Pyelonephritis

Pyelonephritis (pyel(o) – combining form denoting the pelvis of the kidney) is an ascending infection of the kidney. As a rule, it is caused by bacteria that penetrates into the urinary tract from outside through the urethra. It may also ensue in the course of such concomitant diseases as cystitis in women, glomerular nephritis, or urinary stone disease (urolithiasis).

There are two forms of pyelonephritis: acute and chronic ones.

Acute pyelonephritis often begins suddenly with chills. The patient has the general set of symptoms: malaise, headache, profuse sweating, nausea and vomiting. Then, the fever raises rapidly up to 39-40 °C. It is usually accompanied with the dull pain in the loins on the side of the affected kidney. Urination may not be disturbed in uncomplicated cases of pyelonephritis. However, the urine is cloudy and bloody due to the presence of bacteria, protein, and erythrocytes in it. If timely revealed and treated, the patient quickly recovers with the return of the normal kidney function.

Chronic pyelonephritis results from the undertreated acute form of the disease. It is often asymptomatic and can be detected only by means of urinalysis or if the patient has persistent hypertension. In chronic pyelonephritis, the normal renal tissue is replaced by the connective non-functional one. The kidney becomes small and scarred that leads to kidney failure. Among other complications are pyonephrosis (purulent inflammation of the kidney) and urosepsis (presence of urine waste products throughout the body).

A full urological investigation is carried out to determine the underlying cause of pyelonephritis. It includes urinalysis that detects such signs of urinary tract infection as haematuria, albuminuria, bacteriuria, etc.; a urine test strip that reveals the presence of leukocytosis; blood tests; microbiological culture of the urine and antibiotic sensitivity testing.

The first aim of treatment of pyelonephritis consists in removing the underlying abnormalities to prevent the recurrence of disease. Therefore, it includes the administration of appropriate antibiotics to relieve the inflammatory process in the kidney and antibacterial drugs to remove bacteria. The patient must strictly follow a certain diet: one must consume a lot of fruit and vegetables, and drink 3-4 l of water daily. Spicy and fatty food must be avoided. The consumption of salt must be excluded. Surgery is required in severe cases of pyelonephritis or in cases of congenital renal pathologies.

Exercise 6. Answer the questions:

1. What is pyelonephritis?

2. What are the possible causes of the disease?

3. How many forms are there of pyelonephritis?

4. What are the symptoms of acute pyelonephritis?

5. How does chronic pyelonephritis manifest itself?

6. What can chronic pyelonephritis lead to?

7. What investigations are performed to determine pyelonephritis?

8. How is pyelonephritis treated?

Exercise 7. What symptom of pyelonephritis is described?

1. presence of protein in the urine

2. constant high blood pressure

3. slight shaking of the body due to illness

4. dark waste product of kidneys

5. presence of blood cells in the urine

6. feeling of being slightly ill

7. condition of the body when its temperature increases

8. presence of bacteria in the urine

Exercise 8. Insert the necessary preposition:

1. Following … a strict diet means to avoid spicy and fatty food.

2. The patient experienced dull pain … the side of the affected kidney.

3. The presence of urine waste products … the body leads … urosepsis.

4. Some of genitourinary disease are accompanied … painful urination.

5. The urinalysis was carried … yesterday, so you’ll find out your results soon.

6. The treatment of pyelonephritis consists … removing the underlying cause.

7. He bent forward to pick up the pill and suddenly felt obtuse pain … the loins.

8. To prevent the disease … recurrence, it is necessary to complete the course of treatment.

Exercise 9. Put questions to the underlined words:

1. Chronic pyelonephritis leads to kidney failure.

2. Two forms of pyelonephritis are distinguished.

3. Pyelonephritis implies an ascending urinary tract infection.

4. Bacteria causing the UTI penetrate into the body through urethra.

5. Cystitis, glomerular nephritis, urorolithiasis may result in pyelonephritis.

6. The signs of urinary tract infections are haematuria, albuminuria, bacteriuria.

7. Appropriate antibiotics relieve the inflammatory process in the kidney.

8. The urine is cloudy and bloody as there are bacteria, protein, and erythrocytes in it.

Exercise 10. Re-write sentences using the appropriate tense form. Translate them:

1. Purulent inflammation of kidney (to know) as pyonephrosis.

2. Persistent hypertension (to indicate) the problems with kidneys.

3. He (to suffer) from obtuse pain in the loins since last month.

4. People with renal pathologies (should, to avoid) spicy and fatty food.

5. The detection of pyelonephritis (to be) always possible due to urinalyses.

6. During the previous examination the patient (to complain) of painful urination.

7. The patient (to recover) quickly from pyelonephritis, if he (to complete) his treatment.

8. The onset of pyelonephritis (to accompany) with malaise, profuse sweating, nausea and vomiting.

Exercise 11. Translate sentences into English using pronoun one/ones:

1. Ця історія хвороби вже заповнена, та – ще ні.

2. Ці пігулки однакові. Яку з них я маю прийняти?

3. Я розбила свій термометр, мені потрібен новий.

4. Права легеня складається з трьох доль, ліва – з двох.

5. Пієлонефрит – це бактеріальна хвороба, а не грибкова.

6. Лікар виписав мені антибактеріальні ліки, а також протизапальні.

7. Зараз він знаходиться у цій палаті, але згодом його переведуть до іншої.

8. Хронічні процеси призводять до заміщення функціональної тканини нефункціональною.

Exercise 12. Put sentences in order and describe “pyelonephritis”:

1. In severe cases, it leads renal dysfunction due to kidney scarring.

2. It may be the result of cystitis, nephritis, urolithiasis as well.

3. This disease usually manifests itself with dull pain in the loins on the side of the affected kidney, painful urination with cloudy and bloody urine, high fever.

4. Pyelonephritis can be detected by full urological examination.

5. Pyelonephritis can be either acute or chronic.

6. It is caused by bacteria penetrating into the urinary tract from outside through the urethra.

7. Treatment of the disease includes antibiotic therapy and salt-free diet.

8. Pyelonephritis is an ascending renal infection.