Sepsis, which is deadly for a person, in which a general infection of the body with an infection occurs, can be one of the consequences of pyelonephritis. About what else this kidney disease is dangerous for, why it occurs and how it is treated, Izvestia was told on March 27, International Day of the Nephrologist, by the doctor of the Nephrology Department of the Russian Children’s Clinical Hospital of the Russian National Research Medical University. N.I. Pirogova Ekaterina Rusakova.
As the doctor explained, pyelonephritis is an infectious and inflammatory disease of the kidneys, which can also appear in children under the age of one year, when they are not yet able to talk about their complaints. Symptoms of pyelonephritis include high fever (above 38 degrees), lower back pain (usually on one side), foul-smelling and cloudy urine, and nausea and vomiting.
“The complex of symptoms can be combined with discomfort, pain, difficulty in urination and its frequency. In the case of a chronic relapsing course of the disease, the symptoms are erased – without severe intoxication and pain. It is important to note that young children cannot indicate exactly where they have pain, and often describe this condition as a normal pain in the abdomen, ”Rusakova said.
According to her, the occurrence of pyelonephritis is associated with the ingestion of an infectious agent into the kidney, the most common of which is Escherichia coli. Most often, the infection enters the organ in an ascending way: from the lower urinary tract – the urethra and bladder.
At the same time, girls and women are more susceptible to the risks of developing an infection, since they have a shorter and wider urethra, and the genital tract and rectum are located close to it.
The doctor added that in addition to this, the development of the disease can be influenced by congenital anomalies, chronic diseases, including immunodeficiency and diabetes, genetic predisposition, as well as hypothermia or other stress factors.
Rusakova emphasized that the main danger of acute pyelonephritis is associated with its possible complications. Among them are sepsis, intoxication syndrome with dehydration and the creation of a real threat to life, purulent kidney damage with the risk of organ loss. If the process becomes chronic, complete loss of renal function and arterial hypertension are possible. At the same time, with prolonged antibiotic therapy, toxic damage to various organs and systems is not excluded.
Pyelonephritis is diagnosed according to laboratory data in the form of the appearance in the general analysis of urine of a significant number of leukocytes and bacteria. Such a study is especially important for infants with a high fever who have no signs of a respiratory infection, Rusakova said, because they cannot complain of lower back pain or discomfort when urinating.
“It is worth noting that in young children, and especially the first year of life, intoxication quickly develops dehydration, and therefore, as a rule, hospitalization is indicated for them. The basis of the treatment of the disease is the elimination of the cause. First of all, the infectious agent is eliminated with the help of antibiotic therapy lasting at least 10–14 days. For more successful treatment, it is advisable to prescribe an antibiotic in accordance with the results of urine culture, ”the doctor explained.
As Rusakova emphasized, antibiotic therapy for pyelonephritis is used in the vast majority of cases.
Earlier, on March 8, Sergey Doroshenko, an ultrasound doctor at Invitro-Rostov-on-Don, told Izvestia that swelling and loss of appetite could indicate kidney disease. As the doctor noted, kidney disease can develop almost imperceptibly, but at the same time, laboratory parameters can change even before the first signs of the disease appear. If the disease is detected in a timely manner during a preventive examination, this can help slow down the process of its development.
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