Chronic Pyelonephritis

Chronic Plyelonephritis is the chronic inflammation caused by bacteria infection of kidneys. The main lesion is to injury renal interstitium, renal pelvis and renal calices. Because the inflammation progression or recurrence results in damaging renal interstitium, renal pelvis and renal calices and forms scarring tissue, which will cause to nephrarctia and renal insufficiency. Commonly patients may only have abdominal pain and (or) low fever, and no noticeable urinary infection: painful urination, frequent urination and urgent urination. Its primary presentations are nocturia increasing and a bit of white blood cells and proteins. Patients who have the history of long-term or recurrent urinary infection will occur to Uremia at the late stage.
Symptoms and Signs
1. Systemic poisoning symptoms: chill, fever, fatigue and poor appetite.
2. Local symptoms: abdominal soreness, abdominal pain and percussion pain between ribs.
3. Bladder irritation signs: frequency, urgency and pain urination, urination difficulty. And the history of urinary tract infection is more than half a year, with no response for antibateria treatment.
Clinical Symptoms:
This disease presents complicatedly and variously in clinical practice. The main presentation is true bacteriuria. There are a bit of white blood cells and proteins in the urine. And bacteriuria may be persistant or intermittent. Patients mostly have recurrent urinary irritation signs. Some patients may neither have systemic symptoms or noticeable urinary irritation signs. Some patients have low fever, abdominal pain, fatigue, frequent urination or pyuria after recurrent tests. Sometimes, patients may just have sallow complexion, tireness, poor appetite. In children, they present loss of appetite, mental fatigue, anemia, maldevelopment, growth retardation or enuresis, uroclepsia.
It can be divided into five types:
1. Recurrence type: it is typical chronic pyelonephritis. Patients usually recurrently occur to urinary irritation signs, with bacteruira. Low fever or medium fever and dull pain between the kidneys are also the symptoms.
2. Long-term low fever type: patients often have no urinary irritation signs, and just have low fever, dizziness, fatigue, losing weight and poor appetite, which is often misdiagnosed by neuronal low fever, tuberculosis, or other chronic infectious disease.
3. Hematuria type: a minority of patients are characterized with recurrent hematuria. And hematuria can relieve without treatment.
4. Asymptomatic bacteriuria: Patients neither have systemic symptoms nor urinary irritation signs, but there are many bacteria, a bit of white blood cells, and occasional cast in the urine. This type is commonly seen in pregnant women and girls.

5. Hypertensive type: patients may have urinary infection history before, but the main clinical presentation is Hypertensive symptoms featuring with dizziness, headache and fatigue, or occasionally high blood pressure, but no urinary irritation signs. So it is easy to be misdiagnosed by idiopathic hypertension. This disease is one of the basic diseases for progressive hypertension. If young man and women have hypertension, it should be considered to chronic pyelonephritis. Patients may complicate with proteinuria and anemia, and GFR is decreasing.