Pyelonephritis in children: topical methods of treatment. Pyelonephritis in children: treatment of acute and chronic form clinical symptoms of pyelonephritis in children

Date: 21.10.2019

Acute pyelonephritis in children - This is a common disease of kidney pelvis. The pathogenic mechanism is based on the infection of the urinary tract of various types of bacterial flora. Most often during the sowing of urine, golden staphylococcus, streptococcus and intestinal wand are distinguished. The peak of morbidity falls at an early age of up to 5 years. In girls, acute pyelonephritis is diagnosed 3 times more often than that of boys. This is due to the peculiarity of the anatomical structure of the downstream urinary tract. In the frequency of cases of diagnosed diseases in the Russian Federation, acute pyelonephritis in children under 7 years old is in second place. More often, children are sick only with sharp respiratory diseases of the upper respiratory tract. But here there is a certain relationship.

According to statistics, each 4th case of ARVI in young children gives complications in the form of inflammation of kidney pelvis. Therefore, during the treatment of colds, the overall analysis of urine is needed.

In the absence of adequate therapy, the disease can go into chronic pyelonephritis in children. In this case, the infection remains in the renal structures. With a slight decrease in the resistance of the body develops recurrence of pyelonephritis with a complete clinical picture.

Why does the pyelonephritis occur

Pyelonephritis in a child may occur only under the influence of pathogenic microflora. This disease is characterized by purulent inflammation of the renal pelvis. The process can be one-sided or affect both kidneys.

The main reasons for pyelonephritis:

acute colds;
frequent;
rheumatism;
supercooling of the body;
incomplete emptying of the bladder during urination;
non-compliance with personal hygiene;
decrease in immunity;
intrauterine infection of the fetus from the mother;
foci of chronic infection, including.

It is especially worth noting the fact that children under 5 years old do not have its own antibacterial properties. This contributes to the rapid spread of infection by urinary tracts. Children at this age do not have the ability to completely empty their bladder bubble. The increase in cases of diagnosis of pyelonephritis in the child increases in the adolescence. At this time, the infection falls into the renal jelly as a rising path with the genitals.

The first signs of pyelonephritis in children

Consider the first signs of pyelonephritis in children is not just an experienced pediatrician. This is a cunning disease that can be masked for an ordinary cold. The main signs of pyelonephritis are related to the manifestations of the general intoxication of the body of the kid. In a newborn age with intrauterine kidney infection, the only symptom is a long-lasting jaundice of the skin. Unfortunately, the baby and the child in the younger age cannot reliably assess their condition and point out the unpleasant symptoms in the lumbar region or cutting when urination. Therefore, the diagnosis is often established only after the study of urine analysis.

At the older age, the first signs of pyelonephritis in children can be:

weakness;
headaches;
gravity in the lower back;
student urination;
sharp resistant increase in body temperature;
nausea and vomiting;
dry mucous and skin sheaths.

With any manifestations from the above list, immediately refer to the doctor.

Reliable symptoms of pyelonephritis in children and diagnosis

Symptoms of pyelonephritis in children usually appear immediately after the start of the disease:

the body temperature is sharply increased to 39-40 ° C;
vomiting and general weakness appear;
the body of the child is covered with sticky sweat.
the frequency of urination increases by 2-3 times;
the urine color and smell change;
there are pains over the pubic and in the field of the lower ribs on the back side.

When inspected, it is detected:

rapid pulse;
painful palpation of the upper belly departments;
positive symptom of Pasternatsky (with a light impact of the edge of the palm of the kidneys, the child shudders and feels pain);
arterial pressure is slightly higher than the norm.

A general analysis of blood and urine, biochemical blood test for urea and creatinine is prescribed. To clarify the type of pathogenic microflora and determining sensitivity to antibiotics will make a bacterial sowing of urine.

In general analysis of urine, bacteriuria is determined, the large content of leukocytes and epithelial cells. In severe cases, hematuria may be. The urine density is reduced, the protein is not determined.

Treatment of pyelonephritis in children

The treatment of pyelonephritis in children, depending on the severity of the state, is carried out in the hospital or house under the supervision of the precinct pediatrician. The basis of treatment is antibacterial therapy. The antibiotics of a wide range of action and drugs of nanidixic acid are used, which have a pronounced urological septic effect. The drug selection is neversman or nitroxoline. The use of amoxiclava or augmentin is recommended from antibacterial drugs.

Symptomatic therapy is used, aimed at reducing body temperature and removal of intoxication syndrome. Enhance drinking mode. During the delay, diurea can be recommended.

Forecast for life with pyelonephritis in children is favorable. Usually all the symptoms take place within 7-10 days. However, after recovery, it is recommended to undergo regular inspections from the jettle at least 2 times a year.

The infections of the urinary tract of children's age on distribution occupy second place after respiratory diseases. In infants, they can "disguise" under the pathology of the digestive organs: acute abdomen, intestinal syndrome, dyspeptic disorder.

One of the symptoms of pyelonephritis in the older children is the "unpretentious" temperature rise from subfebrile to high numbers. Therefore, each child with incomprehensible malaise and temperature rise must be passed to urine analysis to eliminate pyelonephritis.

Pyelonephritis (kidney inflammation) in children is a disease of the upper urinary tract, in which the inflammation of the kidney tissue caused by microbes. Not only kidney channels are involved in the process, but also blood, lymphatic vessels.

At home, the frequent causative agent is enterobacteria (intestinal wand, Klebsiella and protea). The intestinal wand leads, it is sown in 80-90% of cases. This is explained by the fact that the causative agent has a universal set for the damage to the cloth of urinary tract. Due to the special "Fambriy" bacterium clings behind the wall of the urinary tract and is not "washed off" by the stream of urine.

The cause of infection in hospitals is a blue chopstick, protea and klebseyella. This must be considered when prescribing treatment. When the causative agent is known, then it is much easier to treat.

Paths of infection:

from blood;
from lymph;
from the lower departments of the urinary tract.

Hematogenic (from blood) Infection is more often found in newborns. From mother to child. Here prevention is important during pregnancy, you need to be examined in a timely manner for sexually transmitted infections.

Lymphogenic Infection is due to the presence of a unified system of lymphorage between intestines and blades. Long existing intestinal diseases (dysbacteriosis, colitis) reduce its protective functions, the lymph movement stops. Stagnation increases many times the likelihood of kidney infection with intestinal flora.

The upstream infection ( from the lower departments of urinary tract ) It is more common and characteristic of girls. This is explained by the structure of the urogenital region. The proximity of two departments contributes to an interim. Normally, the promotion of the colonies of microbes in girls is hampered by the usual vaginal microflora, represented by lactobacteriums, which produce lactic acid and create an unfavorable medium - another pH.

Having hydrogen peroxide, the lactobacilli inhibit the reproduction of the harmful microflor. In some cases, a violation of the number of vaginal flora may be observed (lack of female hormones, decrease in the development of local immunoglobulin A, lysozyme). The equilibrium of the relationship between the body and microbes is broken, local immunity decreases. Powerful organisms are beginning to be easily rising from the lower departments to the kidney itself.

Strengthening general and local immunity is a reliable prophylaxis of pyelonephritis.

Causes of the disease

The urinary roads are constantly in contact with the infection, but the infection does not occur. This is explained by the presence of local protective functions. There are many of them and they complement each other. Any violation of their work creates a condition for the disease.

The factors of adverse effects are divided into internal and external:

violation of urodynamics (urine promotion) - hereditary abnormalities, clogging of urinary tract, kidney stones, kidney omission;
the change in the composition of urine - impurities of glucose, crystals, uric acid salts appear;
bacteriuria - the presence of microbes in the urine without signs of the disease;
reduction of general immunity (Cytostatic treatment, chemotherapy);
intestinal diseases;
prematurity, gender (girls are sick more often), blood group IVAB and III B;
diseases and bad mother habits;
supercooling;
early pregnancy and sex life;
medicinal manipulations in urinary tract (bladder catheterization).

If prevention is carried out in schools in a timely manner, then the incidence of children's pyelonephritis will decrease. Girls especially need to avoid hyposhells, do not wear short skirts in cold weather, keep legs warm and comply with hygiene events.

Features of the disease in children up to the year

The causative agent in newborns and children up to the year is in 85% of cases of intestinal wand. Subsequently, the boys in the boys share it decreases to 40%, and in a course of 33% and staphylococcus to 12% increase.

The development of the disease contributes to chlamydia, and the M mother, infection occurs through blood. Provisible to the appearance of pyelonephritis in newborns immunodeficiency conditions, such as prematurity, HIV infection. Then the pathogens will be mushrooms or their combination with bacterial flora.

The structure of the kidney in children up to the year has its own characteristics: the lochanks are still intravenously, ureterals are sorties and have a weak tone. Due to weak innervation, the muscular apparatus of the kidneys is not enough.

According to experts, the child's disease has an early translation to artificial feeding, especially in the first six months of life. These children have a risk of getting around 2.3 times. Thus, the protective role of breastfeeding is proved.

In early age children, the disease is generalized. It takes hard, possibly the development of meningeal symptoms. The child often jershits, vomiting appears at the height of intoxication. When urine, grind and crying. Although these are not characteristic signs of pyelonephritis, but to suspect the disease follows.

To treat at home children up to a year is not recommended due to the severity of the state.

Forms and symptoms of pyelonephritis

By the course of the disease, pyelonephritis is divided into:

acute;
chronic.

Acute pyelonephritis has two forms: primary and secondary.

As an independent disease proceeds primary, and the secondary pyelonephritis of the child appears against the background of various urinary tract diseases (the anomalies of the ureters, kidney stones).

Acute pyelonephritis in children flows with high temperatures of 39-40 ° C. Characteristic pain in the lower back, stomach, joints. Expressed amazing chills. With acute form, the disease proceeds with severe intoxication. It bothers the weakness, the characteristic pose of the child is forced bending and bringing the limb to the belly on the side of the sick kidney.

It takes obstructive pyelonephritis, which is accompanied by the death of organ cells. There is a state of shock with a drop in pressure, lack of urine, up to the development of acute renal failure. For older children, the flow of acute pyelonephritis under the "mask" of appendicitis or influenza is characterized.

For the painting of chronic pyelonephritis for children, the same symptoms are characterized, but they are less pronounced. The child complains of fatigue, frequent urination, which can be combined with anemia or arterial hypertension. Unlike acute, children's chronic pyelonephritis is dangerous to the structural perestroika of the cup-making system of the kidneys.

Diagnosis of pyelonephritis

The first thing to be done by increasing the temperature not related to the cold is to check urine analysis.

Urine Study includes two methods:

microscopic analysis;
sowing on bacterial flora and sensitivity to antibiotics.

Medical Recommendation: urine collection for microscopic examination is carried out with free urination into clean capacity, before the start of antibiotic therapy. It is first necessary to spend a thorough toilet of the external genital organs of the child.

The sensitivity of the method is 88.9%. With microscopy, the sediment draws attention to leukocytes, red blood cells, the proportion of urine and the presence of protein. Signs of pyelonephritis: appearance in urine analysis 5 or more leukocytes, change in urine density. The lack of a method is the high risk of microbes from the environment.

To obtain high-quality diagnostics, the microscopic method must be combined with bacteriological. A modern laboratory method confirming microbial infection is considered to be a prokalcitonin test. Its average in patients with children is 5.37 ng / ml.

Ultrasound (Ultrasound Research) - the use of color and pulsed dopplerography significantly expands the capabilities and accuracy of the method. With it, it is possible to identify the anomalies of development, the expansion of lochs, urolithiasis, hydronephrosis. Show signs of inflammation and wrinkling the kidneys.

Renoscintigraphy (scintigraphy)

Study using isotope (TC-99M-DMSA) allows you to identify the foci that fell out of operation. This is the most accurate method for identifying kidney wrinkling in children. In addition to the traditional method of ultrasound, MRI (magnetic therapy) of the kidneys and computed tomography are used.

Treatment

Pyelonephritis therapy develops from the following steps:

Antibacterial therapy.
Pathogenetic.
Symptomatic.
Mode and proper nutrition.

Recommendations doctors: Antimicrobial therapy with pyelonephritis should be started as early as possible, ideally in the first 24 hours. The late origin (for 3-5 days) leads in 40% of cases to the appearance of the kidney in the parenchyem of the shrinking sites, in other words, a defect is formed. Treatment is carried out by a longer course than adults.

The younger child, the longer therapy. Such an approach has a simple explanation: the child has not yet formed a common and local immunity, the anatomical features of the building of the urinary tract create an obstacle to the urine current. Therefore, acute pyelonephritis in children ends with the chronization of the process with frequent relapses, unless the treatment time is met.

It is necessary to treat for a long time. The course consists of 2 stages: starting antimicrobial therapy for 14 days and an anti-infertion course by Wrospectors for a month. With the anomalies of development, where there is a return back of urine, anti-relapse treatment is carried out for several months sometimes, until the reasons are eliminated.

It is proved that the path of administration of an antibiotic does not affect the result. At home, it is more convenient to use tableted preparations. In the hospital begin to be treated injecting for 3-5 days, then transferred to tablets.

Often used antibiotics are presented in the table:

An ideal option for the choice of antibioticotherpics is the data of Bakposev urine.

Then the treatment blindly excludes, the probability of a secondary case is reduced. Therapy will be aimed at the cause of the disease and will minimize complications.

Anti-inflicted treatment is carried out by 5-nitrofuran derivatives. These include: "Furagin" or "Furamag". From other groups: "Palin", "Neversman", "Nitroxalin"

Naked pyelonephritis can be treated at home. Phytotherapy has proven well-supported and preventive therapy. For this purpose, you can apply "Kanefron".

Diet with pyelonephritis in children should correspond to age. Be balanced, contain more protein. Acute food and salt should be avoided. There is an abundant drink, exceeding the age rate by 50%. Mineral water, better low-alkaline (Essentuki 4, Smirnovskaya) 2-3 ml per kilogram of body weight in one reception.

Prediction and prevention

Uncomplicated pyelonephritis with proper treatment has a favorable forecast. Thoughtful and seasoned therapy will avoid relapses and chronic renal failure.

In order to prevent children's pyelonephritis, you need to stick to simple, but effective rules:

exercise and sport improve blood circulation in the kidneys;
sufficient use of fluid gives good circulation;
timely urination remove stagnation of urine.

The kids who received the treatment of pyelonephritis are subject to observation in the pediatrician and periodically must pass urine tests. It is desirable to consult an nephron once a year.

Insulation of urine tests and urinary tract

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Toddler's health is very fragile. Therefore, pediatricians insist on regular surveys. Each mother should know the importance of the analysis of urine - with its help you can diagnose acute pyelonephritis at the child. Since this disease can be connected with a cold, and with viruses, it is better to be restrained.

Acute pyelonephritis in children is an inflammatory process occurring in the kidneys. To speak more precisely - the disease of the kidney pelvis, which are peculiar urine tanks. It is from them that Urina goes into ureters.

The root cause of the appearance of pyelonephritis - viral . The infection can get into the blood of a sick tooth, the inflamed throat, injuries on the body. Once the microbes penetrate the adrenal glands, the inflammatory process begins, often ending chronic pyelonephritis.

It is noteworthy that most often this ailment overtakes children under the age of 5 years, in particular, girls. Women's genitals are arranged in such a way that the bacteria is in them to penetrate and breed easier.

In addition, this ailment can wear cold character . First, pyelonephritis can be a complication of a banal ORVI. Secondly, the disease is often observed in children suffering from Enuresum. Also, the inflammation of the renal loosen may occur against the background of hypothermia, accompanied by the addition of infection.

That is why even with a cold and flu for children under 7 years old, it is recommended to take a common urine analysis. The late detection of the disease can lead to its chronic form.

Clinical picture

A sharp pyelonephritis occurs in children of younger school age against the background of infection with the body with an intestinal wand, entorococcus, chlamydia, mycoplasma, ureaplasm and other bacteria. With inflammation of kidney pelvis in 80% of cases in the body of a small patient, an intestinal wand is found.

In babies, the microbes provoking pyelonephritis can be listed in the kidneys through a navel ring, inflamed junk rash and so on. Bacteria are separated by blood flow. That is, the nature of the infection of children is descending.

The child of the oldest age is 12-14 years old - inflammation can be ascending. That is, bacteria fall into the urinary channel from the outside, and already from it - in the kidneys. This type of infection is often accompanied by inflammation of external genital organs, dysbacteriosis, inflammation of the intestine. Ascending infection is more often found in girls, as they have a shorter and wide urethrany channel than boys.

Often the sharp pyelonephritis of the child is associated with. It is the defective emptying of the bladder that leads to the fact that the remnants of urin accumulate in the renal loins. And as soon as the microbes come there, inflammation begins. In addition, urine continues to arrive, creating a favorable medium for breeding bacteria.

Not only cystitis provokes stagnation of urine. It can be associated with a congenital defect of renal pelvis, in which Urina is not excreted through the ureter, and throws back to the kidneys.

In babies, sharp pyelonephritis often occurs against the background of Rachita, Malokrovia, hypotrophy, metabolism disorders. In older children, the disease can be associated with non-compliance with personal hygiene, sharp viral infections, rheumatism, weakening immunity.

Treatment of acute pyelonephritis in children is simple, but if you do not spend it on time, serious complications may arise. Up to the infection of blood and the formation of abscesses in the kidneys. On average, 80% of children are recovering and do not have complications in the future. But in 20% of cases, the child may lag in development and even become disabled. Therefore, it is so important to regularly make urine analysis and respond to the slightest changes in the health of the child during the exacerbation of viral diseases.

Babies cannot tell about their feelings. They show that they are bothering something, the only way available for them - wech. But the older children on the inspection of the doctor may say that they have hurts loins and belly . Sharp pains in these areas can be the first external sign of pyelonephritis.

In addition, the inflammation of the kidney pelvis indicates frequent painful urine accompanied by itching and burning. Also, the child can raise the heat (up to 40 degrees), accompanied by chills. Of the general symptoms, the mother should be a permanent headache, weakness, lack of appetite, skin sinusiness.

Young children have symptoms of acute pyelonephritis appear in the form high temperature, intoxication (vomiting, nausea) and, as a result, dehydration. Infants become sluggish, apathetic, often cry, begin to lose weight, refuse food.

Doctors recommend motives to pay attention not only to the frequency and character of the defecation (consistency and colors of the chair), but also on the nature of urination. If the baby is crying during them, most likely, he is experiencing itching and burning in the bladder.

How to reveal and cure pyelonephritis?

Usually for the diagnosis of acute pyelonephritis enough urinary analysis . In difficult cases for reinsurance, the doctor can send a child to Ultrasound kidneys .

The increased content of leukocytes, protein and erythrocytes is a characteristic sign of inflammation of renal pelvis. For babies, 10,000 bacteria per 1 ml of urine is enough, and for older children - 50,000 - 100,000 bacteria to diagnose pyelonephritis.

Since many microbes are insensitive to antibiotics, urine analysis repeat 2-3 times throughout the entire treatment. If there are almost no changes, other drug treatment is prescribed.

To hand over the urine on the analysis, for children 5-7 years old, it is necessary to go up and assemble the middle part of the jet into the sterile capacity. Breasts cannot control urination, so urinary urinas are attached to their urinary channels.

In addition to the high content of bacteria, urine analysis helps to evaluate the work of the kidneys, eliminate or identify the presence of stones, deviations in the development and structure, provoking Urina's back to the kidneys. All these factors are extremely important for the effective treatment of acute pyelonephritis by the child.

Diagnose pyelonephritis, especially in a breast baby, is extremely difficult. Therefore, it is necessary to pay attention to many external factors.

Certificate of illness may be:

rapid pulse;
acute pain in the top of the abdomen;
soreness with a lung impact of the edge of the kidney palm;
elevated blood pressure.

Despite the complexity of the diagnosis and clinical picture, the acute pyelonephritis is treated quite affordable and in a simple way. First of all, the child must observe bed regime . Parents are charged in the duty to ensure full peace. This means there is no TV, extraneous noise and stress.

Treatment of acute pyelonephritis in children implies a special diet , eliminating acute, oily, fried, salty, as well as spices and strong broths. In addition, it is necessary to include in the diet of the sick child as much fresh vegetables and fruits as well as juices and puree.

A diuretic fruits and berries should be the basis of the menu: watermelons, melons, grapes, cherry. You can also give the baby vegetable and light meat broths.

The key to the rapid normalization of the kidneys is abundant warm drink . Older children need to regularly give a decoction of rosehip, diluted compotes and tea. Babies to relieve fluid loss are introduced a special solution in the form of droppers.

Naturally, diet and compliance with the drinking regime is not enough for the treatment of acute pyelonephritis by the child. Powerful drug therapy is necessary.

After analyzing urin on microorganisms, the doctor will appoint antibiotics in tablets. In difficult cases, intramuscular or intravenous injections are prescribed. During 1-2 weeks, the child is treated with preparations containing penicillins, cephalosporins or aminoglycosides.

After them begins treatment wrospectics Disinfecting urine. These drugs include: furazidine, nodium, oxolinium, pepperium acid, co-trimoxazole.

The rate of recovery depends on the severity of the disease and the level of immunity of each child. The main thing is to fulfill the recommendations of the doctor and do not refuse hospitalization if it is necessary.

Preventing acute pyelonephritis in children as such is not. The only thing that can be done is to regularly donate urine analysis, to ensure that the child is not overcooked, did not go to the wet sliders. It is also worth paying special attention to the baby's health during the exacerbation of influenza and cold. All this will help to eliminate the prerequisites for pyelonephritis.

In addition, it is possible to give prophylactic purposes to give the children of older phytics, which has antimicrobial, anti-inflammatory and diuretic effects. Such therapy is also shown after the course of antibiotics.

Since phytotherapy is not suitable for breast babies, parents are advised more attention to paying personal hygiene of children. In addition, it is necessary to regularly show the child to the pediatrician to identify and treat infectious diseases in time, infection with worms, inflammation of the external genital organs, etc.

So, the best prevention of pyelonephritis is a zealous care for health. In addition, children who moved this disease, it is recommended to get registered by the fruit and regularly attend a doctor for three years. You also need to constantly pass Urin to the analysis.

Cognitive video on the topic

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Pyelonephritis is an infectious disease of the kidney, which is quite often found in people of any age. Treat pyelonephritis in children need to consider their age features, differences in the anatomy and the fact that the children's body is generally weaker than an adult. This disease exhibits itself primarily by changes in the process of urination. Urin changes his shade, pain there are pain in the abdomen, the body temperature rises, the child has lethargy and weakness.

All these factors prevent normal development, do not allow regular visits to educational institutions. Therefore, if this disease occurs, each parent is obliged to immediately seek medical attention to the doctor.

Pyelonephritis among children is the most common nephrotic disease. But in medical practice, there are often cases of false diagnosis of this disease, when symptoms and results of analyzes are interpreted in incorrectly and pyelonephritis is confused with another infection of the genitourinary system, for example, with cystitis or urethritis. To be able to correctly distinguish the pyelonephritis in a child from another nephrectic disease, you need to know a number of its features, symptoms, nature of development, treatment, etc.

The tubulone-inter-infectious infectious nephrite (pyelonephritis) is inflammatory processes arising in a cup of kidney, their tubules and connective tissue. The reason for the development of inflammation is an infection caused by the vital activity of any pathogenic bacterium.

Renal tubules are tubes that spend through themselves urine. Urina first accumulates in cups and lochanks, and after entering the bladder. Connecting (interstitial) fabric fills empty space between other structural elements of the kidney and is a certain frame that gives the organ normal form.

Children of any age can be sick with pyelonephritis. In the first years of life, babies of both sexes suffer from this disease in equal proportions, but a year after birth, the chance to get sick with pyelonephritis in girls is becoming somewhat higher. This is due to the features in the structure of the female urinary system.

The infectious damage of kidney tissues can occur due to the activity of the simplest microorganisms, bacteria or viruses. The championship among the perpetrators of the appearance of pyelonephritis in children is occupied by an intestinal wand, followed by protea, golden staphylococcus and a variety of viruses (adenovirus, flu, coke virus). In patients with chronic form of this pathology, the association of microbes is often found when several different pathogenic microorganisms are actively developing in the body.

Methods of infection

In the child's body, as well as in the body of an adult, the causative agent of the disease can get through the following paths:

Through blood. According to vessels, causative agents of infection can get to the kidneys. Most often infection in this way newborns are exposed. They have pyelonephritis may arise after the disease of pneumonia, otitis and other similar pathologies. It does not matter how the infectious focus is located far from the kidneys. In older children and adults, such a way of occurrence is observed less often, only in cases where a person is exposed to the extremely severe form of infectious illness.
Distribution of pathogen through lymphogenic paths. In this case, the disease occurs when the pathogenic body penetrates the lymphorage system between organs responsible for urinary and intestines. In a healthy body, lymph flows from the kidneys to the intestines without any consequences. But in the case when the intestinal mucosa is amazed infectious disease (infection, dysbacteriosis, etc.), the bacteria of the intestinal microflora can also fall into the kidney lymph into the kidneys.
Sometimes pathogenic microorganisms can rise to the kidneys from the genital organs, urinary tract or anus. Such a path of infection is the most common among children older than one year. Especially often this way of infection is found among girls.

Under normal conditions, urinary pathways are directly in contact with an external environment. Such contact is nonzero, i.e., in any case, there is a chance of penetration into the body of alien microflora. But if a person is healthy, his urinary bodies work properly, and local and general immunity function normally, the harmful bacteria will not be able to infect the body.

Favorable factors for the development of the disease

Infection with pyelonephritis is due to preceding factors depending both from pathogenic microflora that has fallen into the body and from the microorganism itself, more precisely, from person. Pathogens have varying virulence, i.e., the ability to infection, aggressiveness and resistance to the impact of the immune system. The higher these indicators of the bacterium or the virus, the most likely the infection of the child. And from the human side, favorable factors for the occurrence of pyelonephritis are:

Violations of the functioning of the urinary system. In case of any failures in the work of the kidneys, in the presence of stones in the paths of the outflow of urin, during crystalluria (when the renal tubules are blocked by small salt crystals), etc.)
Urine outflow problems associated with bladder functional disorders.
The emergence of bubble-ureter reflux. Such an anomaly is a process when the urine from the bladder rises up and again turns out to be in the kidneys.
Ascending infection can be provoked by a disadvantage of personal hygiene, inflammatory processes in external genital organs, in a timely manifold cystite or urethritis.
The development of any acute or chronic disease in a child, which reduces its immunity.
Diabetes.
Various chronic infectious diseases like tonsillitis, sinusitis, etc.
Baby infection with worms.
Hypothermia.
In children who are not yet either year, the development of pyelonephritis can be provoked by the transition to artificial feeding, the use of adhesiveness, teething or any other processes that can undermine the immune system of infants.

Both among children and adults are found 2 types of pyelonephritis. So, the primary pyelonephritis is distinguished. It arises as an independent disease that no factors from the urinary system are preceded. On the other hand, there is also a secondary pyelonephritis, the causes of the occurrence of which they lift in the anomalies of the structure of urinary organs or their functional failure. Such a disease is also called obstructive pyelonephritis. If pathology is caused by a violation of metabolism, then in medical circles it is customary to be called unstructive pyelonephritis.

This disease may proceed both in acute and chronic form. A sharp pyelonephritis is completely cured in a couple of months after the start of therapy. From the chronic form of the disease, the child will get rid of six months, you need to be prepared for the fact that for this period it will happen about two relapses.

Chronic pyelonephritis can be presented in a recurrent (when regular exacerbations are observed) or latent (no manifestations of symptoms, but the results of laboratory analyzes show the presence of pathology) form. Latent pyelonephritis is quite rare, most often such a diagnosis is mistakenly placed, because this disease is easy to confuse with various infectious pathologies of urinary tract or reflux nephropathy, the symptoms of which are defined sufficiently weakly.

Symptoms of pyelonephritis in children

The manifestations of pyelonephritis in children whose symptoms they often cannot describe themselves, they differ strongly. It all depends on the nature and speed of the course of pathology, its gravity, the age of the patient, parallel to developing diseases, etc.

Nevertheless, doctors managed to highlight the most basic signs of pyelonephritis in children:

Increase body temperature. This is one of the most obvious symptoms, since it arises quickly and without any visible cause. This feature is extremely dangerous, since the rise of the temperature often occurs to 38 ° C, and sometimes even higher. Often it is accompanied by a pronounced fever.
Due to intoxication, the child becomes sluggish, drowy, he has a loss of appetite, nausea arises and vomit. The skin is pale, acquires a gray shade, blue circles appear under the eyes. Most often, the manifestation of intoxication is stronger in babies than children are older.
The child has pain in the lower back or abdomen. Children aged 4-5 years old complain of pain in the entire abdomen, and more adult patients usually celebrate discomfort in the loan area or side at the bottom of the body. The pain is nonostic, pulling, it is enhanced when moving and weakens if the body has a body near it.
Sometimes difficulties can occur with the urination process, but this is a non-permanent symptom and it is not manifested in all patients. The child may have incontinence, excessively frequent or, on the contrary, rare urination, sometimes this process is accompanied by pain syndrome.
On the face of the child can be observed a small swelling.
The urine of the patient with pyelonephritis usually changes its shade, unnaturally nerves, acquires a strange smell.

Symptoms in babies

Newborn and very small children cannot describe the nature of their ailments. But when pyelonephritis, they can have a number of symptoms, notable and without explicit complaints:

Body temperature rise up to 40 ° C. Sometimes there may be febrile cramps on this background.
Frequent joining and vomiting.
Failure to chest or mixture, sluggish sucking.
The baby's skin becomes pale, lights the skin on the lips, around the mouth and above the upper lip.
The pyelonephritis is observed unnatural for children of this age weight loss.
The body is dehydrated. The skin dries up, becomes a flabby.

Children of this age can not clearly complain about pain, but they will most likely be. Excessive concern of the baby and its constant crying is a kind of warning about the emergence of severe pain. About half of children of this age have problems with urination. They may have anxiety, redness of the face or a long gratefulness of the child before he starts to write. Often due to pyelonephritis, the baby may have diarrhea. This symptom makes it difficult to examine and often knocks out the doctors, because symptoms arises inherent in the usual intestinal infection.

Diagnosis of disease

The diagnosis of pyelonephritis in children is carried out at a number of laboratory and instrumental research methods. These include:

General urine analysis. All children who have an increased body temperature are exposed to such a diagnosis. For pyelonephritis, a characteristic feature is an increased content in urine leukocytes, as well as proteinuria (protein in the urine).
Urine tests on Nechiphenko, Ambourg or Addis Kakovsky. The purpose of these studies also consists in identifying the increased content of leukocytes (leukocyturia).
The biomaterial sowing is made to identify the type of causative agent of the disease and its susceptibility to various antibiotics.
Blood chemistry. With its help, doctors determine the total amount of protein and protein fractions.
Biochemical urine analysis.
Each sick child is carried out ultrasound and X-ray studies of the organs of the urogenital system. They allow you to recognize the presence of bubble-ureter reflux, various disorders in the structure of internal organs that could contribute to the development of pyelonephritis.

Methodology of treatment

Treat pyelonephritis in small children can only be in stationary conditions. At the same time, it is extremely recommended to place a child in a narrow medical institution specializing in ultraliques or nephrotic diseases. Only with the inpatient treatment of the patient, doctors have the opportunity to regularly monitor the entire process, to carry out the necessary research, to quickly change the therapeutic course. Pyelonephritis treatment in young children includes several mandatory events.

Mandatory compliance with beddown for children with elevated temperature and abdominal pain. As soon as the body temperature is normalized, and the pain sweeps, the patient can be translated into the steamed mode (the child is allowed to move around the room). Soon, with successful patient's therapy, they are transferred to a common mode, including daily walks in the fresh air (up to one hour) in a hospital area.

The child should follow a certain diet. The food diet should be built in such a way as to minimize the effects on the kidneys and at the same time establishing the process of metabolism in the body.

Therapy with antibacterial drugs is the most important element of the entire healing course of pyelonephritis. Medical treatment is carried out in 2 stages. Prior to obtaining the results of sowing urine on susceptibility to antibiotics, drugs are used with a wide range of impact. After the doctors succeed in identifying the causative agent of the disease and establish which drugs do the strongest, the preparations of a wide spectrum are canceled and the antibiotics of a narrow-controlled action are prescribed to replace them. Antibacterial therapy lasts for four weeks. At the same time, it should be changed at the attending agent after every 6-10 days.

Conducts therapy with uroantinessptics. These drugs contribute to the disinfecting of urinary tract. They are not antibiotic means, but despite this, they are able to stop pathogenic bacteria and not give them to fall inside the child's body. The course of receiving such drugs is from one to two weeks.

In addition to antibiotics and uranticsptics, antipyretic, spasmolitics, antioxidant properties, vitamin complexes, anti-inflammatory drugs are prescribed patients. Fully cured the child's disease is possible in 1-2 months of stationary therapy.

Prevention of pyelonephritis in children who have already undergone this disease is extremely important. Even if the disease has long been keen, there is always a possibility of recurrence. As preventive measures, parents must show their children to nephrologist at least once every 2 months. The doctor will give individual recommendations and, if necessary, prescribe a child preventive treatment with the use of antibiotic agents.

Content

Chronic and acute pyelonephritis in children - inflammation of the kidneys, which is accompanied by a change in urine color, stomach pains, high temperatures and general weakness. This problem is often found in children who have suffered infectious diseases. Pyelonephritis can lead to serious health consequences, so it is very important to detect it on time and begin treatment.

What is pyelonephritis in children?

An infectious disease of the kidneys, accompanied by an inflammatory process, is called pyelonephritis. He is subject to newborns, babies, children and adolescents. Among the nephrological diseases is one of the most common pathologies. Inflammation appears against the background of common diseases: ORVI, ORZ, influenza, angina. There is a sharp and chronic form.

Symptoms

Children cannot talk about health problems, so you should carefully monitor their condition. The common symptoms of pyelonephritis in a child include:

sleep disturbance;
bad appetite or its absence;
diarrhea and nausea;
reducing or lack of weight increase;
increased temperature in the absence of cough and cold;
concern when urination due to pain, burning;
change in urine color;
dysuric signs (frequent urges for urination, but urine is small).

Acute form

The symptoms of acute children's pyelonephritis differ depending on the severity of the inflammatory process, the age of the child, concomitant diseases. The main symptoms of the acute form of kidney inflammation are considered:

fever and temperature from 38 °;
intoxication (lethargy, general weakness, nausea, vomiting, drowsiness, bad appetite, bruises under the eyes, pale skin);
pulling abdominal pain and lower back, which are enhanced when moving and subsided during warming;
changing urine (colors, consistency, smell).

In newborns

Pyelonephritis in newborns is manifested in pronounced signs of intoxication:

high temperatures up to 40 °;
less often febrile convulsions;
frequent joining and vomiting;
lack of weight increase or reduced it;
refusal of breast milk or mixture, sluggish sucking;
dehydration, dedication and dry skin;
pale leather with blue around the mouth, eye;
chair disorder, diarrhea;
concern when urination;
redness of face before urinary;
pyelonephritis in infants causes constant crying without a visible cause.

Chronic form

The factors of the manifestation of pyelonephritis in chronic form are not different from the acute stage of the disease, but alternate with the period of complete remission. At this time, even urine tests do not show changes, so the result from diagnostics can be obtained only when the pathology is exacerbated. With a long chronic course of illness without treatment, the following syndromes may appear:

irritability, aggression;
reduction of academic performance;
delay of physical, psychomotor development;
fast fatiguability.

Causes of pyelonephritis in children

Penetration into the urinary system of microorganisms (bacteria, viruses, fungi) becomes the cause of inflammation. The main causative agents of the disease is an intestinal wand, a cinema stick, chlamydia, protea, mycoplasma and golden staphylococcus. Less often inflammation begins due to adenovirus, influenza, cokes, anomalies of the structure of the kidneys and urinary tract. In the chronic form of the disease, several microorganisms are often located in the body. The paths of penetration of infection in the body are several:

Hematogenic. With purulent diseases (ARVI, angina, pneumonia, caries) infection enters the kidneys through blood. It is possible to infect a child from mother during pregnancy, if it has an infectious disease.
Ascending. Infection of the pyelonephritis of the kidneys occurs through the gastrointestinal tract (gastrointestinal tract), the urinary system. Such a path explains why girls are sick pyelonephritis more often than boys, after non-compliance with the rules of hygiene.
Lymphogenic. The infection takes place in the kidney through lymph.

Classification

Nephrols in Russia allocate 2 types of children's pyelonephritis. Classification Next:

Primary and secondary view. The first type is characterized by the absence of symptoms from the bladder and other urinary system organs. The secondary pyelonephritis is called the process when urination disorders and dysmetabolic disorders are noticeable.
Acute and chronic. In the acute form of inflammation, recovery occurs after 3-4 weeks, if the treatment began in a timely manner. In this form there are an active period and the opposite development of signs in clinical and laboratory remission. Chronic disease lasts more than six months. During this time there are several relapses and exacerbations. If exacerbations are apparent, such a form is called recurrent, and if the symptoms are inconspicuous, and only analyzes indicate the problem - latent.

Diagnostics

Children's pyelonephritis can be detected at the pediatrician consultation. In this case, for further surveys, an nephron or a urologist should be visited. Diagnosis of the disease should be carried out comprehensively using instrumental and radial methods. Mandatory laboratory studies to identify the inflammatory process include:

clinical blood test;
blood chemistry;
general urine analysis;
urine analysis morphology;
urine tests on Nechiporenko, Addis-Kakovsky, Ambourg;
sowing urine on the flora;
urine antibioticogram;
biochemical urine analysis.

In order to estimate the functionality of the kidneys and the tubular apparatus, the following laboratory studies are carried out at mandatory:

blood test for urea, creatinine;
zimnitsy's sample;
analysis of the acidity of pH, titrated acidity, ammonia excretion;
control Diurea;
studies of rhythm and urination volume.

Pyelonephritis in a child is diagnosed not only with the help of laboratory tests, but also through instrumental research:

measuring blood pressure;
cT scan;
Ultrasound (ultrasound examination) of the urinary system;
miking cystography;
cystoeometroscopy;
cystometry;
nuclear magnetic resonance;
electroencephalography;
excretory urography;
echoorencephalography;
uroofloummetry;
profilometry;
scintigraphy;
ultrasound doppler renal blood flow.

Watering with pyelonephritis

Urine Analysis In any pathological process, it helps to diagnose the disease, because with its help you can learn a number of important indicators: the number of leukocytes, acidity, density and color of urine, the presence of protein, agents (microorganisms). The urine color for pyelonephritis becomes darker or has a shade of red, the fluid is observed, nonypical impurities (bodies or rare flakes) may appear. The smell of urine becomes silent, it can be noticed in the process of urination.

Treatment of pyelonephritis in children

In the treatment of pyelonephritis, a bed mode is prescribed a child with an elevated temperature. If there are no fevers, a small chamber movement is quite possible. Children follow the overall mode: walks in the fresh air on the territory of the hospital. The child is prescribed a diet on the pessner and treatment with antibiotics. Every 3-4 weeks, antibacterial therapy preparations are replaced by others, even after discharge from the hospital.

After carrying out the main treatment and elimination of inflammation, the child should continue the course and take uroantisseptics, diuretics, antioxidants, spasmolytes for pain syndromes, immunocorrectors, NVPS (non-steroidal anti-inflammatory drugs), antihistamines. The duration of treatment depends on the set of factors, but on average therapy continues from one to three months.

Antibiotics

When pyelonephritis, the main treatment is the reception of antibiotics. Cephalosporins consist of 7-amylocephalosporinic acid. Contemporary preparations include cefanorms, ladef, cefepim, cefomax, chains, which are produced in the form of a solution for injections. High efficiency in drug-carbapene antibiotic drugs: Genhem, Meropenem, Doriprex, Inwasin. Antibacterial action helps destroy most microorganisms. Treatment of this disease with antibiotics also includes aminoglycosides: gentamicin, amikacin.

Diet for kidney

Of great importance in the treatment of pyelonephritis in the child is attached to a diet. Its essence lies in the great consumption of milk and vegetable food. Dairy products normalize urinations, contain calcium, protein, phosphorus. Kefir and Ryazhenka contribute to improving the intestinal microflora, the composition of which worsens after the reception of aggressive medicines. Eggs and cottage cheese are important for the organism of amino acids. After a week, meat and fish are introduced, but only in boiled or stew.

Canned foods, onions, garlic, celery, cauliflower, spinach, meat broths, smoked, pickles, horseradish, spices, cocoa, mustard, sharp, fried, oily food are excluded. In these products there are a large number of excreted salts, for the use of which control is necessary. Abundant drinking water is recommended (1.5 times more daily needs), compotes, low-alkaline mineral water, juices, hots.

Exacerbation

In the event of exacerbation of pyelonephritis in a child, a hospital should go to the hospital, because during this period the hospitalization is recommended. After normalizing the body temperature, reducing back pain, the need for bed mode disappears, and the child can continue to be treated at home. A dining diet is prescribed by Pevznera. To seed a microorganism, which causes inflammation, the child passes ethiotropic treatment.

Effects

Pyelonephritis is a serious illness, so without the right treatment will not pass without a trace. The consequences of kidney inflammation are as follows:

pneumonia;
anuria;
hypoxic brain damage;
intestinal dysbacteriosis;
poor development of internal organs or its absence;
renal coma;
renal failure until kidney failure;
rickets;
iron-deficiency anemia;

Prediction and prevention

In 80% of cases in patients who started treatment at an early stage, the inflammation of the kidneys ends favorably. Clinical recovery occurs a month after the start of therapy. In the future, the disease does not return, pyelonephritis prevention is necessary in children:

Timely treatment of infectious diseases. Angina, Caries, Pneumonia, ARVI (acute respiratory viral infection) can cause the development of inflammation in the kidneys.
Eat a daily portion of water. The aqueous load is used to "leach" bacteria with the resulting urine.
Do not tolerate when you want to the toilet. On time empty the bladder.
Use drinks and food in vitamin C, which acidifies urine, neutralizing bacteria.
Follow the rules of personal hygiene, causing daily by the genitals.
Do not overcoat. The cold contributes to the development of inflammatory diseases.
Regularly pass the surveys and hand over the tests.
Strengthen immunity.

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Attention! The information presented in the article is familiarized. Article materials do not call for independent treatment. Only a qualified doctor may diagnose and give recommendations on treatment, based on the individual characteristics of a particular patient.

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