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Acute management at chronic pyelonephritis

Pyelonephritis chronic — a nonspecific bacterial inflammatory disease of a renal pelvis, its cups, and also a renal parenchyma. Its emergence is promoted by the dysfunction of urinary tract provoked by a nephrolithiasis, a stricture, anomaly of development, nefroltozy, prostate adenoma. Disturbances of hormonal activity at pregnancy, in case of use of glucocorticoid and contraceptive means matter. Chronic pyelonephritis can arise also as a result of acute.
Symptoms. Are not specific: weakness, subfebrile condition (sometimes unmotivated oznoba), appetite loss, nausea, vomiting, at 40 — 60% of patients is registered arterial hypertension (often is the first reason of a call of the doctor, to pay attention to young age, communication of hypertensia with catarrhal diseases, preferential increase of diastolic pressure). The dysuric phenomena urine opacification, morbidity at effleurage on a waist are more specific.
Diagnosis. Represents certain difficulties at a pre-hospital stage.
Complications: azotemic uraemia, hypertensive crisis, paranephritis.
Acute management. If complications are absent and the patient is not hospitalized that ampicillin on 0,5 g each 4 — 6 h, or Acidum nalidixicum to 1 g 4 times a day, or pipemedinovy acid on 0,4 g 2 times a day, either nitroxoline, or derivatives of nitrofurans (0,1 — 0,15 g of a furadonin 3 — 4 times, 0,1 — 02 g of a furagin 2 — 3 times), or 2 tablets of a lidaprim 2 times a day, or to 4 tablets in day of Bactrimum are recommended or 480 (trimetoprimsulfametoksazol).

Hospitalization: at emergence of complications or for the first time the diagnosed pyelonephritis in a nephrology unit.

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