Kidney pelvic inflammation (pyelonephritis) can occur in acute or chronic form. The disease is mostly caused via infection by bacteria. As a result, inflammation of the renal pelvis occurs in the vicinity of the ureters. Typical signs are pain and fever, as well as discomfort during urination. Renal pelvic inflammation should always be examined and treated by a doctor.
What is renal pelvic inflammatory disease?
The technical word for renal pelvic inflammation is pyelonephritis, which comes from the Greek words “nephros” = kidney and “pyelos”= pelvis. This is a serious disease of the renal pelvis near the ureter. This is an acute or chronic inflammation, which in most cases is caused by bacteria. It is one of the most common diseases of the kidney and usually only one of the two human kidneys is affected. Differentially, renal pelvic inflammation differs from renal corticitis in that in the former case, the renal connective tissue is typically affected and in the chronic course, it may also involve affected neighboring organs. Due to the female anatomy of the urethra, which is much shorter compared to that of men, women are twice as likely to be affected by renal pelvic inflammation than men. However, when a person reaches a certain age, the frequency reverses, then it is more men than women who suffer from renal pelvic inflammation. The reason is usually due to an enlarged prostate that obstructs the flow of urine, which promotes the proliferation of bacteria.
Causes
The general cause of renal pelvic inflammation, as with cystitis, is obstruction of the normal flow of urine, which can cause a proliferation of bacteria. Here, for example, a urinary stone may be the cause. If the ureters are not regularly flushed with urine, pathogens can rise from the outside and multiply in the urine-collecting renal pelvis. This usually leads to infections that result in renal pelvic inflammation. Only very rarely is such a renal pelvic inflammation caused by pathogens that are transported via the bloodstream. People with a weakened immune system are particularly at risk, as is the case with pre-existing infections or during treatment with certain medications. Causative pathogens are usually certain intestinal bacteria or staphylococci.
Symptoms, complaints, and signs
Symptoms differ depending on whether acute or chronic renal pelvic inflammatory disease is present. In the acute form, severe pain typically occurs in the lateral regions of the back and may radiate into the pelvis. In addition, there is a general feeling of illness; the affected person feels tired, listless and groggy. The temperature often rises; fever of up to 40 degrees is possible and can sometimes be accompanied by chills. Furthermore, nausea, vomiting and loss of appetite occur. The pulse may increase. In most cases, the typical signs of cystitis accompany the disease, such as a constant urge to urinate and pain when urinating. However, complaints in the gastrointestinal tract are also possible. The symptoms can appear quite suddenly or develop gradually. If the onset of the inflammation is rather slow, often only atypical complaints such as headaches and fatigue are present at the beginning. Chronic renal pelvic inflammation often goes undetected at first because it does not cause any symptoms for quite some time. However, as the kidneys are continuously damaged, it eventually becomes noticeable in chronic headaches, back pain, fatigue, weight loss, high blood pressure, stomach pain, and blood work. Frequently recurring bladder infections or recurrent fever episodes can also be an indication of chronic renal pelvic inflammation. In rare cases, the disease progresses completely without symptoms, which is called a silent course.
Complications
Pyelonephritis (inflammation of the renal pelvis) can result in a number of very serious complications. In some cases, simple pyelonephritis develops into purulent renal pelvic inflammation. Pathogens can then enter the bloodstream and cause blood poisoning (urosepsis) originating in the urinary tract.Some patients also observe blood in the urine during a severe course of the infection, which is often the case especially if a kidney abscess has formed as a result of the inflammation. A complicated course of the disease is also to be expected in cases where the patient has become infected during hospitalization. Treatment is then often difficult because the infection often involves many different, and increasingly antibiotic-resistant, germs. Complications must also be expected in the presence of other risk factors, especially urinary tract obstruction, diabetes mellitus or in pregnant women. As a rule, inflammation of the renal pelvis during pregnancy is harmless and very often goes unrecognized. In rare cases, however, the disease can cause miscarriage or premature birth. If the kidneys are permanently affected by chronic renal pelvic inflammation, this can lead to high blood pressure and a disturbance of the electrolyte balance. Acute kidney failure is not usually expected with renal pelvic inflammatory disease, but in very rare cases this complication occurs.
When should you see a doctor?
A doctor should be consulted as soon as a general feeling of illness or malaise sets in. If there is pain in the abdomen that is persistent or increasing, a clarification of the complaints should be made. If the pain in sexually mature women is not triggered by menstruation, there is cause for concern. If body temperature is elevated, blood pressure is high, or there is a loss of appetite, a visit to the doctor is advised. Irregularities in urination, a renewed urge to urinate immediately after going to the toilet, and chills are signs of a present illness. If the affected person suffers from restricted mobility or discomfort during locomotion, a check-up visit to a doctor is necessary. Headaches, fatigue, sleep disturbances, tiredness and rapid exhaustion are further indications of a health impairment. There is a need for action so that an improvement of the complaints can be initiated by a medical therapy. If back pain occurs, food intake is refused or weight loss occurs, a doctor should be consulted. Taking a pain medication is only advisable after consultation with a medical professional. Loss of libido, limitations in performing daily tasks, and nausea and vomiting should be presented to a physician. If the affected person complains of irregularities of the digestive tract, this is also a sign of a disease requiring treatment.
Treatment and therapy
Treatment of renal pelvic inflammation is usually based on the symptoms. These are very varied, but usually sufferers feel severely ill with loss of appetite and severe fatigue, high fever, which may be accompanied by chills, and severe pain in the lateral and lower abdominal region and/or back. Chronic renal pelvic inflammation can have more fatal consequences than one might initially think, so it must be treated medically immediately to prevent it from becoming chronic in the first place. To determine the diagnosis, medicine uses laboratory and imaging techniques. Special urine test strips can be used to determine whether there are proteins, leukocytes and blood in the urine. With the help of a bacterial culture, the causative bacterial strain can be delimited, which is very important for the choice of the right medication. Renal pelvic inflammation is treated with an antibiotic corresponding to the causative agent and with painkillers. The antibiotic should cause the symptoms to subside quickly, and with them the severe pain. Nevertheless, the same rule applies here: the antibiotic pack must be completely finished even if the symptoms are free, to prevent the bacteria from rising again.
Outlook and prognosis
If medical care is sought quickly, the further outlook of renal pelvic inflammation is favorable. It comes to the administration of drugs that prevent existing pathogens from spreading and kill them. Within a few days, relief from the symptoms can already be expected. Recovery can be achieved after a few weeks. Without treatment, symptoms can increase in intensity and scope and trigger complications.If a chronic disease of the renal pelvis is present, the prognosis normally worsens. In particular, the healing process is prolonged. In support of this, a change in lifestyle has a positive effect on the further course of the disease. Nevertheless, doctors and physicians must analyze the exact pathogen and optimize treatment methods. Only then does the prospect of a cure improve. Overall, the weaker the body’s immune system, the more protracted and difficult the recovery. The complaints can lead to secondary diseases, which in turn have a negative effect on the further course of the disease. For this reason, high-risk patients in particular should seek the cooperation of a physician without delay. These include pregnant women or people with other underlying diseases. In the event of an unfavorable course of the disease, a life-threatening situation may develop. In the case of acute renal pelvic inflammation, the fastest possible medical care is advisable. Otherwise, complications as well as spread of the symptoms are to be expected.
Prevention
Kidney pelvic inflammation or cystitis can be prevented by ensuring a steady flushing of the urinary tract. This is easily done by regularly providing hydration through drinking, thus stimulating the kidneys to work. If little concentrated urine is constantly excreted, pathogens hardly have a chance to rise from the outside and cause an infection, because they are constantly flushed out again. Damp clothes, such as wet swimming trunks and bathing suits, must also be avoided. Chronic renal pelvic inflammation can only be prevented by completely healing an existing renal pelvic inflammation.
Follow-up
In the case of renal pelvic inflammation, there are usually very few and also very limited measures and options for direct aftercare available to the affected person, so that the affected person should ideally see a doctor at a very early stage. It is also not possible for the disease to heal on its own, so the person affected should consult a doctor at the first symptoms and signs. In the worst case, it can lead to blood poisoning and consequently to the death of the affected person if no treatment is initiated. As a rule, inflammation of the renal pelvis can be treated by taking various medications. Care must always be taken to ensure that the correct dosage is taken and also that the medication is taken regularly in order to relieve the symptoms. When taking antibiotics, it should also be noted that they should not be taken together with alcohol. At the same time, the affected person should also rest and take it easy when suffering from inflammation of the renal pelvis. Efforts or stressful and physical activities should be avoided. After successful treatment, no further aftercare measures are usually necessary. It then also does not come to a reduced life expectancy of the patient.
What you can do yourself
In addition to the medical treatment of renal pelvic inflammation, plenty of fluids should be consumed daily. An amount of 3 liters is considered recommended. This is to increase flushing of the urinary tract. In addition, heat is helpful. Anti-inflammatory chamomile baths, a hot water bottle on painful areas and bed rest serve this purpose. As an alternative to the hot water bottle, a hot hay pack can be used. This will relieve a constant urge to urinate and a burning sensation when urinating. Major physical exertion should be avoided. To strengthen the immune system to fight disease, it is recommended to take vitamin C in addition. This also increases the acidity of the kidneys, inhibiting the spread of bacteria. Teas and extracts of birch leaves, bearberry, and elderberry, as well as goldenrod, cranberry, and saw palmetto fruit have also proven effective in relieving kidney pelvic inflammation. Combined bladder and kidney teas are also available in various versions. In addition, a complementary treatment with appropriate Schüßler salts may be appropriate. Mineral water should not contain carbonic acid. The bladder should be emptied as completely as possible. When it comes to drinks, coffee, alcohol as well as black tea should be avoided, as these deprive the body of fluid. After women have gone to the toilet, cleaning should prevent intestinal germs from entering the urethra.When leaving the house should be ensured protection from moisture and cold by appropriate clothing.
