Pyelonephritis is the inflammation of the renal

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Pyelonephritis Is the inflammation of the renal pelvis, tubules and interstitial cells of one or both kidneys. Its causes are: Reflux of urine due to obstruction or congenital structural abnormalities Renal infections Trauma Metabolic disease, which causes destruction of adjacent renal tissue. The commonest metabolic disease implicated is diabetes mellitus There is swelling of the renal parenchyma, scarring, kidney atrophy, and if not checked, failure The clinical picture of the patient with pyelonephritis includes: frequency, dysuria, chills, fever, malaise and dull back pain. If it gets chronic, headache, anorexia, weight loss and the uremic syndrome may occur. Adults who present with pyelonephritis will be treated with antibiotics; antiseptics and high fluid intake as recommended. Ureteritis Is an inflammation of the ureters and is commonly associated with pyelonephritis. Once the kidney infection is cured, ureteral inflammation usually subsides. Unfortunately, chronic pyelonephritis causes the ureters to become fibrotic and narrowed by strictures. Disorders of the Glomerular Function Disorders of the glomeruli disrupt filtration and affect the capillary membrane, making it easily permeable. This results in proteinuria, haematuria, oliguria, hypertension and azotemia. Azotemia is an increase of the products of protein metabolism such as urea and ammonia. Nephrotic syndrome is a clinical disorder resulting from increased permeability to protein. How do patients with nephrotic syndrome present? Patients with nephrotic syndrome present with generalised oedema and proteinuria, which are the most common manifestations. Idiopathic thickening of the basement membrane that occurs in diabetes mellitus can cause it. Give bed rest to the patient with nephrotic syndrome and dietary care to include high protein, low sodium and high calorie. Diuretics and other drugs may be used and the patient should be protected from infection. On the other hand, nephritis manifests with decreased filtration rate, haematuria, oliguria, azotemia and hypertension. There is little proteinuria and oedema. It is a result of inflammation arising from an autoimmune disease or infection. Among the disorders that can be grouped together as nephritic syndromes is acute glomerulonephritis, which may be due to bacteria and viruses. Streptococci are sometimes involved in acute glomerulonephritis. Chronic glomerulonephritis and rapidly progressive glomerulonephritis are the other disorders included among the nephritic syndromes. Acute glomerulonephritis presents with oliguria, proteinuria, haematuria, oedema, and hypertension. The patient with acute glomerulonephritis will be treated with two main objectives in mind. The first one is to protect poorly functioning kidneys.

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