Of elderly chronic pyelonephritis clinical manifestation is not typical,
often complicated, the person that weigh when acute onset, can show the similar
to acute pyelonephritis syndrome, can have obvious symptoms of systemic
infection is one of the more common symptoms are the body unwell, weight loss,
low thermal, urinary incontinence, dysuria, urinary retention, polyuria,
nocturia, etc., a few patients characterized by low back pain, abdominal dull
pain or renal colic, light person can be asymptomatic, only change the urine,
individual patients with high blood pressure, urinary flow obstruction,
indwelling catheter or neurogenic bladder in patients with chronic bacteriuria
should be suspected of chronic pyelonephritis.
The elderly pyelonephritis often exist factors of urinary retention, easy
cause urinary tract sepsis, should add alert, urinary tract sepsis complicated
with shock, high case fatality.
Chronic pyelonephritis is relatively concentrated early renal dysfunction and
GFR relatively well-preserved, due to the bacteria in the medulla at the
beginning, caused widespread inflammation, eventually appear scar, renal tubular
structure distortion, which interfere with the medulla transfer mechanism, these
changes can cause polyuria, nocturia, perforation, kidney diabetes insipidus and
electrolyte lesions involving cortex, have extensive scarring lead to renal
failure.
Easy recurrence, the clinical characteristics of acute pyelonephritis,
another attack can be the original disease recurrence or infection, the two
different nature, and the treatment and prognosis of each different, must
distinguish, recurrence is pyelonephritis not cured, only temporary relief,
under the certain factors contributed to latent bacteria cause inflammation and
infection;Infection is the original disease has again, bacteria have been
destroyed, caused by the new pathogenic bacteria invasion.
Urine bacterial culture results conform to the true bacteria or
pyelonephritis course of more than half a year, accompanied by one of the
following conditions can be diagnosed as chronic pyelonephritis: imaging
examination showed renal pelvis, calyces deformation narrowed;Two kidney size,
renal surface uneven;Renal tubular function have sustained damage.
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