Pyelonephritis ranks second in frequency after acute respiratory diseases, first place in the structure of the pathology of the kidneys and is more often recorded in women of working age. The frequency of pyelonephritis during pregnancy ranges from 12.2 to 33.8% and has a tendency to progressive growth. Among undergrowth, the frequency of pyelonephritis reaches 37%. In 70.4% of women suffering from pyelonephritis, various complications are observed during pregnancy, and in 75.2% during childbirth.
Purpose of the study: To study the characteristics of the onset, Clinical Course of chronic pyelonephritis (CP) in women of childbearing age.
Materials and research methods: 20 women aged 17-40 years were surveyed (on average 25.3 ± 3.4 years). 60% of patients with CP are most often diagnosed between the ages of 21 and 30 years. The plan for the study of patients included finding out complaints, collecting data on the reproductive history of life and disease, examining patients, testing blood and urine, and functional and instrumental examination of the kidneys. The clinical picture of the recurrent form was characterized by specific symptoms of pyelonephritis: pain in the kidney area radiating to the lower abdomen in 7 patients (46.7%), pain and pain during urination in 8 patients (53%), frequent urination in 12 women (80% ), fever with chills in 13 patients (86.7%). In the anemic form of pyelonephritis, signs of the anemic syndrome prevailed - weakness, headaches, dizziness, decreased performance. The specific symptoms are pain in the lumbar region of the aching nature in 3 patients (60%) and mild dysuric disorders in 4 patients (80%). All women had an anemia of the hypochromic type, leukocytosis and accelerated ESR.
Results of the study: recurrent form was diagnosed in 15 women (75.0%) and the anemic form of the disease in 5 patients (25.0%). According to the survey, untimely emptying of urine after urge was found in 15 patients (75%), non-use of hygienic toilet paper in 14 patients (70%), improper hygiene after defecation of the collecting organs in 18 women (90%). The detection of concomitant pathology revealed: chronic cystitis in 70%, chronic endometritis in 29.4%, chronic ofaritis in 5.8%, chronic tonsillitis and sinusitis in 40%, chronic bronchitis in 15% of cases, pain in the kidney area with irradiation to the lower abdomen in 7 patients (46.7%), pain and pain during urination in 8 patients (53%), frequent urination in 12 women (80%), fever with chills in 13 patients (86.7%). In the anemic form of pyelonephritis, signs of the anemic syndrome prevailed - weakness, headaches, dizziness, decreased performance. The specific symptoms are pain in the. lumbar region of the aching nature in 3 patients (60%) and mild dysuric disorders in 4 patients (80%). All women had an anemia of the hypochromic type, leukocytosis and accelerated ESR. An increase in blood creatinine was diagnosed in 8 women (40%). Proteinuria was detected in 12 patients (60%). According to the ultrasound, the following features were identified: an increase in the size of the kidneys in 15%, partial deformity in 25%, and an abnormal development of the kidneys in 14.7% of patients.
Findings:
- Chronic pyelonephritis is most often diagnosed in women aged 21-30 years.
- The presence of focal infection is a factor in the development of pyelonephritis.
- In 40% of cases, CP is the cause of chronic renal failure.