Renal System Disorders: Pyelonephritis

Disorders of the Renal System

Pyelonephritis

• Inflammation of the renal pelvis and functional units of the kidney (nephrons), involving the cortex and medulla (parenchyma of the kidney).
• Higher incidence in women than men.
• Two main types: acute and chronic pyelonephritis.

Acute Pyelonephritis

• Sudden and severe infection of the kidney by Gram-negative bacteria (e.g., E. coli and Proteus mirabilis).
• Signs and symptoms: • Sudden onset of fever • Chills • Nausea • Vomiting • Groin pain • Haematuria • Dysuria and rigor
• Investigations: • Midstream specimen or catheter specimen of urine to identify causative organism • Full blood count to check for raised white blood cells • Intravenous pyelogram to identify urinary tract obstruction • Full nursing and medical history to identify previous urinary tract infection and kidney stones
• Pharmacological interventions: • Analgesics for pain management • Antibiotics to treat the infection • Anti-emetics for nausea and vomiting • Antipyretics to treat pyrexia

Chronic Pyelonephritis

• Progression from acute pyelonephritis, affecting the calyces and renal pelvis of the kidney.
• Can begin in childhood, leading to scarring and fibrosis of the kidney, and eventual renal failure.
• Signs and symptoms: • Fever • Abdominal and groin pain • Hypertension • Dysuria • Proteinuria

Cystitis

• Inflammation of the urinary bladder, which may hemorrhage.
• Most common form of urinary tract infection, affecting women more than men.
• Causes: • Bacterial infection • Sexual intercourse • Pregnancy • Rectal intercourse • Urinary tract obstruction (e.g., enlarged prostate gland) • Chemicals in washing powder • Nylon underwear • Stress
• Signs and symptoms: • Dysuria • Pyuria • Haematuria • Abdominal discomfort • Nocturia • Urinary incontinence

Acute Kidney Injury and Chronic Kidney Disease

• Acute kidney injury (AKI): inability of kidneys to remove accumulated metabolites from the blood, leading to altered fluid, electrolyte, and acid-base balance.
• Causes: primary kidney disorder, systemic disease, or other urological defects.
• Chronic kidney disease (CKD): slow and insidious development, with few symptoms until severe kidney damage.

Nutrition and Associated Disorders

• Nutrition is essential for human existence and kidney function.
• (Note: The text does not provide further information on this topic.)