Chronic pyelonephritis is an inflammatory process of bacterial etiology with predominant involvement of the renal tubular system, renal pelvis, calyces, and parenchyma. Pyelonephritis is the most common kidney disease in all age groups. Girls and women of young and middle age are affected 6 times more often than boys and men.
What chronic pyelonephritis is
By the nature of its course, pyelonephritis is divided into acute, chronic, and recurrent. Chronic pyelonephritis with exacerbation is also distinguished. By the number of affected kidneys, a unilateral and bilateral process is distinguished; by the conditions of onset, primary and secondary; by the patency of the urinary tract, non-obstructive and obstructive. Variants of the course of chronic pyelonephritis include latent, hypertensive, anemic, azotemic, and asymptomatic forms, as well as remission.
Causes and risk factors
The most common causative agents are Escherichia coli, Proteus, enterococci, and Pseudomonas aeruginosa. The pathogen most often enters hematogenously from a focus of infection in the body, less often urinogenously from the lower urinary tract. The risk is higher with kidney stones, bladder or urethral obstruction, diabetes mellitus, a catheter in the bladder, urinary retention, pregnancy, an enlarged prostate, prolonged immobility, and also with a weakened immune system.
Symptoms of chronic pyelonephritis
When the infection spreads to the kidneys, chills and shivering or night sweats occur, along with fatigue and general malaise, a temperature above 38.3 °C, pain in the side, back, or groin, nausea, and vomiting. In older people, mental changes or confusion may be the only sign. A urinary tract infection may also manifest with symptoms of cystitis.
- Pain, burning, or stinging during urination
- Frequent and urgent urges to urinate
- Dark or cloudy urine
- High temperature, chills
- Pain in the lower back or side
Features in women
Urinary tract infections are more common in women because their urethra is shorter and located closer to the anus. For this reason, the risk of infection is higher after sexual activity or when using a diaphragm as a contraceptive. Menopause also increases the risk of urinary tract infection.
How it is diagnosed: urine tests, ultrasound, and other methods
A urine sample is taken to detect the infection. A urinalysis looks for leukocytes, red blood cells, bacteria, and chemicals such as nitrites. A culture of midstream urine allows bacteria to be identified. A complete blood count and blood culture may be performed. To check for other problems of the urinary system, computed tomography of the abdominal organs, intravenous urography, ultrasound examination of the kidneys, and voiding cystourethrography are used.
Possible complications and when to see a doctor
Complications include a life-threatening reaction of the body to the infection (sepsis), and kidney damage or scarring. The risk of sepsis is higher in young people, the very elderly, and those whose body cannot fight the infection. A doctor is consulted for pain in the back or side, chills, fever, vomiting, and also if symptoms return soon after treatment.
The condition itself is not a reason to call an ambulance; 103 or 112 — if confusion, drowsiness, or difficulty speaking appear.
The material is for reference purposes and does not replace consultation with a doctor.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer