The Elderly the Symptoms of Chronic Pyelonephritis

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.

The Symptoms of Acute Pyelonephritis

Acute pyelonephritis is mainly caused by e. coli, is an acute infectious disease. So, what are the common symptoms of acute pyelonephritis?The expert points out, there are three kinds of common symptoms of acute pyelonephritis, the following will introduce the concrete.

1, bacteremia and sepsis

Although there are symptoms of the patients with acute pyelonephritis, can be in the process of their disease complicated with bacteremia, but this kind of bacteremia and more severe gram-negative sepsis without obvious correlation.

2, shock

When there was a shock, acute pyelonephritis, must rule out the possibility of urinary tract obstruction.A situation which is particularly important is obstructed kidney disease associated with acute nipple necrosis, it can be caused by loss of renal papilla and ureteral obstruction.If severe pyelonephritis or bacteremia in diabetic patients, especially patients with poor response to treatment, should be highly suspected the possibility of concurrent nipple necrosis.

3, convulsions, and convulsions

Children with acute pyelonephritis in patients with urinary tract symptoms are often not obvious, the onset in addition to the systemic symptom such as high fever, convulsions, seizures are common.Under 2 years old children, such as fever, vomiting, nonspecific abdominal discomfort, or inactive, may be acute pyelonephritis;The only meaningful individual evidence may not be active.Account for around 10% of its febrile illness;For older children, the clinical manifestation and the adult is more similar.When children with recurrent urinary incontinence, often hint associated with renal infection in the urine concentration of functional impairment.


If you meet the above three kinds of situation, should the patient to the hospital immediately, otherwise it will lead to more serious consequences.If you have any questions, can contact me by email liu476qiang@gmail.com.

The Cause of Pyelonephritis

Pyelonephritis is caused by all kinds of pathogenic microorganism directly affect the renal pelvis and calyces mucosa of renal tubules, renal interstitial infective inflammation.Found in recent years, in some patients with pyelonephritis renal bacteria exist in the scar tissue antigen, show that in the pathogenesis of acute pyelonephritis, kidney damage induced by inflammation can also be one of the reasons.

The pathogenic bacteria of pathogenic bacteria that cause pyelonephritis in e. coli, for most, the second vice escherichia coli, proteus, streptococcus faecalis, etc.

Transmission:

1, the uplink infection: ascending infection is the most common way.When the body resistance decline, the urethra mucous membrane after a slight injury, bacteria easy invasive bladder and kidney infections.Because of the female urethra than men short, wide, female urethral mouth has often been pollution of excrement and urine, so easy to cause disease.On the kidneys of bacteria invasion in renal pelvis mucosa, cause inflammation, and then the calyces, nipple, renal tubular upward, in violation of renal parenchyma.

2 line, blood infection, bacteria from the body within the lesion invasion of blood flow, arrived in kidney cause inflammation, cause inflammation, blood infection, the bacteria first reached the renal cortex, and at the most small abscess formation, and then along the renal tubules spreading downward to the renal papilla and renal pelvis.

3, lymphatic infection;


4, direct infection, trauma, or organ of the adjacent kidney infections, bacteria can be invaded directly renal arteries and veins cause inflammation.