Pyelonephritis is the most common inflammatory diseases of the urinary system. It amounts to 65-70% of all inflammatory diseases of the urinary organs.
Pyelonephritis Pyelonephritis - is infectious and inflammatory process simultaneously or by turns striking the pelvis and the kidney tissue itself. In the final stage is usually involved glomeruli and renal vessels. Among adults, pyelonephritis occurs in 1 in 100 people, and among children from 1 in 200. Most patients become ill at the age of 30-40 years. Often ill young woman after sexual debut. Young women suffer pyelonephritis more often than men. This is explained by the peculiarities of the urethra in women. Since the it is shorter, easier and faster the infection gets into the bladder and upper urinary tract. Plays a role, and the proximity of the vagina, causing micro-organisms is even greater. In men, pyelonephritis is often associated with urolithiasis, chronic prostatitis, the restrictions of the urethra, the peculiarities and anomalies of the kidneys and urinary tract infections. In older men, a factor increasing the frequency of pyelonephritis is an adenoma of the prostate, which disturbs the flow of urine, which facilitates the development of infection.
The causes of pyelonephritis can be endogenous (internal) infection. This micro-organisms that live permanently in the body. And exogenous (external) infection - microorganisms trapped in the genito-urinary organs of the external environment. Most often it happens E. coli, Proteus, staphylococci, enterococci, Pseudomonas aeruginosa, Klebsiella. Perhaps the development of pyelonephritis, with the participation of viruses, fungi and mycoplasma. Some micro-organisms under the influence of adverse factors (antibiotics, changes in acid-base status of urine) are transformed into other forms that are resistant to external influences and wait out a bad situation. In this case, the disease does not manifest itself. But when a suitable conditions bacteria become active and cause a form of disease which responds poorly to treatment.
Microorganisms can enter the kidney in three ways:
Hematogenous (blood-borne) route. In this case the primary inflammatory focus may be in another body (tonsillitis, otitis media, sinusitis, dental caries, bronchitis, furuncle, etc.) or in another part of the genitourinary system. On the micro-organisms enter the bloodstream to the kidneys. To ensure that the infection was delayed in the kidneys, predisposing factors are required: this is often a violation of the outflow of urine and blood disorders in the kidney. But some bacteria can infect and completely healthy kidney, for example, several species of staphylococci. Brought blood to the kidneys microbes settle on the vascular loops of renal glomeruli, causing changes in the inner lining of blood vessels, destroy it, penetrate into the lumen of the renal tubules and are excreted in the urine. Around these blood clots developing microbial inflammation. By the tenth day from the beginning of an acute infection period ends. After three weeks of recovery begins kidney tissue, and by the sixth week on the site of inflammation formed scar.
Rising or urinogennym. (Urina - urine). This route of infection in the kidney is most common in children. At the same micro-organisms enter the kidney from the lower urinary tract with a reverse current of urine. To do this, a violation of the dynamics of the movement of urine. Normally, urine flows from the ureters into the bladder and the reverse flow of urine into the ureters is missing. But if a throw of urine from the bladder to the ureter, which is called the cystic reflux, possibly penetration of micro-organisms from the bladder to the kidney. Other causes of incontinence double driving dynamics kidney, hydronephrosis, Nephroptosis, the presence of stones in the urinary tract.
Another way of infection in the kidney - rising along the wall of the urinary tract, namely the wall of the ureter. In addition to the infection, which rises on the wall of the urethra, inflammation of the wall may cause the movement of urine on the ureter and reflux disease in the kidney into the urine.
Most common first two pathways of infection in the kidney: hematogenous and urinogenny. But for the occurrence of pyelonephritis, not only the presence of infection in the kidney, even necessary predisposing general and local factors.
Common factors - a state of the immune system of the human body. Often the presence of reduced immunity in the body the focus of chronic infection in any organ. Defects in immune facilitate the emergence of the disease in the presence of even the most innocuous microorganisms. Facilitates the development of pyelonephritis and diabetes. Local factors - a violation of the outflow of urine from the kidneys (renal abnormalities, and urinary tract infections, urolithiasis, trauma of the kidneys and urinary tract, prostate adenoma) and circulatory disorders of the kidney itself. Sometimes the development of pyelonephritis by a variety of instrumental methods of investigation of the kidneys.