1. Kidney infection or
pyelonephritis
:Definition
Pyelonephritis is an infection of the
. kidney and the urethres
Causes 1- urinary tract infection, in
the presence of occasional or
persistent back flow
urine from the bladder into the-2
ureters or kidney pelvis
(. (vesicoureteric reflux
2. Classification of
pyelonephritis
Acute uncomplicated
pyelonephritis sudden
development of kidney
(.inflammation
Chronic pyelonephritis (a long-
standing infection that does not
clear
3. Causes incidence, and risk
factors
The risk is increased if there is a history
of cystitis, renal papillary necrosis,
kidney stones, vesicoureteric reflux, or
. obstructive uropathy
Acute pyelonephritis can be severe in
the elderly and in people who are
immunosuppressed (for example, those
(.with cancer or AIDS
4. .
:Symptoms or back pain-
Flank pain
Severe abdominal pain-
.high fever and persists for more than 2 days -
Chills with shaking.Warm, flushed, moist -
. skin
. Vomiting, nausea -
. Fatigue and general ill feeling -
Painful urination, urinary frequency or urgency -
., nocturia
Cloudy or abnormal urine color, foul or -
. strong urine odor, and hematuria may occur
Mental changes of confusion -
5. Diagnostic studies
A urinalysis commonly reveals white-
blood cells (WBCs) or red blood cells
(. (RBCs
A urine culture may reveal bacteria in-
. the urine
. A blood culture may show an infection-
An intravenous pyelogram (IVP) or CT-
scan of the abdomen may show
enlarged kidneys with poor flow of dye
. through the kidneys
6. Treatment
The goals of treatment are control of
the infection and reduction of
. symptoms
Acute symptoms usually resolve within 48 to
. 72 after appropriate treatment
Due to the high mortality rate in the elderly
population and the risk of permanent kidney
. damage prompt treatment is recommended
7. antibiotics are selected to treat the
.infection
Intravenous (IV) antibiotics may be used
initially to control the bacterial infection if
infection is severe a 10- to 14 day course of
antibiotics chronic pyelonephritis
Kidney damage can result from these
infections. The elederly, infants, and people
with a compromised immune system
so receive frequent monitoring for potential
problems and to receive IV antibiotics,
additional IV fluids and other medications as
necessary
8. :Complications
. Recurrence of pyelonephritis
Perinephric abscess (infection
(. around the kidney
. Sepsis
. Acute renal failure
. Chronic renal failure
9. prevention
Prompt and complete treatment of
cystitis pyelonephritis. Chronic or recurrent
.urinary tract infection of the kidneys
Preventive measures may reduce
symptoms and prevent recurrence of
infection. Keeping the genital area clean and
remembering to from front to back
Urinating immediately after sexual
intercourse may help eliminate any bacteria
10. Prevention
Increasing the intake of fluids
to encourage frequent urination that
. flushes bacteria from the bladder
Drinking cranberry juice
prevents certain types of
bacteria from attaching to the wall
of the bladder
11. Glomerulonephritis is an
inflammation of the kidney’s filtering
. mechanisms, called the glomeruli
Glomerulonephritis can be acute ,
,which means it occurs suddenly
or chronic , meaning symptoms
develop gradually and continue over a
number of years
12. common in children between the ages
.of 2 and 12, particularly boys
Children with frequent streptococcal
infections
people with diseases such as hepatitis,, or
.diabetes
What causes it
occurs after a streptococcal
infection, such as strep throat-
certain toxins, such as paints
. its cause is not known
13. What are the signs &
symptoms
? often flu-like, such as general fatigue,
,nausea, vomiting, loss of appetite, fever
and abdominal and joint pain. These types
of general symptoms can continue for up to
one month before symptoms of kidney
failure appear
14. swelling. They can progress to high blood
pressure, visual disturbances,
shortness of breath, blood in the
urine, and a reduction in urine
.production
Chronic glomerulonephritis develops so
gradually that it is often not discovered until
. a routine physical exam
As this condition progresses, it causes high
blood pressure, swelling, and other
.symptoms of kidney failure
15. How is it diagnosed
complete medical history, physical -
. examination, and laboratory tests
check a urine sample for blood and -
high levels of protein
check for high levels of the waste
. products creatinine and urea in blood
If a streptococcal infection is suspected,
throat culture, will reveal this bacteria.
a biopsy, to study under a
microscope. An eye exam may show
signs of vascular changes in people
.with chronic glomerulonephritis
16. the treatment
bedrest and medications
to cure any infection, increase urine-1
, output, and lower blood pressure
to relieve any strain on the kidneys so- 2
they can recover full function
diet control to your intake of sodium,
protein, and fluids. Most children recover
, fully
17. no treatment to stop the
progression of chronic
glomerulonephritis. Once kidney
, failure has occurred
waste products must be removed
from the bloodstream for the
kidneys through a process called
. dialysis
A kidney transplant may also
.be an option
18. You can help prevent acute
glomerulonephritis by treating
streptococcal infections following the
full course of medication
Nursing intervention
reliefe symtoms &prevention -1
complication
Diatery intake :protein restriction –-2
.increase cho
Monitor I &O -vital signs-activity -3
level-edema-hypertentio
Proternurea &hematuria
Patient education (medication -4
,diet,avoidance of trams ,infection
&follow -up
19. Nephrotic syndrome
IS condition marked by very high levels of
protein in the urine; low levels of protein in
the blood; swelling
of Nephrotic syndrome
Symptoms of Nephrotic syndrome
Frothy urine
Proteinuria
Low serum protein
Lipiduria
Swelling around the eyes
20. it results from a specific glomerular defect
and indicates renal damage. The prognosis
is highly variable, depending on the
underlying cause. Some forms may
. progress to end-stage renal failure
Causes About 75% of nephrotic syndrome
cases result from primary (idiopathic)
glomerulonephritis
Some tubules may contain increased lipid -1
deposits
. lesion in patients with adult idiopathic-2
21. Other causes of nephrotic
metabolic diseases such as -1
; diabetes mellitus
collagen-vascular disorders, such
as 2 -systemic lupus
erythematosus and polyarteritis
circulatory diseases, such as -3
heart failure and sickle cell
anemia; 4- nephrotoxins, such as
mercury, gold, and nonsteroidal 5-
anti-inflammatories; allergic
reactions; infections, such as
22. Diagnosis
Consistent proteinuria in excess of 3.5
; g/24 hours strongly suggests syndrome
examination of urine reveals an
increased number of granular, and waxy,
. fatty casts, and oval fat bodies
Serum values that support the diagnosis
are increased cholesterol, phospholipid, and
triglyceride levels and decreased albumin
. levels
Histologic identification of the lesion
requires a kidney biopsy
23. Treatment
.correction of the underlying cause- 1
Supportive treatment consists of-2
protein replacement with a nutritional diet of
1 g protein/kg of body weight, with restricted
.sodium intake
a diuretic for edema; and an antibiotic-3
. for infection
Immunosuppressants ,-4
. antihypertensives, and diuretics
Angiotension-converting enzyme -5
inhibitors can decrease protein loss in urine