Synonyms
Medical: pyelonephritis Upper UTI (urinary tract infection), pyonephrosis, urosepsis
Definition
Inflammation of the renal pelvis (pyelonephritis) is an interstitial (i.e. between the actual renal tissue), bacterial, tissue-destroying (destructive) inflammation of the kidney and the renal pelvic caliceal system. Inflammation of the renal pelvis can occur on one or both sides.
Causes
Chronic inflammation of the renal pelvis can be caused by an insufficiently treated urinary tract infection (UTI) (risk factors may be present). The original germs only serve as an impulse, since the chronic inflammation is maintained without germs.
Risk factors
- Metabolic diseases with immune deficiency (e.g. diabetes mellitus)
- Anatomical obstructions of urinary flow (bladder neck, urethral valve)
- Urinary flow obstructions (kidney stone, enlarged prostate (prostate hyperplasia), tumor, pregnancy)
- Lying bladder catheter
- Urine backflow from the bladder into the ureter (vesicoureteral reflux)
Symptoms
Often there are almost no noticeable symptoms. General symptoms such as headaches, loss of appetite, fatigue, slight temperature increase (subfebrile temperatures) etc. may occur. In an acute episode, fever and pain in the kidney area may occur.
Diagnosis
The diagnosis is difficult, as specific symptoms are often missing. Often during routine examinations the following is noticeable because of the above mentioned complaints: To rule out risk factors, ultrasound, x-rays and urogram should be used. In the x-ray, a clumping of the renal pelvic caliceal system and scarred retractions are noticeable. The function of the kidney should be checked for restrictions. – White blood cells (leukocyturia) and bacteria (bacteriuria)
- Urinary
- Increased inflammation values (BSG, CRP)
- Abnormal blood count (renal anaemia = anaemia)
- Incipient kidney weakness (renal insufficiency / kidney failure)
- High blood pressure (articular hypertension)
Therapy
Antibiotics should be used in acute phases. Under certain circumstances, long-term therapy may be necessary to prevent recurring infections (relapses). If risk factors are present, they should be eliminated (possibly also by surgery). Furthermore, therapy can be supported by homeopathic medication. We have created a completely separate topic for this.
Forecast
If the chronic inflammation of the renal pelvis is detected in time, the inflammation can heal. If this is not the case, renal function decreases sharply in the final phase of the disease. The result is a so-called shrunken kidney with high blood pressure, kidney weakness (renal failure) and uraemia (uremia) (see below).
