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Chronic pyelonephritis: symptoms and treatment, diet

What it is?

Chronic pyelonephritis is the most common form of kidney disease, manifested in all age categories of the population. It is characterized by inflammatory processes in the tissue envelopes of the kidneys (parenchyma) and in the CLS (cup-and-pelvis system), responsible for the functions of accumulation and excretion of urine.

The disease is often found in patients unexpectedly, with general deterioration of the condition or by the results of urinalysis. Since the chronic form of pyelonephritis often develops without acute symptomatology, and patients do not even suspect its presence.


Causes of chronic pyelonephritis

Chronic pyelonephritis

Many diseases that occur latently (secretly) can become more active under favorable circumstances. Chronic pyelonephritis, which was transferred in childhood or adolescence, is more likely to return with functional pathological processes in the urinary system caused by:

  • an imbalance between intake and consumption of the vitamin in the body (hypovitaminosis);
  • consequence of hypothermia (hypothermia);
  • a decrease in the protective functions of immunity;
  • consequence of physiological or psychological conditions (fatigue or fatigue);
  • effects of focal chronic infections (tonsillitis, inflammatory processes of the uterus and appendages, etc.);
  • not treated with acute inflammatory processes.

In children of early age, the manifestation of chronic pyelonephritis is a consequence of obstructive uropathy - a condition blocking the function of the ureter.

In men, the pathology develops with absolute and relative androgen deficiency caused by hormonal changes, or as a result of prostate adenoma.

The causes of the development of chronic pyelonephritis in women are associated with some anatomical features of the body, due to:

  • short urethra (urethra);
  • constant presence of microorganisms from the rectum and vagina in the outer third of the urethra;
  • failure of complete emptying of the bladder;
  • the possibility of infection in the bladder through sexual intimacy.

In many women, the disease is able to intensify because of pregnancy. During this period there is a natural decrease in the immune factor, so that fetal antigens are not rejected by the mother.

The fight against pathogens is not at the proper level, which serves as a predisposing factor to the development of chronic form of pyelonephritis in pregnancy.

Weak symptomatic signs, an underestimation of the danger of the disease, a non-serious attitude toward treatment, create the prerequisites for the transition of pyelonephritis to the chronic form of the disease.

Symptoms of chronic pyelonephritis

Symptoms of chronic pyelonephritis

Symptoms of chronic pyelonephritis are divided into local and general.

Local symptoms of chronic pyelonephritis in women are more pronounced. It is manifested in patients with a secondary form of the disease caused by exacerbation of chronic pyelonephritis caused by a number of diseases that cause disorders of urinary outflow from the kidneys - urolithiasis (urolithiasis), prostatic hyperplasia, hormone-dependent tumors of the uterus, nephroptosis (omission of the kidney), etc.

Patients experience periodic pulsating or aching pain, not associated with the activity of movements, and more often - at rest.

The general symptoms of the disease are divided into early signs and late ones. Early symptoms are not associated with impaired renal function.

There are:

  • fast fatigue;
  • episodic asthenia (weakness);
  • lack of appetite;
  • poor tolerance of habitual loads, which can be provoked by the venous fullness of the kidney;
  • a slight rise in blood pressure and temperature.

Possible complications

Sudden sharp exacerbation of pathological processes can cause acute renal failure, and the progression of the disease leads to the development of chronic renal failure (the syndrome of irreversible disorders of renal functions). There are:

  • unpleasant or painful sensations in the lower back;
  • dry mouth and heartburn;
  • low level of psychological activity;
  • puffiness of the face and pallor of the skin;
  • allocation of more than 3 liters of urine (urine) per day.

The late signs of the disease, as a rule, indicate the presence of CRF and are characteristic of bilateral renal damage.

The clinical picture depicting the course of chronic pyelonephritis, symptoms, diagnostic indices and the stages of the pathological process plays a huge role in the preparation of the therapeutic protocol.

Stages of the disease

  1. In the initial stage of the disease inflammatory processes and edema of connective tissues (interstitial) of the inner layer (cerebral) kidneys, which cause vascular contraction, decrease of renal blood flow, development of tubular atrophy, are noted.
  2. The second stage is characterized by a diffuse narrowing of the arterial kidney bed, the absence of interlobar arteries and a decrease in the size of the cortex, which is determined by the nephrogram.
  3. The last, the third stage - is due to the narrowing and deformation of all renal vessels, the replacement of renal scar tissue, the formation of a wrinkled kidney.

Diagnosis of chronic pyelonephritis

Urine, with the chronic form of pyelonephritis, is one of the components of the diagnostic examination. It is examined for leukocytes and red blood cells the presence of protein, salts and bacteria. As additional techniques are carried out:

  • Assessment of the kidneys by excretory urography;
  • Detection of the pathogen and verification of its sensitivity to drugs by the seeding method;
  • Evaluation of structural changes in the kidneys by ultrasound;
  • CT and MRI, detecting urolithiasis (urolithiasis) and tumor neoplasms.

Treatment of chronic pyelonephritis, drugs

Treatment of chronic pyelonephritis

Treatment of any form of pyelonephritis is aimed at eliminating the causes that cause an obstruction of urine outflow. Surgery for urolithiasis, prostate adenoma, or surgical correction of ureteral pathologies, can, if not relieve the disease, ensure long-term remission of the disease.

Preparations, with a chronic form of pyelonephritis are selected according to the results of a sowing tank. This is usually antibacterial drugs.

A further treatment regimen includes:

  1. Elimination of the cause of pathological processes in the kidneys (recovery of urine flow, elimination of circulatory problems).
  2. Selection of effective antibacterial treatment of nephrotoxic therapy.
  3. The appointment of immunomodulating and immunostimulating drugs for immune correction.

With the failure of conservative therapy, treatment of chronic pyelonephritis with surgical techniques aimed at restoring the outflow of urine is prescribed. One of the main components of the healing process is the diet.

Recommendations for a diet

A balanced diet contributes to a quick recovery. When the disease worsens, the diet should include fresh fruits and vegetables, as well as at least 2 liters of liquid. Inadequate in the diet - fried, spicy, fatty and salty foods.

Chronic course of the disease requires a serious attitude to the diet. Recommended:

  • include in the diet a small number of meat or fish broths;
  • Fish and meat are not fatty varieties boiled, or cook only for a couple;
  • vegetables and fruits in fresh and boiled form;
  • cereals, dairy products and vegetarian dishes;
  • Watermelons, melons and pumpkin dishes;
  • liquid consumption increased to 2.5 liters;
  • horseradish, garlic and radish should be excluded from the diet;
  • the use of salt per day limit to 8 grams.

Forms of manifestation of the disease

Clinical medicine distinguishes various forms of manifestation of the disease.

By origin:

  • in the form of a primary form, not associated with the previous urological pathology;
  • secondary form of the disease, caused by pathologies of a urological nature.

At the location of the process of inflammation:

  • one-sided or two-sided localization;
  • total defeat (of the entire kidney);
  • segmental localization (segment or site damage).

According to the stage of the disease:

  • stage of exacerbation;
  • stage of remission.

The severity of inflammatory processes caused by:

  • active phase of inflammation;
  • latent (secretive) phase of inflammation;
  • weakening / reducing the process of inflammation - remission.

According to the clinical forms of manifestation:

  • latent or recurrent;
  • hypertensive, anemic and azotemic;
  • hematological, nephrotic and septic.

By the degree of nephron damage (degree of CRF)


The main rule for the prevention of chronic pyelonephritis is the timeliness of the treatment of diseases that cause the development of disturbances in the normal movement of urine.

Significantly reduces the risk of developing a long pathological process - compliance with hygiene rules and the timeliness of medical examinations. To ensure that the kidneys are always healthy, do not overstep the limits of hypothermia.


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