What is the difference between urolithiasis and pyelonephritis. Diuretics for renal failure, pyelonephritis, urolithiasis, stones

The minimum course of antibiotic therapy is 14 days. In case of a malignant course, the frequency of exacerbations is more than 2 times a year, a prophylactic course of antibiotic therapy in a half dose is recommended 2 weeks after the main course.

Also highly active against microorganisms determined by urine culture are antibiotics of the cephalosporin series, mainly of the latest generations. They are convenient for long-term use due to a minimum of side effects.

Aminoglycoside antibiotics have a powerful antimicrobial effect, show high efficiency in the treatment of chronic pyelonephritis.

But, due to their inherent nephro- and ototoxicity, their appointment requires caution, the use is justified in complicated forms of the disease.

Other groups of antimicrobial agents are also used according to indications. In addition to the use of antibacterial drugs, it is necessary to eliminate urodynamic disorders (treatment of urolithiasis, prostate adenoma, plastic elements, etc.). Also use general strengthening agents.

In case of pain syndrome, antispasmodics are prescribed, for the correction of arterial hypertension, antihypertensive drugs are prescribed. Quite actively in the treatment of chronic pyelonephritis use folk remedies - "". But in order for folk remedies to be beneficial, their use should take place only in combination with drug therapy and in moderation.

Diet

During an exacerbation of chronic pyelonephritis, dietary nutrition is aimed at reducing the load on the kidneys.

To combat intoxication in the first 2 days, food is limited to plant foods and a large amount of liquid.

In the next 1-2 weeks, a dietary table number 7 is assigned.

The food is predominantly vegetable and dairy, lean meats are gradually included. Chemical sparing is provided (spicy, smoked, fatty is excluded), without mechanical (special grinding of products is not required).

Food is steamed or boiled. Salt is completely eliminated or used in a minimal amount. Multiplicity of food intake - up to 6 times a day in small portions.

Prevention

Measures to prevent the development of chronic pyelonephritis are aimed at curing the acute form of the disease, correcting urodynamic disorders, and eliminating persistent foci of inflammation in the body.

The methods of anti-relapse prevention include adequate treatment of exacerbations using prophylactic courses of antibiotic therapy according to indications, compliance with nutritional recommendations, and the fight against parallel pathological conditions that can complicate the course of pyelonephritis.

To prevent swelling of organs and limbs, diuretics are prescribed for kidney disease. The appearance of edema is associated with a violation of the kidneys, as a result of which sodium and water are not sufficiently excreted from the body. The choice of diuretics (diuretic) should be dealt with by the doctor, since the choice of remedy depends on the nature of the edema, the age and condition of the patient. In addition, there are natural diuretics that are excellent for kidney disease, such as some vegetables or watermelon.

Diuretics for various kidney diseases

The kidneys can be seriously ill, and when a person decides to make a diagnosis and prescribe therapy on his own, he must be prepared for the fact that each drug has contraindications and side reactions, and this can noticeably worsen well-being. And if you try to remove stones with the help of diuretics, then urolithiasis can result in blockage of the urinary canals, where surgery is indispensable. Therefore, it is not recommended to self-medicate, at the first signs of impaired kidney function, you should contact a therapist or urologist. The specialist will select a competent treatment and prescribe useful drugs depending on the problem.

When kidney problems are mild, doctors try to get by with natural diuretics, but if the symptoms of kidney failure or any disorder are pronounced, a synthetic diuretic comes to the rescue.

Sand in the kidneys

Unhealthy diet, metabolic disorders, excess weight lead to the fact that sand begins to settle in the kidneys. The danger of this condition is that the resulting sand does not create discomfort and, in general, does not hint at the presence. However, leaving the body, the sand still causes exacerbations. For some people, the entire process does not go without symptoms. Having diagnosed such a pathology, the doctor resorts to the help of such means as Fitosilin or Urolesan. These are plant-based products that are not addictive. The course of treatment for patients ranges from a week to a month - depending on the severity of the disease.

Urolithiasis disease

One of the best in the treatment of this disease is considered "Furosemide" - a strong diuretic drug, potassium-sparing action. In addition to him, "Veroshpiron" or "Aldakton" are prescribed, which belong to a similar group. It is worth noting a number of side effects: drowsiness, hyperkalemia and menstrual irregularities in women.

Renal colic

The disease develops against the background of urolithiasis, and occurs due to a violation of the outflow of urine. An attack of severe renal colic requires medical attention. To reduce spasm, you can take painkillers. But you can’t do without the help of NSAIDs and diuretics:

• NSAIDs (non-steroidal anti-inflammatory drugs) are indicated for renal colic, their action is aimed at eliminating symptoms, for example, relieving fever and spasms. Such drugs have an anti-inflammatory effect.
• Diuretics help to slow down the development of the disease, which is why herbal preparations are prescribed: Canephron or Fitolizin. It is worth noting that Fitolizin is also a good anti-inflammatory and antispasmodic agent.

Pyelonephritis or inflammation of the kidneys

Pyelonephritis needs complex treatment: diet plus kidney pills. Antibiotics and diuretics are often prescribed. Means such as "Veroshpiron" or "Uregit" stimulate blood flow to the kidneys, increasing the activity of the organ, which contributes to the speedy removal of pathogenic organisms and excess fluid. Therapy takes no more than a week, after which the patient should be tested.

Glomerulonephritis

A pathology characterized by bilateral damage to the kidneys, when the glomeruli become inflamed, which provokes the accumulation of toxins in the body. With glomerulonephritis, diuretics from the potassium-sparing group are prescribed, for example, Hydrochlorothiazide, Spironolactone or Furosemide. If there are contraindications, the drugs can be easily replaced with analogues: "Hypothiazid", "Lasix" or "Uregit".

Renal failure (PN)

To begin with, doctors are trying to do without medication, because the initial therapy is reduced to a salt-free diet and reduced water consumption. When methods fail, patients are treated with pills. Intensive treatment is prescribed when diuretics are shown to be drunk every day for a week. Among them:

• "Amiloride";
• "Veroshpiron";
• "Diver";
• "Furosemide";
• "Uregit".

At the initial stage of the development of kidney disease, you can try to avoid taking medications. Nature has provided folk remedies for kidney diseases, such as:

• Bearberry is an herb that relieves spasms and relieves exacerbations. You will need a large spoonful of grass, filled with 250 ml of boiling water. Infused and drunk 2 times a day.
• Yarrow is considered a good helper in relieving spasms and inflammation, in addition, it stimulates the removal of excess fluid from the body. The recipe is similar to the previous one.
• With PN, stigmas of corn, which are taken infusion for a month, will relieve pain.

Using diuretic herbs, it should be remembered that together with the liquid, they remove useful trace elements. The course of treatment should be limited to 10 days.

In addition to herbs, vegetables and berries are excellent natural diuretics for the kidneys. These include: cucumbers, carrots and beets, celery, melon and watermelon. Instead of eating the ingredients separately, you can mix the vegetables into a vegetable smoothie or make fresh celery juice. Rosehip, strawberry, currant and lingonberry infusions have also proven to be good diuretics.

Why is it necessary to treat pyelonephritis with kidney stones first of all?

Often urolithiasis disease accompanied chronic pyelonephritis with frequent exacerbations and transitions to subacute and acute pyelonephritis.

The question arises, what comes first: pyelonephritis or kidney stones? In this article, we will tell you how pyelonephritis and urolithiasis are related, as well as how to treat acute and chronic pyelonephritis with kidney stones.

Relationship between chronic pyelonephritis and kidney stones

Chronic pyelonephritis, accompanied by constant infectious inflammation in the tissues of the kidneys, leads to the gradual death of nephrons and the appearance in the urine of clots from dead cells of the renal tissue and desquamated epithelial cells. All this creates the so-called protein matrix of the stone - a framework on which bacteria are fixed and mineral salts precipitate, forming stones.

In addition, in chronic pyelonephritis, congestion in the kidneys increases, because, due to inflammation, the outflow of urine through the ureters is disturbed. The formed stones, in turn, injure the urinary tract and the process becomes endless. Any pyelonephritis that develops against the background of nephrolithiasis is considered complicated.

Stones in the kidneys and ureters constantly irritate the renal parenchyma and lining of the ureters, bladder, and urethra, causing inflammation and pain. Pathogenic bacteria settle on the injured surface of the urinary tract by adhesion (adhesion), entering the kidneys either ascending (through the urethra and bladder with inadequate personal hygiene) or hematogenously (with blood flow from focal infections in other organs, for example, with the presence of caries, stomatitis, tonsillitis, etc.).

Since kidney stones and chronic pyelonephritis are closely related, it is necessary to treat these diseases in a complex manner.

Reasons for the formation of kidney stones

Currently, a number of studies have been carried out confirming the bacterial nature of urolithiasis of the kidneys. As you know, some kidney stones, such as phosphates, formed during the alkaline reaction of urine pH> 7, are of bacterial origin. There is even a term "infected kidney stones". However, until now it was believed that stone formation in general is associated with metabolic disorders and other factors. More recently, scientists were able to detect in the body of people suffering from urolithiasis, special ultra-small bacteria that cause stone formation in the kidneys.

Antibiotic treatment of pyelonephritis and cystitis in urolithiasis of the kidneys

At the first sign of cystitis or pyelonephritis, you should immediately consult a doctor who will send you for a urine test and select the necessary antibiotics to treat the infection. Usually, in chronic pyelonephritis, long-term (from 2 weeks to 1-2 months) courses of antibiotics and antibacterial drugs are prescribed.

Antibiotics for pyelonephritis

Most often, the following antibiotics are used in the treatment of pyelonephritis:

• Agumetin, Ampiox, Amoxicillin, Amoxiclav (amoxicillin with clavulanic acid), and other beta-lactam antibiotics;
• Cifran, Ciprofloxacin;
• Biseptol, Co-trimoxazole;
• Palin, 5-nok (although these drugs often do not create the concentration in the kidneys necessary for a complete cure).

Antibacterial and anti-inflammatory drugs for pyelonephritis

With complicated pyelonephritis and the presence of kidney stones, along with antibiotics, antibacterial preparations of plant origin are prescribed:

• Kanefron-N (tablets or drops);
• Phytolysin paste;
• Urolesan (drops and capsules).

Phytotherapy of pyelonephritis in urolithiasis

Herbs with antibacterial, astringent and anti-inflammatory properties are used to treat inflammation in the kidneys and ureters.

The composition of kidney fees and teas include the following components:

• Antibacterial: St. John's wort, round-leaved wintergreen, chemist's chamomile, one-sided ortilia (upland uterus), umbrella winter love, cinnamon rose hips, etc.
• Astringents and anti-inflammatory: stinging nettle, shepherd's purse, licorice root naked, meadowsweet grass (meadowsweet), etc.
• Diuretic: lingonberry leaves, bearberry (bear ears), drooping birch leaf, orthosiphon (kidney tea), etc.

With pyelonephritis associated with urolithiasis, herbs should be added to herbal preparations, dissolving and crushing kidney stones:

• highlander bird (knotweed),
• horsetail,
• woolly erva grass (half-fallen),
• madder root.

Hygiene with frequent cystitis and pyelonephritis

Treatment of chronic pyelonephritis with urolithiasis should always begin with the sanitation of foci of infection in the body, careful personal hygiene. It is necessary to thoroughly brush your teeth in the morning and in the evening, to prevent the occurrence of pustular diseases, to treat caries in a timely manner.

In addition, people who suffer from frequent cystitis or chronic pyelonephritis, or who have kidney stones, should never wash themselves with soap and antibacterial agents containing triclosan. When washing, you should use special hygiene products containing in their composition lactic acid to restore and preserve the natural protective microflora of the mucous membranes of the genitourinary system, which protects the urinary tract from the penetration of pathogenic bacteria from the outside.

The chronic form of pyelonephritis is an inflammatory process that spreads in the kidneys. The disease manifests itself in the form of malaise, pain in the lumbar region and other symptoms.

Pyelonephritis in the chronic form has several stages, each of which is manifested by certain signs. performed with antimicrobials.

General information about the disease

Chronic pyelonephritis is a nonspecific inflammation of the kidney tissue. As a result of the spread of the pathological process, destruction of the vessels of the organ and is noted.

The chronic form develops against the background of previously transferred acute pyelonephritis, in which the treatment was carried out incorrectly or was completely absent. In some cases, the pathology may be asymptomatic and many patients do not even notice the presence of the disease. Pyelonephritis can become chronic for several reasons:

• reflux urine;
• inadequate treatment of the acute form;
• violation of urine excretion as a result of narrowing of the urinary tract;
• chronic intoxication.

Chronic pyelonephritis according to ICD-10 has the N11 code and is divided into several forms depending on various signs.

Statistical data

According to statistics, chronic pyelonephritis is established in 60% of cases of diseases of the genitourinary system with the development of an inflammatory process. In 20%, the pathology develops against the background of an acute course.

The disease is established most often in women and girls. This is due to the anatomical structure of the urethra. It is easier for viruses and bacteria to enter the female body through the vagina, from where they penetrate the kidneys and bladder.

The chronic course differs from the acute one in that the pathological process affects both kidneys, while the organs are not equally affected. This form most often proceeds latently, and remissions are replaced by exacerbations.

Etiology of the disease

Pyelonephritis develops as a result of the activation and spread of pathogenic microbes against the background of the influence of various factors. Most often it is an infection with Escherichia coli, streptococci, enterococci and other microorganisms.

Additional causes of inflammation in the kidneys are:

• incorrectly carried out treatment;
• , prostate adenoma, urinary reflux and other diseases of the genitourinary system that have not been diagnosed and treated in a timely manner;
• the multiplication of bacteria that have been in the tissues of the kidneys for a long time;
• decreased immunity as a result of prolonged infectious diseases or immunodeficiency states;
• chronic pyelonephritis can be a complication after SARS, tonsillitis, measles, pneumonia or scarlet fever (children are most susceptible);
• chronic pathologies such as diabetes mellitus, tonsillitis, obesity or intestinal disorders;
• in women, or during the onset of sexual activity;
• unidentified congenital diseases of the genitourinary system.

Hypothermia and the presence of autoimmune reactions can provoke the development of a pathological process.

Clinical picture

The chronic form of pyelonephritis may be asymptomatic. Signs during the period of remission do not appear. They become pronounced at the stage of exacerbation. The main clinical manifestations of pyelonephritis include:

1. Body intoxication. It is characterized by the presence of general weakness, nausea, vomiting, malaise, loss of appetite, and headaches and chills. When diagnosing, pallor of the skin and tachycardia are noted.
2. Painful sensations. They are localized mainly in the lumbar region.
3. Bad smell of urine, especially can be observed early in the morning, after sleep.
4. Pain when urinating, .

Against the background of chronic pyelonephritis, water and electrolyte disturbances occur, which manifest themselves in the form of dry mouth, the appearance of cracks on the lips, peeling of the horse cover and constant thirst.

The disease has several stages, each of which is manifested by special symptoms, in the presence of which the doctor can determine the degree of development of the pathology and prescribe the necessary treatment.

1. Aggravation. At this stage, the signs are pronounced. Severe pain and intoxication of the body are observed. In a laboratory blood test, an ESR acceleration is established. Anemia is also observed. Lack of treatment at this stage leads to the development of renal failure, the diagnosis and therapy of which are difficult.
2. Latent. The symptoms are not pronounced. Patients often complain of increased fatigue and constant weakness. In exceptional cases, hyperthermia is noted. Painful sensations in the lumbar region and during urination are practically absent. The ability of the kidneys to concentrate urine against the background of the pathological process decreases, which is reflected in its density. In a laboratory study of urine, the presence of bacteria and leukocytes is established.
3. Remission. There are no symptoms at this stage. The disease is not manifested by any signs, which complicates the diagnosis. During a laboratory study of urine, a slight deviation from normal values ​​\u200b\u200bmay be established. When exposed to negative factors, the stage of remission passes into the stage of exacerbation, the symptoms become aggressive, the patient needs medical care.

Disease classification

Based on the ICD-10, the varieties and forms of chronic pyelonephritis are determined by various factors. Allocate:

1. Primary chronic form. Pathology develops on a healthy organ, the pathological process affects both kidneys.
2. Secondary chronic form. It is a complication of another pathology. It is first one-sided, then the inflammation affects the second kidney.

A certain group of scientists prefers to divide pyelonephritis into a community-acquired form and nosocomial when the patient requires hospitalization. Depending on the localization of the pathological process, there are:

• Unilateral.
• Double-sided.

According to the severity of the disease, the disease can be divided into:

• Complicated when other pathologies join.
• Uncomplicated, occurring without concomitant diseases.

A separate group includes pyelonephritis occurring with renal failure. Most often complicated forms.

Methods of treatment

Diagnosis and therapy is complicated by the fact that in remission the disease does not show symptoms. Each patient with chronic pyelonephritis requires an individual approach and complex treatment. First of all, to relieve symptoms during the exacerbation stage, drugs are prescribed to relieve symptoms and destroy pathological microorganisms.

When establishing a chronic form of pyelonephritis, the following groups are assigned:

• Cephalosporins. "Kefzol", "Cefepim" or "Tseporin";
• Semi-synthetic penicillins. "Amoxiclav", "Ampicillin" or "Oxacillin", these are broad-spectrum antibiotics that help destroy the microorganisms that caused the development of the disease;
• "Negram", the drug belongs to the group of nilidixic acids;
• in severe cases, "Tobramycin", "Gentamicin" or "Kanamycin" are prescribed.

Ascorbic acid, "Selenium", "Tocopherol" are used as antioxidants. in the chronic form of pyelonephritis are prescribed for up to eight weeks. In the case of a severe course of the exacerbation stage, antibacterial drugs are administered intravenously, which helps to achieve greater efficiency and faster results. One of the most modern remedies for pyelonephritis is "5-NOC". It helps in a short time to stop the symptoms and relieve inflammation.

The patient should limit the consumption of fatty foods, salty and spicy foods, and also observe the drinking regimen prescribed by the doctor.

Folk methods

Treatment of pathology can occur after the relief of the stage of exacerbation and only after consultation with the attending physician. The most effective are the following recipes:

1. White acacia tea. Brew like regular tea. Drink half a glass for 10 days.
2. A decoction of beans. A glass of beans, chop, pour a liter of boiling water, put on fire and bring to a boil. Take daily for 7 consecutive days.
3. Heather infusion. Two tablespoons of dried herbs pour two cups of boiling water and leave for an hour. Then strain and drink in large sips.

With pyelonephritis, baths with the addition of tincture of pine branches are also useful. The water temperature should not be less than 35 degrees. The duration of the bath is no more than 15 minutes. The course of treatment is 15 procedures.

Disease prevention

To avoid the development of inflammation in the tissues of the kidneys should be observed. Experts recommend:

• avoid hypothermia;
• Healthy food;
• strengthen immunity;
• timely treat infectious diseases.

The chronic form is dangerous because it may not manifest itself for a long time. The disease is established in the diagnosis of other pathologies. In case of symptoms, you should consult a doctor, since the acute form always develops into a chronic one, which is difficult to treat.