Pyelonephritis

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nephritis

nephritis (nəfrīˈtəs), inflammation of the kidney. The earliest finding is within the renal capillaries (glomeruli); interstitial edema is typically followed by interstitial infiltration of lymphocytes, plasma cells, eosinophils, and a small number of polymorphonuclear leukocytes. The disease is thought to be immunological, but immunoglobulins and drug antigens have been found in only a few cases. The damage is usually reversible when the cause is recognized and removed, but severe cases can progress to fibrosis and renal failure. The disease can take several forms. Pyelonephritis is usually associated with a bacterial infection transmitted from the bladder or blood; it affects the renal pelvis and is treated with antibiotics. Glomerulonephritis, or Bright's disease, causes degenerative changes in the glomeruli and is believed to be an allergic response to infection elsewhere in the body. Symptoms include headache, mild fever, puffiness of the eyes and face, high blood pressure, and discoloration of the urine. Treatment includes bed rest and limiting the intake of water, sodium, and proteins, and, if necessary, dialysis; antibiotics are given to halt infections (e.g., streptococcal) invasion. The disease occurs more frequently among the young. About 95% of patients recover from the acute phase of the disease; however, if glomerulonephritis becomes chronic, renal damage results after many years, causing kidney failure.
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The following article is from The Great Soviet Encyclopedia (1979). It might be outdated or ideologically biased.

Pyelonephritis

 

an inflammation of the calyxes, pelvises, and parenchyma of the kidneys caused by the colon bacillus, staphylococcus, Pseudomonas aeruginosa, Proteus, and by other microorganisms. Primary, acute or chronic, and unilateral or bilateral forms of pyelonephritis are distinguished from secondary pyelonephritis, which is preceded by other diseases of the kidney and urinary tract. The morphologic changes associated with the disease take the form of clusters of cellular infiltrates. In chronic pyelonephritis, the kidney surface exhibits multiple cicatricial retractions. The cortical layer is thin and uneven.

Acute pyelonephritis often begins with fever, chills, and pain in the lumbar region. Urination is painful and frequent, and there may be headaches, nausea, and vomiting. Nitrogenous residues may increase in the blood in the early stages. The urine contains pus, red blood cells, albumin, and numerous bacteria, more than 100,000 per ml of urine. Treatment consists of antibacterial therapy with sulfanilamides, nitrofurans, and antibiotics. During the stage of fever, the intake of protein should be limited. Later the diet may be normal, with a copious intake of fluids, application of heat to the lumbar region, and antispasmodics.

The presence of chronic pyelonephritis is often revealed during urinalysis or the taking of blood pressure. The patient may complain of general weakness, headache, lack of appetite, pain in the lumbar region, and increased frequency of urination. The skin is pale and dry. The disease’s progress is bilateral. The urine’s specific gravity decreases and hypertension frequently develops, as does renal insufficiency. Diagnostic methods include urinalysis and examination of the renal functions, roentgenography, the use of radioisotopes, and occasionally biopsy of the kidneys. Treatment consists of prolonged antibacterial therapy with such drugs as nitrofurans, sulfanilamides, antibiotics, and NegGram. In the case of hypertension, hypotensive drugs are prescribed and the impaired urine flow is normalized. If such contraindications as renal insufficiency, obstruction of the urinary tract, and marked hypertension are absent, treatment in the Truskavets, Essentuki, Zheleznovodsk, or Sairme sanatoriums may be prescribed.

REFERENCES

Pytel’, A. Ia., and S. D. Goligorskii. Pielonefrit. Moscow, 1961.
Ratner, N. A. Bolezni pochek i gipertoniia, 2nd ed. Moscow, 1971.

F. M. PALEEVA

The Great Soviet Encyclopedia, 3rd Edition (1970-1979). © 2010 The Gale Group, Inc. All rights reserved.

pyelonephritis

[¦pī·ə·lō·ne′frīd·əs]
(medicine)
The disease process resulting from the effects of infections of the parenchyma and the pelvis of the kidney. Also known as interstitial nephritis.
McGraw-Hill Dictionary of Scientific & Technical Terms, 6E, Copyright © 2003 by The McGraw-Hill Companies, Inc.