Pyelonephritis is a serious bacterial infection of the kidney that can be acute or chronic.

Acute pyelonephritis:

Acute pyelonephritis is a sudden inflammation caused by bacteria.

It primarily affects the interstitial area and the renal pelvis or the renal tubules.

Chronic pyelonephritis:

Chronic pyelonephritis is persistent kidney inflammation that can scar the kidneys and may lead to chronic renal failure.

This disease is most common in patients who are predisposed to recurrent acute pyelonephritis.

Incidence:

Pyelonephritis occurs more commonly in females, probably because of a shorter urethra.

Incidence increases with age and is higher in the following groups:

1.sexually active women as intercourse increases the risk of bacterial contamination.
2.pregnant women
3.diabetics
4.persons with other renal diseases.

Causes:

1.bacterial infections of bladder :

The most common causative organism is Escherichiacoli,Proteus, Pseudomonas, Staphylococcus aureus, and Enterococcus faecalis

2.Use of a catheter to drain urine from the bladder.
3.Use of a cystoscope to examine the bladder and urethra.
4.surgery on the urinary tract
5.Conditions such as prostate enlargement and kidney stones that prevent the efficient flow of urine from the bladder.
6.Defects or abnormalities in the urinary tract that block the flow of urine.

Symptoms:

Acute pyelonephritis:

In this case symptoms develop rapidly. The symptoms are:

1.Fever
2.Urgent and frequent urination
3.Burning during urination
4.Nausea and vomiting
5.Pus and blood in the urine
6.Tenderness in the flanks
7.Changes in the color of the urine
8.Headache
9.Loss of appetite
10.Coliky continous pain

Chronic pyelonephritis:

In this case the infectious inflammatory disease may progress slowly undetected over many years until there is enough deterioration to produce kidney failure. Thus, the conditions seen are:

1.Hypertension (high blood pressure)
2.Anemia
3.Symptoms related to renal insufficiency may be seen.

Diagnosis:

Taking the medical history

Performing physical examination and Tests includes:

1.Blood tests and blood cultures
2.Urinalysis and urine culture. Typical findings include:

a.pyuria (pus in urine)
b.significant bacteriuria. Urine culture reveals more than 100,000 organisms/mm3 of urine.
c.low-specific gravity and osmolality.
d.slightly alkaline urine pH. Alkaline urine pH results from the production of urease from the bacteria or organism, which breaks down the urea.
e.proteinuria, glycosuria, and ketonuria. These findings usually occur in patients with diabetes who are at increased risk for infections including pyelonephritis.

3.Ultrasound study of the kidneys.
4.X-rays
5.CT scan

Complications:

1.Severe or recurrent infections may cause permanent kidney damage and lead to chronic kidney disease.
2.In rare cases, infection in the kidney may spread to the bloodstream which is a serious condition called sepsis.
3.Acute renal failure, a temporary condition in which the kidneys stop working, can also result.
4.Perinephric abscess.

Treatment:

Antibiotic therapy
Anatomic abnormalities may need to be surgically treated.

Prevention:

Intake of fluids to achieve urine output of more than 2,000 ml/day to help empty the bladder of contaminated urine.
Homoeopathic treatment:

1.Colocynth:

a.Urinous odor or perspiration
b.Agonizing pain in abdomen, causing patient to bend double, is most characteristic.
c. Sensations: Cutting, twisting, grinding, contracting and bruised
d.better by doubling up, hard pressure, warmth
e.worse from anger and indignation.

2.Nitric acid:

a.urine darkand strong smelling
b.pricking pains as from splinters
c.aggravation in the night and on walking.

Author Bio: Dr Guptha faculty for the medical billing training

Category: Medicines and Remedies
Keywords: medical, coding, billing, training,