Pyelonephritis treatment

Pyelonephritis is an inflammation of the kidneys that develops due to infection. It primarily affects the renal tubules and the renal pelvis and calyces, resulting in impaired blood filtration, loss of trace elements, and other disorders.

Acute and chronic pyelonephritis have a common nature - an inflammatory process in the kidneys, but differ in the course and severity of clinical manifestations. Both forms are characterized by impaired urination, changes in urine, pain in the lower back and general signs of inflammation. At the same time, acute pyelonephritis is usually accompanied by a sudden onset and bright symptoms. In chronic pyelonephritis, symptoms may be less pronounced or occur periodically. Fever in pyelonephritis is usually present only in the acute form of the disease.

Symptoms of acute pyelonephritis may include:

• Pain in the lower back, lumbar region, or side;

• Frequent urge to urinate;

• Changes in urine color, presence of sediment;

• Nocturnal urination;

• Mild swelling;

• Thirst;

• Fever;

• General weakness;

• Nausea, vomiting.

The symptoms may vary depending on the form and stage of the disease, as well as the presence of comorbidities. In some patients, acute pyelonephritis develops against the background of cystitis, prostatitis, or other urinary system conditions.

In men and women, pyelonephritis symptoms are similar, but in children the disease may present atypically – with nocturnal urination, weight loss or gain, etc.

In chronic pyelonephritis, a sluggish inflammatory process persists, causing the symptoms to be less pronounced.

Symptoms of chronic pyelonephritis may include:

• Periodic dull pain in the lower back, side, or lower abdomen;

• Changes in urine color, sediment;

• Increased thirst;

• Swelling;

• Fatigue;

• Weight loss or gain;

• Nocturnal urination, etc.

Chronic pyelonephritis can flare up and then go into remission. During flare-ups, symptoms intensify, prompting the patient to seek medical help. During remission, symptoms may nearly disappear.

To ensure accurate diagnosis and effective treatment, pyelonephritis is classified according to several parameters.

By the number of affected kidneys, pyelonephritis can be:

• Unilateral – one kidney is affected;

• Bilateral – inflammation in both kidneys.

By the nature of the inflammatory process:

• Acute;

• Chronic.

Chronic pyelonephritis is further divided into:

• Latent – slow-progressing inflammation;

• Recurrent – the disease progresses with frequent flare-ups;

• Hypertensive – accompanied by high blood pressure;

• Anemic – accompanied by anemia, etc.

By urinary tract patency:

• Obstructive – patency is impaired due to stone formation;

• Non-obstructive – normal urine flow is maintained.

By infection route and presence of other conditions:

• Primary – developed as an independent disease;

• Secondary – developed as a complication.

Thus, pyelonephritis of the kidneys has several clinical forms and course variants, which differ in the prevalence of the inflammatory process, the nature of the symptoms, the causes of development and the functional state of the urinary tract. A clear definition of the type of pyelonephritis is of key importance for choosing an effective treatment strategy, assessing the risk of complications and the prognosis of the disease.

In most cases, pyelonephritis occurs due to bacteria entering the kidneys. This can happen in two ways: through the urethra or from other organs via the bloodstream and lymphatic fluid. The most common causative agent is Escherichia coli; less commonly, enterococcal or staphylococcal infections.

Additionally, kidney inflammation may begin due to impaired urine flow in conditions such as polycystic kidney disease, prostate adenoma, inflammation of the uterine appendages, etc.

Risk factors that increase the likelihood of developing pyelonephritis include:

• Urethritis;

• Cystitis;

• Tonsillitis;

• Sinusitis;

• Pneumonia;

• Urolithiasis;

• Diabetes mellitus;

• Low immunity;

• Helminth infections;

• Hypothermia;

• Pregnancy.

If an infectious focus is present in the body, blood and lymph can carry bacteria throughout the system. Therefore, kidney inflammation can develop even with pneumonia or tonsillitis.

Pyelonephritis during pregnancy is a common complication that requires special attention from a physician. During pregnancy, the load on the kidneys increases, hormonal changes occur, and urine outflow may be impaired due to compression of the urinary tract by the enlarged uterus. This creates favorable conditions for the development of infection and inflammation in the kidneys.

The disease may develop for the first time during pregnancy or represent an exacerbation of chronic pyelonephritis. Most often, the condition occurs in the second and third trimesters. Symptoms may be less pronounced than outside pregnancy or may be masked by general manifestations of gestation, which complicates timely diagnosis.

Pyelonephritis during pregnancy is dangerous due to possible complications for both the mother and the fetus. The inflammatory process can lead to impaired kidney function, the development of arterial hypertension and anemia, as well as increase the risk of preterm labor and intrauterine infection.

Treatment of pyelonephritis in pregnant women is carried out exclusively under medical supervision, taking into account the gestational age and the general condition of the woman. Therapy is aimed at eliminating the infection, restoring normal urine outflow, and preventing complications, using only methods and medications that are safe for the fetus.

At the initial appointment, the nephrologist reviews the symptoms bothering the patient and their medical history, including any chronic conditions or recent illnesses. A physical examination is conducted to check for swelling and other visible signs. The doctor may also perform percussion (tapping) under the ribs – pain indicates an inflammatory process.

To confirm the diagnosis, the following tests may be required:

• General urine analysis;

• Bacterioscopic urine test;

• Nechiporenko urine test;

• General blood test;

• Blood biochemistry;

• Ultrasound of the kidneys and pelvic organs.

The scope of examinations is determined individually, based on symptoms and overall health status.

The tactics of treatment of pyelonephritis are always determined individually and depend on the form and stage of the disease, the presence of complications, the general condition of the patient and the functional state of the kidneys. If the patient has chronic pyelonephritis, treatment requires a comprehensive approach, taking into account the frequency of exacerbations, the activity of the inflammatory process and the results of the examinations.

Most commonly prescribed:

• Antibiotic therapy;

• Antipyretics;

• Anti-inflammatory drugs;

• Antispasmodics;

• Physiotherapy;

• Diet;

• Surgical treatment (in case of complications).

Medication is the main treatment. The doctor prescribes drugs to eliminate the infection and inflammation, and to relieve symptoms. 

In cases of obstructive pyelonephritis and complications, surgical treatment may be necessary. At “Oxford Medical”, surgeries are performed using minimally invasive methods and the latest medical technologies.

Diet is an important component of comprehensive treatment for pyelonephritis and is aimed at reducing the load on the kidneys, decreasing inflammation, and maintaining a normal water and electrolyte balance. Nutrition for pyelonephritis is selected individually, taking into account the form of the disease, the stage of its course, and the patient’s general condition.

During treatment, it is recommended to limit the consumption of foods that irritate the kidneys and promote fluid retention in the body. These include salty, spicy, and smoked foods, fatty meat, processed foods, canned products, spices, and alcohol. Such products may increase swelling and worsen the function of the urinary system.

The diet should be balanced and include a sufficient amount of vegetables, fruits, grains, fermented dairy products, and lean meats or fish. Adhering to an appropriate drinking regimen is important if there are no contraindications from the physician. Adequate fluid intake helps eliminate bacteria and toxins from the body.

Dietary recommendations may change depending on test results and the course of the disease; therefore, dietary adjustments should be made only on the recommendation of a doctor.

Acute pyelonephritis is usually treatable with medication. However, if treatment is delayed or incorrect, the disease may become chronic or cause complications. The most common complications include:

• Purulent kidney inflammation;

• Nephrogenic arterial hypertension;

• Paranephritis – bacterial inflammation of the tissues surrounding the kidneys;

• Glomerulonephritis – damage to the kidney’s filtering glomeruli;

• Kidney failure;

• Blood infection;

• Kidney shrinkage;

• Kidney tissue necrosis, etc.

The main cause of pyelonephritis is infection. It can enter the kidneys through the urethra or the bloodstream from another part of the body. Therefore, to prevent it, the following is recommended:

• Timely treatment of all infectious and inflammatory diseases;

• Avoid self-medication;

• Prevent hypothermia;

• Strengthen the immune system;

• Women should have an annual gynecological exam, and men should visit a urologist-andrologist regularly.

At “Oxford Medical”, you can undergo lab tests and diagnostics using state-of-the-art equipment from leading brands. Once the diagnosis is confirmed, our doctors will choose the optimal treatment and help you recover. Our clinic employs highly qualified specialists with many years of experience.

At the private clinic “Oxford Medical”, all conditions are provided for comprehensive treatment of acute and chronic pyelonephritis.

Patients choose our clinic due to the following advantages:

• Comprehensive treatment approach. Pyelonephritis therapy is selected taking into account the form of the disease, the stage of the inflammatory process, and the individual characteristics of the patient.
• Modern diagnostics. Examinations are performed using expert-class equipment, allowing timely diagnosis and effective monitoring of treatment results.
• Experienced doctors. Medical care is provided by qualified specialists with many years of practical experience.
• Comfortable conditions and convenient service. Patients can undergo diagnostics, treatment, and follow-up care in one medical facility without queues and in a friendly atmosphere.

At “Oxford Medical”, patients receive high-quality medical care and support at all stages of treatment.

The cost of pyelonephritis treatment depends on the form and stage of the disease and, accordingly, on the chosen treatment strategy. You can review current prices for medical services in Kyiv at the “Oxford Medical” clinic on our website or by contacting the contact center. More detailed information about the treatment program and its cost will be provided by the doctor during the consultation.

You can book an appointment at a convenient time by phone or via the online appointment form on the website.