Modern approach to the diagnosis and treatment of pyelonephritis

Abstract

Pyelonephritis is an infectious and inflammatory lesion of the kidneys that occurs when pathogenic and opportunistic microflora spread from the underlying sections of the urinary tract. One of the most common pathogens is Escherichia coli. The disease occurs in women more often than in men, which is associated with structural features of the urethra and its anatomical proximity to the anus. According to statistics, 50–60 % of women have had an episode of urinary tract infection at least once in their lives. The main contingent of patients with pyelonephritis are women who are of reproductive age and have an active sex life. When called to the patient, the family doctor may hear the complaints of fever, rigors, pain in the lumbar region, frequent and painful urination. To establish the diagnosis, it is necessary to conduct a complete blood count and a urinalysis, as well as the Nechiporenko test, which shows an increased content of leukocytes. The main method of treatment is antibiotic therapy; as a rule, improvement occurs within the first two days. With the ineffectiveness of treatment and the development of resistance to antibacterial drugs, a transition to a chronic form is possible. Before the era of the discovery of antibiotics, this disease was considered deadly due to the high risk of developing septic complications, in particular, it was pyelonephritis that caused the premature death of the Russian Emperor Alexander III, who died in the Livadia Palace in the Crimea in 1894.