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The past, people with a history of urinary tract infection by the length (more than six months or 1 year j to diagnose chronic pyelonephritis, which is not correct. Chronic pyelonephritis present its diagnostic criteria should be: a general expression of chronic interstitial nephritis at the same time there is renal pelvis, renal fibrosis and deformation of light (relative to blood on clinical imaging), together with history or bacteriological evidence of a clear sense of the urine. According to the of 46 cases of urinary track a sense of the results of 22 years, About half of patients relapse several times in the course of the disease, but only by 8.7% in the diagnostic criteria of chronic pyelonephritis. Therefore, a sense of history must not be the length of the urine to diagnose pyelonephritis.
Etiology
No complications in the urinary tract just very few chronic pyelonephritis, in a complex situation, it will happen. Therefore, chronic pyelonephritis is mainly composed of the following 3 conditions: urinary tract obstruction complicated by infection, known as obstructive pyelonephritis; renal reflux associated with pyelonephritis (kidney reflux disease, another chapter details), formerly called non-obstructive chronic atrophic pyelonephritis, in fact this disease is due to the bladder and ureter reflux causes (functional obstruction); a small number of idiopathic chronic pyelonephritis, its pathogenesis is unknown.
Pathological changes
Chronic py


elonephritis, chronic interstitial nephritis in addition to general changes, the kidney can be uneven appearance, both sides of the kidney can vary in size, with irregular cortical scarring, can lead to renal calyx, renal pelvis deformation, renal pelvis, calyces chronic inflammation and fibrosis, cortical thickness and irregular, irregular kidneys shrink, resulting in condensation kidney.
Clinical manifestations
In the long course of chronic pyelonephritis, most obvious when the question may be no clinical symptoms, clinical manifestations can be divided into A main categories: directly related to the clinical manifestations of infection; and the extent of renal injury and positioning the clinical manifestations. Despite occasional episodes of acute pyelonephritis, but the infection is often associated with clinical symptoms and signs were slight. Asymptomatic Bacteriuria is more common, lower urinary tract irritation symptoms such as frequent urination and difficult urination, lower back and abdominal discomfort, and intermittent fever and so on. With the long-term tubulointerstitial damage caused by physiological abnormalities related to the clinical manifestations are more significant. Including hypertension, can not guarantee sodium concentration dysfunction and prone to hyperkalemia and acidosis. Although these symptoms can be seen in various forms of glomerular disease and renal tubular interstitial nephritis, but there are degrees of difference. Patients with chronic pyelonephritis is often associated with the above-mentioned abnormal degree of renal failure (or elevated serum creatinine level) out of proportion. When the serum creatinine level of 2 ~ 3mg/dl, the other kidney patients often do not appear unusual or very mild state L, while patients with chronic pyelonephritis can often appear
Significant polyuria, nocturia increased, hyperkalemia and acidosis. And this concentration of patients due to renal dysfunction, particularly prone to dehydration.Do not understand this article [online expert advice] Favorite [Print] [Close]
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