Emphysematous pyelonephritis is a dangerous complication of diabetes mellitus.

Diabetes mellitus – a serious endocrinological disease, which, unfortunately, affects millions of people around the world. Diabetes can lead to many dangerous complications that take people's lives. One of the rarer, but no less serious complications of diabetes mellitus is one of the forms of acute pyelonephritis – emphysematous pyelonephritis. The development of this disease threatens a person with the likelihood of losing a kidney. Therefore, effective treatment of diabetes mellitus and prevention of its complications are important measures to help prevent the development of emphysematous pyelonephritis.

What bacteria lead to the development of emphysematous pyelonephritis

Emphysematous pyelonephritis – This is an acute inflammatory process of the kidneys, which occurs in connection with the penetration of specific microorganisms capable of gas formation into the tissues of the kidney. It is the toxic effect of such microorganisms that provokes the development of necrotizing inflammation in the kidney. These microorganisms include Escherichia coli, Proteus and Pseudomonas, which are able to break down glucose into acid and gas. In almost 80% of cases, gas formation is observed precisely in patients with diabetes mellitus, mainly in elderly women with a high blood glucose level and a rather low level in the urine. Other causes of emphysematous pyelonephritis include obstructive processes in the urinary tract or abscesses in the kidneys. In most cases, kidney damage is unilateral.<

Clinical picture of emphysematous pyelonephritis: main symptoms

Emphisematous pyelonephritis is a severe disease with a characteristic clinical picture. The process begins acutely, with an increase in body temperature to febrile values, chills, tachycardia, pronounced symptoms of intoxication and impaired renal function. Dehydration and acidosis cause both kidney and liver failure. There is hyperazotemia and circulatory failure. Emphysematous pyelonephritis is often accompanied by & nbsp; thrombosis of the renal vessels and necrosis of the papillae of the kidneys. At the same time, necrotic processes in the surrounding tissue cause irritation of the parietal peritoneum and the development of peritonitis. Patients complain of pain throughout the body, symptoms of bacteriotoxic shock often appear. Emphysematous pyelonephritis requires an urgent start of therapeutic measures.

Diagnosis of emphysematous pyelonephritis: laboratory and instrumental methods

Diagnosis of emphysematous pyelonephritis is not difficult. Take into account the patient's history, the presence of characteristic previous diseases. A laboratory blood test indicates the presence of an inflammatory process, a high concentration of protein, leukocytes and bacteria is noted in the urine. Bacteriological examination of urine allows you to determine the causative agent of the disease. During the examination of the patient, symptoms of peritoneal irritation and a positive symptom of Pasternatsky attract attention. On the review urogram, there is a curvature of the spine towards the affected kidney, and a symptom characteristic of emphysematous pyelonephritis – accumulation of gas in the peritoneal tissue. Ultrasound examination of the kidneys also confirms the presence of gas in the perirenal tissue and an inflammatory process in the kidney itself.

Methods of treatment and prognosis for emphysematous pyelonephritis

The treatment of emphysematous pyelonephritis has some difficulties. It is believed that conservative therapy is not effective enough for emphysematous pyelonephritis and the patient needs urgent surgical intervention. In cases where surgery is contraindicated, it is recommended to drain the kidney. If emphysematous pyelonephritis proceeds in parallel with a heart attack and kidney necrosis – nephrectomy should be the operation of choice. Organ-preserving operations for emphysematous pyelonephritis are also performed, but due to the threat of a rapid deterioration in the patient's condition, nephrectomy is performed much more often. Almost 80% of those with emphysematous pyelonephritis who underwent nephrectomy have a complete recovery. With conservative treatment of this disease, the mortality rate reaches 50%.