a lot of vegetables and fruits.

Video - Treatment of pyelonephritis

Video - How to treat pyelonephritis with folk remedies

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

What is pyelonephritis

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

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

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

• kidney abscess;
• hypotension;
• sepsis;
• bacterial shock;
• kidney carbuncle;
• renal failure.

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

• chills, fever;
• increasing weakness;
• tachycardia;
• dull pain in the lower back;
• dyspnea;
• temperature 38.5-39 degrees;
• fatigue;
• disturbance of urine outflow;
• headaches and muscle pain.

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

Chronic

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

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

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

Causes

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

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

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

At-risk groups

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

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

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

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

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

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

Provoking factors

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

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

Treatment of pyelonephritis at home

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

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

Compliance with the regime

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

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

Drink plenty of fluids

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

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

Medical nutrition

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

• baked apples;
• bright orange pumpkin;
• fermented milk;
• cauliflower;
• young beets;
• carrot.

Drug therapy

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

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

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

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

Physiotherapy

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

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

Drugs for the treatment of pyelonephritis

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

Names of antibiotics and uroantiseptics

Antibacterial therapy based on the results of bacteriological examination of urine

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

Name of antibiotic group

1 g every 6 hours.

0.5 g every 8 hours.

1.2 g every 4 hours.

3.5 mg/kg in 2-3 dilutions.

15 mg/kg in 2 doses.

3-5 mg/kg in 2-3 injections.

0.1 g up to 2 times.

0.3 g up to 2 times

0.2 g 1 time at the initial stage of treatment, then in a maintenance dosage of 0.1 g.

0.5-1 g up to 3 times.

0.5 g up to 3-4 times.

1 g up to 2 times.

480 mg 2 times.

960 mg 2 times.

0.1-0.15 g three times.

50-100 mg three times.

2 tablets 4 times.

100-300 mg 2 times.

Intravenously or intramuscularly

1-2 g every 4-6 hours.

0.5-1 g up to 1-2 times.

0.5 g up to 4 times.

Diuretics

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

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

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

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

Nonsteroidal anti-inflammatory drugs

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

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

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

Drugs to improve renal blood flow

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

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

Immunomodulators and adaptogens

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

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

Treatment of pyelonephritis with folk remedies

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

• lovage;
• violet;
• St. John's wort;
• series;
• nettle;
• yarrow;
• calendula;
• strawberries;
• parsley;
• bearberry;
• sage.

Bearberry (bear ears)

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

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

Lingonberry leaves

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

Cranberry or lingonberry juice

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

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

Medicinal preparations for oral administration or external procedures

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

Kidney diseases are increasingly common in medical practice. They can develop for many reasons. This includes an unhealthy lifestyle, inflammatory diseases of neighboring organs, infections of the genitourinary system, and so on. This article will discuss such a pathology as acute pyelonephritis. The symptoms and treatment of the disease are well known and described. In this article we will find out the features of correction of this pathology. It is also worth mentioning what symptoms acute pyelonephritis has in children.

Common kidney diseases

The inflammatory process in the lining of the organ and the pyelocaliceal system is called pyelonephritis. This pathology can take various forms. At the moment, the following manifestations are known to medicine:

• acute pyelonephritis (symptoms and treatment will be described below);
• chronic inflammation (most often has no manifestations);
• aggravated pathology (asymptomatic course of the disease followed by the addition of symptoms).

All these forms bring considerable discomfort to a person. That is why it is so important to make a timely diagnosis and prescribe the correct treatment. Otherwise, the patient may face serious complications that will lead to hospitalization and surgery.

Acute pyelonephritis

Symptoms and treatment for this disease may vary. When prescribing therapy, it is imperative to take into account the patient’s complaints. In some cases, pathology develops from an existing disease. In this case, it is necessary to treat not only the inflammatory process, but also its cause.

Pathology develops mainly due to the proliferation of bacteria. These include microorganisms of Escherichia coli, Proteus, Pseudomonas aeruginosa, enterococci, staphylococci, and so on. Less commonly, pathology develops due to viral damage to the organ.

Pathology most often develops due to bacteria from neighboring organs entering the kidney. Less commonly, the patient is diagnosed with so-called ascending acute pyelonephritis. The symptoms and treatment for this type are somewhat different. In this case, pathogenic microorganisms penetrate through the urethra into the bladder and only then affect the renal system.

Signs of the disease

Depending on the symptoms of acute pyelonephritis, appropriate treatment is prescribed. Remember that the correction should not be carried out independently. Only a qualified specialist will be able to select the correct medications and their dosage regimen.

Symptoms of pathology may vary. Most often, a high temperature rises and pain occurs in the peritoneum. However, these symptoms may be conditional and do not always indicate an acute inflammatory process in the kidney. Let's consider the main signs of pathology.

Fever or hyperthermia

Acute pyelonephritis is often manifested by elevated temperature. In this case, the person does not feel other signs of a cold.

The patient begins to feel chills and sweating increases. In some cases, seizures or delirium may occur. If acute pyelonephritis in children has such symptoms and treatment is not carried out immediately, the consequences can be disastrous. In children, such conditions can be especially dangerous. Elderly people are also at risk.

Acute pyelonephritis (symptoms) often begins with pain. The low-grade fever remains. Unpleasant sensations can be pressing, bursting or pulling. However, more often they are sharp with lumbago in the lower back.

The pain can also be girdling and affect the lower abdomen. In some cases, acute pyelonephritis in women has symptoms in the form of cutting sensations during urination and immediately after it. This may indicate the addition of cystitis. In this case we are talking about an ascending pathology.

General deterioration in health

Pathology often manifests itself as a general malaise. In this case, the patient's digestion is impaired. The most common symptoms are nausea and loss of appetite. In more severe situations, diarrhea and vomiting may occur.

Blood pressure also increases, which in itself leads to headaches and tinnitus. Sometimes the patient may lose consciousness. This condition is especially dangerous for pregnant women and young children. What are the symptoms of acute pyelonephritis in infants?

Signs of pathology in children

Often children cannot say what is bothering them. In this case, parents will have to guess on the coffee grounds. Pathology in newborns and infants is manifested by severe anxiety and crying. Also, when the temperature rises, parents do not show signs of a cold. The baby presses her legs to her tummy and cries angrily. Outwardly, this manifestation is similar to ordinary colic, but unlike gas formation, pyelonephritis does not go away on its own. Moreover, over time, the baby’s condition only worsens.

How to diagnose pathology?

If there is a suspicion of acute pyelonephritis in children, symptoms and treatment should be related. Several methods are used for diagnosis.

• Questioning and inspection. This method cannot provide reliable information about the disease. The doctor examines the patient and learns about the symptoms that bother him. During palpation, the pain may intensify. This indirectly indicates pathology.
• Ultrasound. This method is more accurate. During the examination, the specialist examines the walls of the organ and determines the degree of expansion of the pyelocaliceal system. The data obtained may indicate illness.
• Laboratory research. These include general blood and urine tests, as well as biochemistry. Often, if pathology is suspected, bacterial culture of urine is performed. Based on the results, it is possible to determine the microorganisms present and determine their sensitivity to certain antibiotics.
• Radiography. This manipulation is performed much less frequently. However, it can give an accurate picture of kidney health. During diagnosis, a contrast solution is used and injected into the kidney. After this, the image of the organ is displayed on an X-ray machine.

Acute pyelonephritis: treatment at home

This pathology is mainly treated within the walls of a hospital. However, many patients refuse hospitalization for various reasons. It must be remembered that this can lead to the development of complications.

• Most often it involves a pathology such as acute pyelonephritis and treatment with antibiotics. However, before prescribing drugs, it is necessary to conduct laboratory tests. Otherwise, you can only make your situation worse. If antibacterial drugs are taken incorrectly, bacterial resistance to the antimicrobial agent develops and the human immune defense decreases.
• Acute pyelonephritis (symptoms and treatment) is also described in some detail by the healthy lifestyle magazine. There are folk remedies for correction. Some of them may be quite useful. However, you should not risk carrying out such manipulations without the participation of a doctor.
• Must be associated with a disease such as acute pyelonephritis, symptoms and treatment. Diet and a certain regimen are additional methods of correction. They will alleviate the patient's condition and speed up recovery.

Let us consider in detail how acute pyelonephritis is treated at home.

Use of antimicrobial drugs

Quite often, for a disease such as acute pyelonephritis, treatment with broad-spectrum antibiotics. In this case, a preliminary analysis of the sensitivity of microorganisms is not performed. Such a correction may not be very effective and may lead to more advanced pathology.

The most correct prescription would be a recommendation given after a preliminary analysis. At the same time, the sensitivity of certain bacteria to certain medications is determined. Most often, doctors prescribe the following medications: Ofloxacin, Norfloxacin, Ciprofloxacin, Amoxicillin and others.

In most cases, the effect of the drugs is noticeable within one week after treatment. Within a month of such therapy, complete recovery occurs. However, doctors strongly recommend continuing treatment for up to two months. Long-term exposure allows you to destroy all pathological microorganisms and prevent the disease from becoming chronic.

Use of immunomodulators

This should not be done on your own. Such correction is always combined with the use of strong medications. Acute pyelonephritis cannot be cured with immunostimulating drugs alone.

Immunomodulators allow you to quickly cope with pathology and improve the condition of the body after long-term use of antibiotics. These drugs include the following: “Interferon”, “Fiferon”, “Likopid”, “Canephron”, “Isoprinosine”, “Dekaris”, “Prodigeozan” and so on. Correction can be carried out for quite a long time (up to several months). In this case, one medication is replaced by another for a more effective effect.

The use of diuretics in the treatment of pathology

Often, medications that have a diuretic effect are used to correct pathology. Most often these are teas made from medicinal herbs, for example: “Brusniver”, “Kidney tea” and so on.

You can also use solutions and capsule forms of drugs. Most often these are Cyston, Canephron and others. It is worth noting that these medications can be used during pregnancy. However, before doing this, it is still worth getting advice from a specialist.

Surgical treatment of pyelonephritis

In more advanced situations, surgical intervention is used. It is performed under general anesthesia and can be of two types: organ-preserving or organ-carrying. In the first case, the affected kidney is decapsulated. In this case, the walls of the organ are dissected and purulent and pathological formations are removed. The doctor tries to preserve healthy tissues as much as possible and not disrupt the blood flow in them. The prognosis for such treatment is usually favorable. In this case, it is necessary to follow the instructions given to the patient.

Complete removal of the kidney is performed when it is not possible to leave the organ. In this case, donor material can be used. However, there is no guarantee that it will take root. A person can live quite normally with one kidney. In this case, it will be necessary to monitor the condition of the organ more carefully.

Therapeutic exercises for illness

You can treat pyelonephritis at home with the help of special exercises. Most often they are prescribed to expectant mothers. After all, it is this group of women who are susceptible to the development of an inflammatory process due to increased pressure of the uterus on the organs.

Doctors recommend taking the knee-elbow position several times a day. This makes it easier for the kidneys to work and reduce pressure on them. Also, if you have unilateral acute pyelonephritis, then you should lie down and sleep only on the opposite side. This way you can avoid increased pressure on the diseased organ and improve the flow of urine from it.

Diet for acute pyelonephritis

To treat acute pyelonephritis, a diet and an appropriate regimen can be used. Most often, doctors recommend complete rest during illness. Especially if there are symptoms such as high fever, increased blood pressure, weakness and chills.

The diet involves high fluid intake. The patient needs to increase the volume of fluid consumed to two or even three liters per day. Such an effect will be positive only if the outflow of urine is not impaired. In addition to simple clean water, you can drink cranberry and lingonberry fruit drinks. Such drinks perfectly cleanse the urinary tract from pathogenic microbes.

Following a diet involves avoiding smoked and salty foods. Such products contribute to fluid retention in the body. This can only make the situation worse. During an exacerbation of the disease, it is recommended to completely eliminate salt from your diet.

It is also necessary to exclude sweets, baked goods and any allergens from the menu. It is strictly forbidden to eat tomatoes in any form. Avoid alcohol. Meat and fatty broths should be excluded from the patient’s diet. What can you eat with acute pyelonephritis?

Give preference to light vegetable soups and steamed products. Eat small portions, but more often. Between each meal, drink several glasses of water and the fruit drinks described above. Avoid coffee and strong tea. These drinks can only aggravate the condition by causing a large increase in blood pressure.

The use of herbs: traditional methods of correction

Treating acute pyelonephritis with herbs is quite dangerous. However, many patients resort to this method.

• knotweed. This plant must be collected and thoroughly cleaned. After this, the herb is passed through a meat grinder and mixed with a small amount of liquid. The resulting solution must be squeezed out through gauze and drunk half a glass before meals.
• Collection of herbs. You can prepare the composition from bearberry, flax seeds and licorice root. Boil all ingredients and strain. Take 50 milligrams of the drug an hour before your next meal.

Remember that some herbs may be contraindicated for a particular patient. That is why, before using them, you should still consult a doctor to obtain permission for such treatment.

Summing up and concluding the article

You now know a lot about a disease such as acute pyelonephritis (symptoms, treatment with herbs and other methods). Remember that the pathology is quite dangerous and can lead to serious complications. That is why her treatment should be carried out within the walls of a hospital, and not self-prescribed. The disease is especially dangerous for young children and the elderly. To make the right appointments, you should first undergo an examination. If there are disturbances in the outflow of urine, a catheter is used.

Monitor the condition of your kidneys. If one of the symptoms appears, do not procrastinate, contact a specialist! Only in this case is there a chance that the pathology will not develop into a more serious form. Good health to you!

Pyelonephritis is not a death sentence, but an unpleasant disease that can be dealt with at home if everything is done correctly. Proper treatment of pyelonephritis at home will help you forget about this problem forever.

Features of the disease

Pyelonephritis is a fairly common disease caused by an inflammatory process in the kidneys. An infection that enters the body through the blood can affect the kidney parenchyma, calyx and pelvis. If the disease that has arisen is not treated in a timely manner, there is a high probability of developing a more complex disease - nephrosclerosis.

The development of particularly severe forms of the disease can lead to disastrous results, including death. With each new exacerbation of the disease, the condition of the kidney tissue worsens and scarring occurs. It is very important to recognize the disease in time and begin treatment so that chronic pyelonephritis does not develop.

Symptoms of the disease

Symptoms of pyelonephritis directly depend on what type of pathology you have encountered.

Acute pyelonephritis characterized by:

• acute pain in the lumbar region;
• elevated temperature;
• changed color of urine;
• in some cases, nausea and vomiting may occur;

Chronic pyelonephritis does not have such pronounced symptoms. They appear only in moments. Among the signs of chronic disease it is worth noting:

• pain in the lumbar region;
• increased fatigue;
• headache and general weakness.

If the symptoms described above occur, you should immediately seek advice from a specialist.

Diagnosis of pyelonephritis

It is very important to correctly diagnose the pathology, because the symptoms that appear cannot always show the full picture.

1. First of all, the doctor prescribes a general blood and urine test. From them you can see whether the number of leukocytes has increased and whether protein has appeared.
2. To complete the picture, radiography and excretory urography are performed. Thanks to these studies, it will be possible to determine whether the size of the kidneys has changed and how affected they are.
3. To present the picture of the course of the disease in more detail, CT, angiography, and cystography can be used.

If acute pyelonephritis develops, the patient should be immediately hospitalized, where he will be provided with the necessary first aid and treatment will be prescribed. The patient is prescribed a course of up to 6 weeks. As a result of pyelonephritis, kidney failure can occur.

The key to successful treatment is timely and accurate diagnosis.

Treatment of pyelonephritis with folk remedies

Many patients find it difficult to treat their disease in a hospital, so they are looking for alternative methods. In this case, folk methods will come to the rescue. Treatment with folk remedies is allowed if the measures taken are aimed at preventing exacerbation if chronic pyelonephritis occurs. Such methods, in combination with basic therapy, lead to a speedy recovery.

Below are some of the most effective recipes:

• A drink made from flax seeds can not only relieve inflammation of the kidneys, but also cleanse them. Flax seeds in the amount of one tablespoon are steamed with a glass of boiling water. The resulting composition is further boiled over high heat for about 3 minutes. After this, let the drink infuse, an hour will be enough. The resulting drug is taken for two days, 0.5 cups twice a day.
• Treatment of kidney pyelonephritis with folk remedies will be more effective if you use the herbaceous plant knotweed, commonly known as knotweed. Preparing the solution is very simple. Well-washed leaves of the plant are twisted in a meat grinder. Add water to the resulting mass and bring to a puree-like consistency. Leave for a few minutes to allow the solution to infuse, then squeeze out the liquid. The composition is taken before meals, 0.5 cups.

• Those who are faced with an unpleasant illness can try using hop cones. To prepare the decoction, you need to pour 2 large spoons of the raw material with boiling water, in an amount of 0.5 liters. The composition should infuse for 2 hours. The drink is taken up to four times a day before meals.
• For those who have discovered alarming symptoms of this disease and, along with drug treatment, actively use folk remedies, you should definitely try medicinal herbs - a very effective method. You can easily prepare this infusion yourself. The necessary components are freely available in any pharmacy. You will need: kidney tea, calamus and bearberry leaves, flax seeds, licorice root and birch buds. A collection of these herbs in the amount of 3 small spoons is poured with 0.5 liters of water and boiled for no more than 5 minutes. Cool the resulting drug, strain and drink one glass 30 minutes before meals three times a day. Continue for 2 months.
• Sea buckthorn berries help with the development of kidney diseases.

Treatment with folk remedies can be used only after a preliminary discussion of this issue with a doctor.

Diet is an important component of treatment

The first and most important component of treatment for kidney pyelonephritis is diet. If all the symptoms of an acute inflammatory process are present, then the doctor prescribes a strict diet.

• The most important thing is to drink as much fluid as possible. This means not only water, but also tea, juices, etc.;
• Eliminate salt and foods high in salt from the diet;
• Try to eat more fresh vegetables and fruits;
• Food should be boiled, steamed;
• Exclusion of salty, fried, rich, fatty and baked foods, as well as sauces, spices and seasonings;
• Do not drink carbonated drinks;
• Remove foods that have a high level of acidity from your diet;
• Refrain from drinking alcohol, spices, coffee;
• During the melon season, the use of pumpkins, watermelons, and melons will help in treatment.

Careful adherence to the diet in combination with the main treatment can lead to the expected result.

Prevention of pyelonephritis

Very often, kidney pyelonephritis can be avoided if you follow some simple rules. In particular:

• Try to drink more non-calorie liquid;
• Empty in a timely manner and do not tolerate if the bladder is full;
• Avoid hypothermia;
• Try to promptly eliminate any source of infection in the body (caries, sore throat, inflammation of the skin, etc.), if you do not treat such manifestations, they can provoke inflammation of the kidneys.

It is not difficult to cure kidney pyelonephritis if you strictly follow all the doctor’s recommendations. You will be able to cope with the problem much faster if you include treatment with folk remedies, the help of which is difficult to overestimate.

A disease in which the inflammatory process spreads to the renal parenchyma and pyelocaliceal system, and also affects the interstitial tissue of the kidneys. Pyelonephritis is a very common disease, the development mechanism of which can start after another respiratory viral disease.

Pyelonephritis is provoked by the penetration of pathogenic microflora into the kidney both from the external environment and from its other concentrations in the body. It has been proven that for the development of an inflammatory reaction in the kidney, along with the presence of pathogenic microbes, a violation of the outflow of urine through the ureter is necessary. In the process, an increase in intrapelvic pressure occurs, and this causes venous congestion of the kidney, disruption of capillary blood flow and the development of tissue hypoxia. The main route of infection of the kidney is hematogenous, but urinogenic is also common, for example, as a result of vesicoureteral reflux. With a high frequency of infection spreading through the hematogenous route, it is noted that a particularly virulent infection localized in the kidney can initiate inflammation even with normal urodynamics.

Susceptibility to pyelonephritis among the female population is estimated to be higher - even in girls, doctors diagnose pyelonephritis as a complication of such common cystitis, balanoposthitis or vulvovaginitis. With the approach of old age and old age, the risk of developing pyelonephritis also increases in men, due to the relationship of the disease with benign hyperplasia and prostate cancer, bladder cancer and other “age-related” diseases that disrupt urodynamics. According to statistics, pyelonephritis is diagnosed in every tenth person who has not previously suffered from kidney disease, but the disease is difficult to diagnose in practice, since its symptoms are sparse.

Causes of pyelonephritis are a combination of the spread of pathogenic microflora in the body and the development of any urological disease leading to impaired urine outflow. Pathogenic microflora in this case can be represented either by an increased number of opportunistic microflora, for example, Escherichia coli and paracoliforms, as well as originally pathogenic bacteria - the Proteus group, staphylococcus, enterococcus, etc. The normal outflow of urine is based on compression of the ureters either from the outside or from the inside, which is possible in the presence of tumors, urinary stones, scar changes in the ureter and urethra. A risk factor, among other things, is unprofessional or poor quality of instrumental, diagnostic and therapeutic procedures, which damages or compresses the urinary tract.

Pyelonephritis is a disease characterized by extensive qualifications. In clinical practice, primary and secondary pyelonephritis are distinguished:

• primary pyelonephritis - inflammation of the kidney unrelated to any urinary obstruction; it is also called uncomplicated
• secondary pyelonephritis is also complicated, since inflammation in this case develops due to microbial infection and is accompanied by a violation of the outflow of urine from the kidney.

Pyelonephritis, among other things, is divided into acute and chronic, as well as unilateral and bilateral, that is, spreading to one or two kidneys. Acute pyelonephritis occurs both with and without the participation of pathogenic microflora, that is, it can be both primary and secondary. Chronic pyelonephritis can be either a consequence of acute primary or develop exclusively from secondary. Exacerbation of chronic pyelonephritis is usually facilitated by cooling and changes in climatic living conditions, increased physical and even mental stress, and impaired urodynamics. Acute and chronic pyelonephritis include several varieties or stages.

Acute pyelonephritis		Chronic pyelonephritis
Serous - development of leukocyte infiltrates along the blood vessels of the interstitial tissue of the medulla of the kidney		Active inflammation phase	Pyonephrosis
	Apostematous - with the formation of abscesses on the kidney	Latent inflammation phase
	The formation of a carbuncle, that is, the development of a suppurating infarction of the kidney tissue
	Abscess formation
Necrotic		Remission phase

Pyelonephritis is accompanied by a very broad, but at the same time not entirely specific clinical picture, which is more correct to consider separately for its acute and chronic forms. Symptoms are also determined by the pathogenesis and nature of the disease, the severity of morphological changes in the kidney, the patient’s age and the characteristics of the body’s defenses.

Symptoms of acute pyelonephritis:

• interstitial serous pyelonephritis - the kidney is full-blooded, but tense and enlarged in size, but destruction of the renal tissue has not yet developed;
• purulent pyelonephritis - changes that occur at the stage of serous pyelonephritis are rapidly (up to 1-2 days) complemented by destruction of renal tissue;
• intense pain develops in the lumbar region - manifests itself even with light pressure in the costovertebral angle and in the lower back;
• body temperature rises - up to 39-40°C, which is often accompanied by chills, which are replaced by profuse sweating;
• signs of intoxication appear - headache, general weakness, thirst, lack of appetite, tachycardia, nausea and vomiting;
• profuse sweating affects the amount of urine produced, which decreases;
• the urine itself becomes cloudy due to the abundance of leukocytes and bacteria in it; it may also be transparent if the ureter is blocked by pathological impurities;
• palpation indicates rigidity of the muscles of the lumbar region on the side of the disease; an enlarged and painful kidney can be felt;
• the formation of pustules, that is, the flow of serous pyelonephritis into purulent one, is accompanied by a decrease in pain, but an increase in body temperature and sweating with further persistent subfertility;
• Sometimes patients with a kidney abscess are forced to take a position with the leg brought to the stomach on the side of the disease, which relieves the pain.

Symptoms xchronic pyelonephritis:

• the phase of active inflammation is accompanied by symptoms exactly repeating the clinical picture of acute pyelonephritis;
• the phase of latent inflammation is manifested by rare pain in the lower back, dysuria and general malaise usually do not report themselves at this stage;
• the remission phase does not differ in any painful symptoms;
• in general, the symptoms of chronic pyelonephritis are divided into local and general:
  • local - a feeling of heaviness and dull pain in the lower back, cloudy urine;
  • general - increasing weakness and fatigue, decreased performance, headache, dry mouth, low-grade fever, pale skin, decreased relative density of urine
• over time, the functioning kidney parenchyma is replaced by connective tissue, and this becomes a condition for kidney shrinkage

How to treat pyelonephritis?

Treatment of pyelonephritis- a complex and lengthy process that occurs mainly when using conservative techniques. If conservative treatment in a short time does not lead to a positive trend in the patient’s condition, surgical intervention is advisable. Treatment strategies vary depending on the form of the disease - acute or chronic, primary or secondary, right-, left- or bilateral. The nature of treatment is determined by the pathogenesis of the disease and the characteristics of its clinical course.

Treatment of acute pyelonephritis assumes:

• it is advisable to be hospitalized in the urology department to carry out a full range of diagnostic and therapeutic procedures;
• for serous pyelonephritis, the use of medications is aimed at restoring the patient’s immunity, suppressing the pathological process and suppressing the proliferation of diagnosed microflora;
• for purulent pyelonephritis, surgical intervention is strictly indicated - the minimum volume of surgery (for apostematous pyelonephritis) consists of kidney decapsulation, which consists of dissection and eversion of the fibrous capsule, and nephrostomy, which is drainage of the renal pelvis;
• in case of carbuncle and kidney abscess, the patient is shown organ-preserving operations, consisting of decapsulation of the kidney, cruciform dissection of the abscess, drainage of the purulent cavity and pelvis if the outflow of urine from it is impaired; organ-saving operations are advisable if it is possible to restore the function of the diseased kidney;
• in case of secondary pyelonephritis, treatment makes the primary goal of eliminating the cause of impaired urine outflow, which often involves treating the underlying disease against which pyelonephritis developed:
  • for small stones and in the early stages of pyelonephritis, ureteric catheterization is appropriate;
  • if pyelonephritis lasts longer than three days or if catheterization fails, emergency surgery is performed - percutaneous puncture of the kidney under ultrasound control or ureterolithotomy with drainage of the renal collecting system;
  • postoperative treatment of patients with acute secondary pyelonephritis involves the use of the same drugs as for acute chronic pyelonephritis
  • the appointment of therapeutic massage, physical therapy and physiotherapeutic procedures is carried out in order to prevent the development of postoperative complications and speed up the recovery period;
• in case of severe pyelonephritis and the development of urosepsis, the patient is indicated for nephrectomy if the opposite kidney is functional enough for such radical measures

Treatment of chronic pyelonephritis assumes:

• elimination of the causes underlying the disturbance of urine outflow or renal circulation, up to surgical interventions determined by the primary disease (nephrolithiasis, BPH, nephroptosis, hydronephrosis);
• carrying out etiotropic antibacterial therapy - taking into account the sensitivity of urine microflora to drugs; these can be semisynthetic penicillins, cephalosporins, aminoglycosides, tetracyclines, macrolides, fluoroquinolones, as well as chemotherapy drugs; Frequent changes of antibacterial agents are appropriate due to the rapid development of resistance of pathogens to them;
• the appointment of immunocorrective drugs - the administration of vitamins B 6, C, E contributes to increased immunoresistance.

In acute primary pyelonephritis, the prognosis is generally favorable, but the disease should not be allowed to become chronic. Otherwise, the prognosis sharply worsens, and complications arise - chronic renal failure, nephrogenic arterial hypertension, etc. The general prognosis for chronic pyelonephritis is determined by the duration of the disease and may be favorable. unless the above complications occur.

What diseases can it be associated with?

Pyelonephritis rarely develops as an independent disease; rather, it is a complication of diseases of the genitourinary system or a consequence of the spread of opportunistic or pathogenic microflora to the kidneys.

Pyelonephritis is at risk of developing when the genitourinary tract is affected by an infection in people whose bodies exhibit urodynamic disturbances, namely:

• in a given area (prostate, bladder or kidney, female organs, etc.);
• - formation of stones in the organs of the urinary system;
• cicatricial changes in the ureter and urethra.

Treatment of pyelonephritis at home

Among other things, an important component in the positive therapeutic effect is:

• bed rest,
• plentiful nutrition - carbohydrate-rich foods, fermented milk products,
• consumption of vitamins - both in natural products and in the form of pharmaceuticals.

The main stage in the treatment of pyelonephritis is followed by a recovery period, which is recommended to be carried out in the intensive care unit if there has been surgical intervention in the body. Be that as it may, the treatment is complemented by the administration of immunomodulators and antispasmodics; for the purpose of detoxification, saline solutions and diuretics can be administered intravenously under the control of electrolyte balance.

What drugs are used to treat pyelonephritis?

In the treatment of any type of pyelonephitis, conservative methods, including the prescription of medications, occupy a significant place. Antibiotics are indispensable, because in the majority of cases the course of pyelonephritis is related to the influence of microbes of a bacterial nature.

Antibiotics are selected taking into account the sensitivity of the microflora revealed during urine testing; preference is given to broad-spectrum drugs. Another important principle of treatment is the frequent change of antibacterial agents to prevent the development of pathogen resistance to them. It is important that the drugs do not undergo changes during exposure and do not affect the kidneys with their toxicity. These could be:

Parenteral and oral fluoroquinolones are highly effective against pyelonephritis pathogens.

Along with antibiotics, nalidixic acid preparations (for example,), nitrofurans (,), and soluble sulfonamides (for example,) are used. Drugs like Trental and are distinguished by their pathogenetic effects.

The appointment of vitamins (mainly B 6, C, E) allows you to increase the protective properties of the body in its fight against the causative agent of the disease. In the complex treatment of patients with pyelonephritis, it has proven itself positively - it is distinguished by strongly pronounced immunomodulatory and microcirculation-restoring properties.

Treatment of pyelonephritis with traditional methods

Treatment of pyelonephritis- a complex process that requires an integrated approach and qualified knowledge. If, after consulting a specialist, the patient is allowed to stay at home and follow conservative treatment (which is likely in case of chronic pyelonephritis or its state of remission), you can consult a doctor about the use of folk recipes to treat the inflammatory process. It is not recommended to use folk recipes as part of self-medication.

The following recipes are popular:

• combine crushed juniper berries, mantle leaves, heather, and nettle in equal proportions; 1 tbsp. Place the mixture in an enamel bowl, pour 1 cup of boiling water and boil for 5 minutes; cool, strain, take ¼ cup 4 times a day until complete recovery;
• combine bearberry leaves, calamus, flax seeds, kidney tea, licorice root, and birch buds in equal quantities; 6 tbsp. pour the mixture with a liter of water, put on low heat and boil for 5 minutes, then cool and strain; take a glass three times a day, half an hour before meals for two months, then re-examine;
• combine lingonberry and wintergreen leaves, cinquefoil herb and parsley root in equal proportions; 2 tbsp. pour 2 cups of boiling water over the mixture, simmer over low heat for 5 minutes, cover the container, leave for an hour; strain, take warm 4 times a day half an hour before meals in the amount of ¼ cup;
• Boil 200 grams of oats in a liter of milk until the broth is reduced by half; take ¼ cup three times a day throughout the course of the disease, until complete recovery;
• 1 tbsp. combine crushed elecampane root with ½ liter of honey; take 1 tsp. in the morning on an empty stomach and in the evening before bed until complete recovery.

Treatment of pyelonephritis during pregnancy

Pyelonephritis in its acute form is a common disease for pregnant women. This is simply explained by anatomical changes in their body, hormonal changes and greater susceptibility to infectious diseases. Expectant mothers who, even before pregnancy, suffered from impaired renal and bladder function or suffered from acute cystitis are at a particularly high risk. The disease belongs to the category of those that can be completely prevented if you make efforts to maintain your health and be sufficiently attentive to the development of diseases preceding pyelonephritis.

Acute pyelonephritis in pregnant women is considered a separate category in clinical practice. In general, this is not a special form of the disease, but rather a typical acute secondary pyelonephritis. A specific view of the course of such a process is explained by the physiological nature of the conditions underlying its development:

• decreased tone of the upper urinary tract due to changes in the balance of female sex hormones during pregnancy;
• pressure of the pregnant uterus on the ureter (usually the right one due to the position of the uterus)
• asymptomatic bacteriuria.

With a similar clinical picture in pregnant women, pyelonephritis is more complicated; it is especially dangerous in the second and third trimester, when the risk of its development is high.

If a pregnant woman is suspected of developing acute pyelonephritis, an urgent ultrasound of the kidneys is necessary, which makes it possible to note a rarefaction halo around the kidney, limitation of its mobility, increase in size and decrease in echogenicity of the parenchyma.

Treatment of pregnant women is carried out in a hospital setting. To begin with, the normal flow of urine from the renal pelvis is restored, then the use of antibacterial therapy is activated:

• restoration of urine outflow - positional drainage therapy (the woman takes a position on her healthy side with the foot end of the bed raised), if this is ineffective, catheterization of the renal pelvis or installation of a stent is indicated;
• antibacterial therapy - selected taking into account the minimal toxic effect on the body of the mother and fetus (drugs of choice may be erythromycin, sulfonamides, nitrofurans; aminoglycosides, tetracyclines, fluoroquinolones are more toxic, but very effective).

In the absence of positive dynamics of the patient, surgical treatment is indicated - nephro- or pyelostomy. The drainage from the kidney is removed 1-1.5 months after birth.

Termination of pregnancy in acute pyelonephritis is rarely performed, the indications for which are usually acute renal and liver failure in the mother, acute fetal hypoxia or intrauterine death. The general prognosis for acute pyelonephritis in pregnant women is favorable, of course, subject to a timely response to dangerous symptoms.

Which doctors should you contact if you have pyelonephritis?

• Ambulance team

Often the clinical picture of pyelonephritis is not so informative as to make a diagnosis in a short time based on the patient’s complaints alone. However, it is still recommended to act quickly, and therefore a patient with suspected pyelonephritis (with a characteristic history and a minimum number of dangerous symptoms) urgently undergoes instrumental and laboratory diagnostics.

In case of asymptomatic chronic pyelonephritis, provocative tests (prednisolone or pyrogenal) can be used to identify it for special indications. A decrease in the relative density of urine, a decrease in the rate of tubular secretion and reabsorption have some diagnostic value, since in chronic pyelonephritis the function of the tubules is primarily impaired.

History is of great importance in recognizing acute pyelonephritis:

• the nature of the temperature reaction, the presence of chills and other suspicious symptoms.
• the patient has recently suffered purulent diseases (furunculosis, tonsillitis, injuries with suppuration, etc.),
• a history of other urological diseases (nephroptosis, urolithiasis, prostate diseases, etc.),
• ongoing endoscopic studies.

During the examination, it is recommended to determine the level of blood pressure, which in the early stages of acute pyelonephritis may be slightly increased, and decreases with increasing intoxication. An objective examination usually reveals tension in the abdominal wall muscles, pain on palpation in the lumbar region, and a positive effleurage symptom.

Among all laboratory tests aimed at identifying chronic pyelonephritis, priority is given to urine tests. Laboratory examination of urine can reveal leukocyturia, which is probably absent in the first stages, when the inflammatory process is localized mainly in the renal cortex, as well as in cases of urinary tract obstruction. When detecting leukocyturia, it is necessary to determine its degree and the presence of active leukocytes and Sternheimer-Malbin cells in the urine. Be sure to determine the presence of bacteria in the urine and the degree of bacteriuria, and it is important to combine bacteriological and bacterioscopic methods for detecting bacteriuria. The sensitivity of the identified microorganisms to antibacterial drugs must be determined.

A laboratory blood test for acute pyelonephritis demonstrates an increase in ESR to 40-50 mm/h or more, leukocytosis with an increase in the content of band forms. With the development of purulent pyelonephritis, as intoxication increases, red blood counts worsen, the level of medium molecules and α 2 -microglobulin increases.

Survey and excretory urography are carried out in order to form an idea of ​​the function of each kidney separately and of changes in the renal collecting system caused by impaired outflow of urine or a purulent process.