Pyelonephritis

Definition

Pyelonephritis (upper Urinarius tractus infection) is a kidney

cup bacterial infection, tubule, and interstitial tissue of one
or both kidneys. (Brunner & Suddarth).
 Etiology
• The main cause is the infection with reduced host pressure
(Seprti calculi, Malgnanci, hydrineprosis, or trauma). Echercia
Colli is the most prevalent cause of polyonephritis
• Pyelonephritis is often as a result of ureterovessical reflux,
wherein an incompetent ureterovessical widespread causes
urine to flow back (reflux) into the ureter.
• The obstruction of the tractus Urinarius (which increases the
vulnerability of the kidneys to infections), bladder tumors,
strictures, prostaticinal hyperplasia Benigna, and Urinarius
stone is another cause.
Classification of Pyelonephritis
• Acute pyelonephritis
Acute pyelonephritis often occurs as a contamination
of bacteria in the urethra or after an action to inject
instruments such as catheter or cystocope.

• Pyelonephritis Chronic
Pyelonephritis chronic occur more frequently after
chronic obstruction with reflux or chronic disorders. Its
development is slowly and usually associated with acute re-
attack, although the client may not have a history of acute
pyelonephritis.
Pathophysiology
Pyelonephritis occurs when bacteria enters the renal pelvic,
causing inflammatory reactions, and white blood cells are
increased. Inflammation causes odema in the affected
tissues, starting on the papillae and occasionally dealers to
corteks. Infections can rise or ascending as soon as cystitis
or prostatitis, or descending, when there is an infection
pharyngitis in the bloodstream.
Once the infection is treated and inflammation is cured, it
can leave fibrous tissues and scar. Calyx kidneys become
rough due to scarr in the intestinal tissues. If the infection is
cured, more scar, fibrosis, and tubule absorption disorder
and secretion resulting in decreased renal function.
 Clinical manifestations
1. Acute pyelonephritis:
The kidneys will be enlarged, occurs abcess focal Parenchym, and the buildup of
polymorphonuclear lymphocytes around and within the tubule. The particular sign of
the patient will appear to be acute stressed even though in some cases this disorder
is minimal or no Manifestation.
High body temperature, chills, nausea, flank pain on the affected area (Costovertbra
Angle {CA} soft), headache, muscle aches and very weak. Pain usually spreads down
to Epigastrik and can colic if infection is a complication of the stone. In percussion or
palpation above the CVA feels soft. Generally, patients experience dysuria,
frequencies, urgency, and other signs of cystitis in a few days. Bloody urine, foul odor,
and WBC and cylindrical increase.
Urine and sensitivity cultures are conducted to reappear Diagnos. At Urinaliysis will
be found antibody-coated bacteria, bacteriuria, cylinder WBC increased and injected
urogram renal shrinking with the channel system calyceal to be irregular.
2. Pyelonephritis Chronic:
Specific manifestations do not exist. It is found when
evaluated Hypertensinya or complications hypertension The
disease is the most frequent manifestation. In laboratory
examination found Azotemia, Pyuria, anemia, acidosis, and
uric proteins. Also found loss of kidney ability to attach
urine.
 Medical Management
1. Acute pyelonephritis
Medical management in acute pyelonephritis has the following objectives:
Eliminate pathogenic organisms with antibiotics that are tightly to kill germs that have been
found in urine and sensitivity.
Remove all factors or diseases that cause host defenses to decline. If it is found stone or other
obstruction that causes infection often relapse then proper treatment should be done if
necessary surgery.
Therefore, the growth of bacteria inhibited with broad-spectrum antibiotics is sulfonamides or
combinations of sulfa methoxazole and trimethoprim usually used there is the first treatment
unless the patient is allergic to any of these drugs. This antibiotic is passed on for 10 days to 2
weeks.
Antibiotics are administered orally or with a single high dose method. In acute cases of severe
pyelonephritis antibiotics administered intravenously. Explain to patients that oral medications
should be taken up to 1 prescription to prevent recurrence of the infection. Treatment of
recurrent infections is prophylactosis of antibiotics (penicillin).
2. Chronic pyelonephritis
The main goal of medical management is to prevent further
kidney damage. If bacteria are found to give proper
antibiotics. Chronic pyelonphritis tends to be less painful.
Hypertension control is necessary.
Due to kidney damage can be hypertension more severe,
increased kidney damage.