Pyelonephritis (pyelonephritis) refers to inflammation of kidney , mostly caused by bacterial infection, generally associated with urinary tract infection, not easy to distinguish in clinic . According to the clinical course of the disease , pyelonephritis can be pided into two stages as acute and chronic , chronic pyelonephritis is an important cause of chronic renal insufficiency.
(a) acute pyelonephritis
The disease can occur at any age, but is mostly common in women of childbearing age, abrupt onset, mainly have the following symptoms.
1 general symptoms of high fever, chills, fever often between 38 to 39 DEG C, also can be as high as 40 DEG C. Heat is not the same, is also a type of relaxation, intermittent or missed type. Accompanied by headache, body aches, sweating, sweating, etc..
2 urinary symptoms in patients with low back pain, mostly dull pain or ache, not a few, abdominal cramps, radiation to the bladder along the direction of transmission in the ureter, medical point of upper ureter (intersection of external rectus and umbilicus line) or lumbocostal point (intersection of psoas muscle and twelve outer ribs) tenderness, positive kidney pain. The patient often has frequent micturition, urgency, dysuria and other urinary bladder irritation symptoms, in the morning of infection, systemic symptoms may precede. Children with urinary tract symptoms are often not obvious, in addition to the onset of high fever and other systemic symptoms, often convulsions, seizures.
3 gastrointestinal symptoms are loss of appetite, nausea, vomiting, inpidual patients can have abdominal or whole abdominal pain.
(two) chronic pyelonephritis
The symptom is lighter than the acute period, sometimes can appear as asymptomatic urine. More than half of the patients with acute pyelonephritis history, followed by symptoms of fatigue, fever, anorexia and lumbago, and accompanied by frequent urination, urgency, dysuria and other urinary irritation symptoms. Acute onset also occurs. The course of more than half a year or 1 years for chronic pyelonephritis, recently developed renal pelvis had scar formation, intravenous pyelography see renal pelvis seeper, kidney shape deformation, not smooth, or two sizes called kidney of chronic pyelonephritis. There may be damage to renal tubular function, such as decreased concentration, low permeability, low specific gravity urine, nocturia and renal tubular acidosis. To the late stage, there may be damage to glomerular function. Renal hypertension is caused by chronic pelvic inflammatory disease, and it is generally believed that patients with high renin and some of the release of vasoconstrictor peptides and vascular sclerosis, stenosis and other diseases. After a small number of patients with unilateral renal disease, hypertension can be improved.
The clinical manifestations of chronic pyelonephritis complicated, easy to attack again, the reason is: the predisposing factors exist; the mucosa of renal pelvis, renal papilla due to scar deformation, is conducive to the long-term incubation; after the use of antibiotics, drug-resistant bacteria produced, or inside the cell, make the antibiotic lose the sterilization ability; 4. In humoral immunity or antibiotics, the bacterial membrane can not be formed, exists in the protoplasmic mass form, still in the medulla dowshock vitality, so once a favorable environment, re growth and reproduction of pleural again this is sinister, protoplasmic strain (type L). Therefore, chronic pyelonephritis is considered to be more difficult to cure and progressive disease.
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