Diseases

Inflammation of the kidney - symptoms, causes and therapy

Inflammation of the kidney - symptoms, causes and therapy



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Pyelonephritis: a common kidney disease

Inflammation of the renal pelvis is usually a bacterial infection, starting from a bladder or urethritis. As a rule, the kidney pelvis and kidney tissue are affected and there is a strong feeling of illness with fever and pain. A chronic course with absent or only mild complaints is less common. In most cases, antibiotic treatment is imperative to avoid complications and to cure the serious illness. Women are affected much more often than men and often use proven home remedies and herbal remedies for prevention.

A brief overview

Inflammation of the kidney is a common infection that requires appropriate treatment. The following summary provides a quick overview of the clinical picture and the correct measures. Further information can be found in the following article.

  • definition: Pyelonephritis describes an acute or chronic, mostly bacterial infection of the kidney pelvis and kidney tissue.
  • Symptoms: Acute inflammation usually manifests itself in a strong feeling of illness with fever, flank pain and frequent as well as painful urination. Symptoms such as abdominal pain and nausea and vomiting can also occur. The chronic form is more likely to result in phases of illness and the symptoms may be less pronounced or even completely absent.
  • causes: Infection of the renal pelvis is usually preceded by a disease of the lower urinary tract, such as a bladder infection or urethral infection. The harmful germs rise into the kidney, where they multiply and cause the discomfort.
  • diagnosis: In addition to the clinical examination, a urine and blood sample is often taken during diagnosis. In this way, the exact clinical picture and, if necessary, the causative agent can be determined. Imaging methods such as ultrasound are also used.
  • treatment: In most cases, antibiotic therapy is required to effectively fight the infection. In severe cases, hospitalization may also be necessary.
  • Naturopathic treatment: Various home remedies can help heal and prevent urinary tract and kidney infections. In addition to plenty of fluid and heat, medicinal plants such as bearberry and cranberry are also used.
  • Preventive measures: Proper intimate hygiene, especially for women, is just as important as regular urination and appropriate clothing to flush out bacteria and prevent hypothermia.

Definition

Inflammation of the renal pelvis is an acute, or in rare cases also chronic, bacterial infection of the renal pelvis (Greek: pyelos) and usually also of the kidney tissue. If both structures of the upper urinary tract are affected, this is referred to as pyelonephritis, whereby nephritis in the actual sense stands for inflammation of the kidneys of various structures of the kidney tissue. In a few cases, only the kidney pelvis is inflamed, which is then called pyelitis.

The kidney basin lies within the kidney and forms a kind of collecting basin for the urine produced and excreted by the kidney tissue. Most of the time, the pathogens reach the kidney pelvis via the lower (draining) urinary tract (urethra, bladder, ureter), where the actual inflammation develops. Because the urethra is shorter in women than in men, the disease is also much more common in women.

The kidney: structure and function

The structure of each of the two paired kidneys can be divided into three large areas: the renal cortex, the renal medulla and the renal pelvis. The actual purification of the blood takes place in the renal cortex by filtering out the polluting ("toxic") substances and then removing them. First, it is passed on to the collecting tubes of the renal medulla, via which the now concentrated urine is passed into the kidney pelvis. From here, the urine passes through the ureters to the bladder to be excreted.

The kidneys thus detoxify the body, but also perform other important tasks, such as the formation of red blood cells and various regulatory functions (including fluid and electrolyte balance, blood pressure, bone metabolism).

Symptoms

The symptoms of acute renal pelvic inflammation also occur in phases in the chronic form, which usually develops as a result of an untreated or unhealed acute infection. Inflammation of the renal pelvis is in any case a serious illness, which can lead to serious complications, even if there are no symptoms (atypical course) or only slight symptoms are noticed at first.

Acute pyelonephritis

The main symptoms of acute renal pelvic inflammation are unilateral, sometimes bilateral, flank pain, which can radiate into the groin and is often described as stinging or pulling. Tapping your fingers on the kidney region can significantly increase the feeling of pain. The symptoms and the entire course of the disease can appear very violently. Most of those affected have a very strong general feeling of illness. This also leads to fever, chills, nausea and vomiting. Other gastrointestinal complaints and abdominal pain can also occur and can also weaken those affected.

In addition, there are usually complaints of urination. Sufferers complain of pain and burning when urinating and frequent urination, although only small amounts of urine are excreted (dysuria, stranguria and pollakiuria). Milky urine or dark discoloration is common. These are signs that bacteria (bacteriuria) and white blood cells (leukocyturia) are excreted or that there is blood in the urine.

There are also asymptomatic courses or rather untypical symptoms that make it difficult to recognize the disease. Men are more likely to complain of pain in the groin or scrotum.

The disease becomes life-threatening if complications form a kidney abscess and the germs spread to the bloodstream. If this is not diagnosed in time and treated accordingly, the bacteria will become poisoned by blood. This so-called urosepsis (sepsis from the urogenital tract) can be fatal under certain circumstances.

Chronic pyelonephritis

If an unhealed acute inflammation of the renal pelvis changes into a chronic course, there are usually recurrent episodes of illness with acute symptoms (at least three to four times a year). Usually there is no fever.

In the phases between this flare-up, there are rather non-specific complaints. These include symptoms such as headache, general fatigue, loss of appetite and a strong feeling of thirst. In addition, dull or oppressive flank pain is felt, which is also perceived as diffuse back pain.

Chronic renal pelvic inflammation causes slow, continuous damage to the kidney, which can lead to further complications, such as kidney failure. Since the kidneys are also involved in blood formation, anemia can also develop. Furthermore, a reduction in fluid excretion can promote high blood pressure.

Causes

Inflammation of the kidney pelvis usually develops secondary to bacteria that first affect the lower urinary tract and then rise up to the kidneys. Often there is a bladder infection (cystitis) or urethritis (urethritis) before the kidneys are affected. In most cases, it is Escherichia coli bacteria (E. coli) that enter the urinary tract from the intestine, where they can then trigger the infection, for example, through an impaired immune system.

Less often, other bacterial germs, viruses or fungi cause inflammation. It is just as rare that the germs reach the kidneys primarily, i.e. via the bloodstream and the lymphatic system. Naturopathic medicine is also thought to be related to chronic small intestinal inflammation, which can spread to the kidneys.

Risk factors

There are various reasons why women are more likely to develop kidney inflammation. Anatomically, a shorter urethra with an entrance closer to the anus favors bacteria to enter more quickly. Urinary tract infections can occur more quickly, particularly during pregnancy and the related physical changes. Hormonal changes, for example in the menopause, also contribute to an increased risk.

Other risk factors include underlying diseases such as diabetes mellitus and a general immune deficiency (e.g. HIV infection). An enlarged prostate (prostate hyperplasia) in men or kidney stones and bladder stones can cause bottlenecks in urine outflow, which results in an accumulation of urine. These circumstances in turn promote bacterial growth.

If there is a need for a bladder catheter over a longer period of time, this also increases the risk of urinary tract infections. In addition, congenital malformations or acquired damage to the kidney and urinary tract can promote the occurrence of inflammation.

Diagnosis

During the doctor's visit, a detailed patient survey should first be carried out, which, among other things, will be used to answer specific questions as to whether the symptoms are acute or possibly a chronic course. During the subsequent clinical examination, the kidney region in particular is examined and the sensation of pain is tested by palpating and tapping. Ultrasound is also often used to examine the kidneys and urinary bladder.

If there is a suspicion of pyelonephritis, a urine examination is carried out for further diagnosis in any case. A urine sample can be used to determine whether white and red blood cells are excreted, which is typical of this type of inflammation. In addition, the pathogens can be determined using a urine culture. However, this may only be necessary if antibiotic therapy is not effective.

Blood tests supplement the diagnosis and may provide information on existing kidney dysfunction. In the case of high-risk individuals and possible further health impairments, further examinations may be necessary to determine the causes and to order appropriate therapy.

Treatment

The most important therapeutic measure for bacterial pelvic inflammation is taking an antibiotic. This is the only way to effectively combat the pathogen and rule out possible complications. A so-called broad-spectrum antibiotic is often used, which is effective against a large number of different bacteria. If the person concerned does not respond to the prescribed medication or if there is a chronic inflammation, it is usually necessary to determine the pathogen and use a special antibiotic. Other forms of therapy must be chosen if the bacteria are not the cause of the disease. To relieve fever and pain, appropriate medication can be taken if necessary.

The duration of the acute illness is usually five to ten days, provided that antibiotic therapy is followed consistently. After about two to three days, the symptoms should improve significantly. If this is not the case or if the infection is particularly serious, hospital treatment may be required.

If causes requiring treatment have been identified during the examination, further therapies may be advisable, also to reduce the risk of recurring infections. A check-up after the end of therapy ensures that the infection has healed completely and has left no kidney damage.

Naturopathic treatment

Simple and well-tried home remedies support recovery. It is important to stay in bed for the duration of the therapy, to keep the kidney region warm (body wraps, hot water bottle) and to drink enough fluid (two to three liters of water daily). Regular urination removes the harmful germs from the kidneys and urinary tract faster. This is also a preventive measure in general.

In naturopathy, medicinal plants are used, among other things, that strengthen the immune system and have an antibacterial effect. For example, while Echinacea (coneflower) stimulates the immune system, the leaves of the bearberry (Arctostaphylus uva-ursi) and the somewhat milder cranberry leaves are considered to be urine disinfectants and are often used at the first signs of cystitis. The application takes place via tea preparations (bladder and kidney teas).

The cranberry (or cranberry) can also be an effective supplement in the treatment of kidney and urinary tract infections. Juices, concentrates or capsules and tablets made from cranberries or cranberries can help those affected by an antibacterial, diuretic and anti-inflammatory effect. They prove to be good natural remedies, especially when the first signs of an illness begin. Preparations made from nasturtiums and horseradish (horseradish) also work against bacterial infections with their mustard oils. All of these natural remedies are also a good choice for relapse prevention.

Preventive measures

In addition to the above-mentioned home remedies and medicinal plant applications, some simple hygiene measures can also prevent the development of urinary tract infections. Women should pay attention to clean the genital area from the vagina towards the anus after defecation, so that no bacteria enter. Regular urination, especially after sexual intercourse, cleanses and reduces the risk of infections.

Above all, people who are prone to bladder infections should avoid hypothermia and make sure they are appropriately warm and dry. (jvs, cs)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dr. rer. nat. Corinna Schultheis

Swell:

  • Herold, Gerd: Internal Medicine 2019, self-published, 2018
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  • Pschyrembel online: Acute Pyelonephritis (PN) (accessed: June 24, 2019), pschyrembel.de
  • German Society for Urology (DGU): S3 guideline epidemiology, diagnostics, therapy, prevention and management of uncomplicated, bacterial, community-acquired urinary tract infections in adult patients, status: April 2017, detailed guideline view
  • German Society for General Medicine and Family Medicine (DEGAM): S3 guideline on burning when urinating, status: July 2018, detailed guideline view
  • Amboss GmbH: Pyelonephritis (renal pelvic inflammation) (accessed: June 24, 2019), amboss.com
  • Merck & Co., Inc .: Bacterial Urinary Tract Infections (UTIs) (accessed: June 24, 2019), msdmanuals.com
  • Mayo Clinic: Kidney infection (accessed: June 24, 2019), mayoclinic.org

ICD codes for this disease: N12ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.


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