Current approach to the diagnosis and treatment of pyelonephritis

Pyelonephritis is an infectious inflammatory lesion of the kidneys that occurs when pathogenic and opportunistic microflora spread from the underlying parts of the urinary tract. One of the most common pathogens is Escherichia coli. The disease occurs more often in women than in men, which is due to the structural features of the urethra and its anatomical proximity to the anus. According to statistics, 50-60% of women have experienced an episode of urinary tract infection at least once in their lives. The main group of patients with pyelonephritis are sexually active women of reproductive age. When visiting a patient, a family doctor may encounter complaints of fever, chills, pain in the lumbar region, and frequent and painful urination. To establish a diagnosis, it is necessary to conduct general blood and urine tests, as well as a urine test according to Nechiporenko, during which it is possible to establish an increased leukocyte content. The main method of treatment is antibiotic therapy; as a rule, improvement occurs within the first two days. If treatment is ineffective and resistance to antibacterial drugs develops, a transition to a chronic form is possible. Before the era of the discovery of antibiotics, this disease was considered deadly due to the high risk of developing septic complications, in particular, it was pyelonephritis that caused the premature death of the Russian Emperor Alexander III, who died in the Livadia Palace in Crimea in 1894.