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November 24, 2016 00:01

kidney disease

ureteritis-nefralny syndrome is formed in kidney and ureter disease, but can be caused pathology and lower levels of the genitourinary system, as a result of violation of mochevyvedeniya and ascending infection.There is no doubt that the diagnosis and treatment of diseases of kidneys and ureters must deal with urologists, but more often, especially in the abdominal, pain syndromes and peritoneal and abdominal trauma they arrive in surgical hospitals, where there is always a urological service.

kidney disease are diverse, surgeons and urologists often have to meet with the diagnosis of urolithiasis and pyelonephritis, or a combination thereof.

Kidney stones

urolithiasis - chronic kidney disease, characterized by impaired metabolic processes in the body with the formation of stones in the cavity system, ureters, bladder, prostate and urethra of urine salt and organic compounds.

Stones often localized on the right, in 40-50% of cases in the pelvis, in 30% of cases are detected during colic or uretera

l hydronephrosis in cups and bladder within 12-15% of cases.According to the chemical composition, they are: oxalate, phosphate, urate, cystine, protein and mixed structure.The size of sand, small (up to 0.5 cm), medium (up to 1 cm), large and staghorn.In 90-95% of cases of urolithiasis accompanied by the development of progressive pyelonephritis, hydronephrosis, pielonefroza and sometimes paranefrozom.

clinical picture of the disease is heterogeneous kidney.Stones in an inert state may not occur;When you join pyelonephritis developed pain and a feeling of heaviness in the lower back, pain often radiating to the lower abdomen, leg;the passage of sand or stone along the ureter is accompanied by the development of renal colic, and the presence of concomitant pyelonephritis clinical manifestations brighter.Renal colic is accompanied by a sharp cramping pain in the lumbar region, radiating to the groin, genitals, thigh.Diagnosis of kidney disease usually does not cause problems, but sometimes it is necessary to differentiate with the pathology of the abdominal cavity.You can use techniques: Autograph - when colic spraying chloroethyl loin causes a decrease in pain;Lorin-Epstein - while sipping over testicle has been a sharp increase in pain in the corresponding half of the abdomen, and the lumbar region;OPshanetskii - palpation of the abdomen of the patient in standing in a bent position when colic is not detected signs of peritoneal irritation, and in the localization process in the abdomen, this test is positive.

In the study of urine a distinctive feature of this kidney disease is the presence of microscopic hematuria or red blood cells predominance of leukocytes in urine assays for Nechyporenko and Addis Aleksander Kakowski.To confirm the diagnosis is sufficient to carry US, survey and excretory urography.When complications (hydronephrosis, pyonephrosis, paranefroz) complex is expanding, but is carried out only by a urologist.

pyelonephritis

pyelonephritis - nonspecific kidney disease, characterized by inflammation of interstitial renal pelvis system.Pyelonephritis - mainly secondary disease process (80%), in violation of the developing urinary passage infections climbing from the lower divisions.There are acute;and chronic pyelonephritis (unilateral and bilateral).

Clinic kidney disease depends on the extensiveness of tissue damage, the virulence of the microflora, the patient's age and reactivity.There are a pain in the lumbar region radiating to the suprapubic and groin, thigh, often marked by frequent and painful urination (pollakiuria).Pain is accompanied by transient chills and fever.The diagnosis of kidney disease is based on clinical picture and urine and blood tests.Ultrasound can be found an increase in the size and expansion of the renal pelvis system.Urography in the acute phase is not carried out.

Chronic pyelonephritis is formed after three months of acute flow.The clinical picture of renal disease and atypical diverse, but mostly marked recurring pain in the lumbar region, the phenomenon of cystitis, weakness, malaise, pale and pasty face, tenderness, positive symptom Pasternatskogo.For the diagnosis of kidney disease should be identified: leucocyturia (if in the general analysis of urine is not detected, you need to study or nechyporenko Addis Aleksander Kakowski) bacteriuria, the presence of protein, signs of pyelonephritis ultrasound and urography (cavity expansion system).

This is revealed and the form of chronic pyelonephritis: wavy, latent, hematuric, calculous, tubular, anemic.These studies reveal the formation of a kidney ailment as a hydronephrosis.In the presence of chronic pyelonephritis is necessary to bear in mind the specific infection.

the transition from inflammation of kidney tissue (for carbuncle, or purulent pyonephrosis perinefrite) on perirenal tissue develops paranephritis (rare flora drift occurs through hematogenous).Suppurative process in perirenal tissue develops very quickly, but, given the cross-connective bridges, the bowl has a limited nature of the process (usually high), although, in some types of microflora can be generalized.A distinctive feature of this kidney disease is a dramatic and progressive worsening of the patient's condition because of intoxication syndrome on the background of already existing kidney disease.Pain sharp, peculiar to any purulent inflammation, but can occur and, as a renal colic.Localized pain in the lumbar region and in the upper quadrant, especially with a deep breath and cough due subphrenic involvement in fiber, sometimes formed into the pleural cavity effusion.

diagnosis of kidney disease

diagnosis of kidney disease based on the presence of a typical pattern (having the disease, the formation of intoxication syndrome, typical pain syndrome).On examination, it marked pasty skin in the lumbar region, the muscles tense and painful on palpation, reflex spinal curvature in the affected side, flexion in the hip and knee limb (psoas sign) mobility limitations due to pain.Symptoms pronounced Pasternatskogo (percussion pain in the lumbar region) and Yisrael (pain with pressure in the lumbar triangle).Confirm the diagnosis ultrasound and plain radiography of the abdominal cavity (the kidney is lowered, the dome of the diaphragm is high, phrenic sinus does not expand, the shadow blur, contoured lumbar muscles)

ureters (ureter), which are cylindrical, slightly flattened epithelial-muscular tube diameter of 615 mm, renal pelvis connected to the bladder.There are three levels of anatomical narrowing: initial, iliac, and the transition to the pelvic part which most often occurs infringement stones, stricture formation.

From ureter disease is most common urolithiasis, which is shown developing colic.When docked stone-free process.If the infringement is developing hydronephrosis due to violation of the passage of urine, and in its subsequent stricture.Inflammatory diseases of the ureters (ureterity, pieloureterity) often go down, when you receive the microflora of the renal tissue or lymph vessels, but there may be an upward pieloureterit or pyelonephritis, while the defeat of the renal pelvis.

damage ureter (open, closed, partial and full) by origin are divided into 4 groups: traumatic (open and closed);operational (especially when pelvic operations);when endovezikalnyh studies (catheterization and retrograde urography);when downgrade stone extractors.In the early days can not be seen, but in the future, depending on the level and type of damage, accompanied by peritonitis, periureterita ,: paranephritis;urinary streaks, urinary fistula ureteral stricture (diagnosis difficult, requires the involvement of an experienced urologist).

malformations and ureteral tumor is quite rare, their diagnosis is complex and must be performed by a urologist, to suspect they may be in the formation of uretero-nefralnogo syndrome, as well as the presence of concomitant kidney disease.

ureteritis-nefralny syndrome is accompanied by characteristic clinical picture.Pain in somatic diseases and injuries of permanent, or spasm of functional somatic (usually urolithiasis) pathology cramping in the form of colic, radiating from the lumbar region in the lower abdomen: from the upper ureter in celiac or iliac region;of the middle part - in the groin;from a lower division - in the genitals and thigh.There are dysuria, oliguria, anuria.In the study urine is characterized by: leykotsituriya (especially in inflammatory diseases, it is desirable to conduct a bacteriological study), the presence of haematuria (especially urolithiasis, tumors, trauma), the presence of protein (especially high content of the pathology), salts cylinders.Identifying these symptoms is an indication for further specifying topical diagnosis of kidney disease.The easiest method is burdensome and ultrasound examination (reveals the position, pathology parenchyma, pelvis, presence of stones, malformations) by ultrasound is not diagnosed.Survey urography reveals the position, the presence of stones in the pelvis, but urate, ksanitovye and cystine stones are not detected, and they make up more than 10% of urolithiasis.Available excretory urography using urokontrastov: reveals hydronephrosis, presence of stones, strictures, malformations, certain types of tumors.Cystoscopy and cystochromoscopy, retrograde urography informative for the diagnosis of kidney disease, simple and accessible, but they can only perform a urologist or surgeon, passed specialization in urology.If you suspect that a tumor is a magnetic resonance imaging.Other methods, and many of them, recently or left;or applied strictly on the testimony.