Saturday, February 16, 2013

Will Chronic Pyelonephritis Cause Chronic Renal Failure


The persistent or recurrent Chronic Pyelonephritis would lead to Chronic Renal Failure (CRF), i.e. uremia. Conversely, if CRF patients are associated with renal infections, this would aggravate the condition. Those kinds of cases commonly happen in clinic, once the renal infections are being controlled, the symptoms will be greatly relieved, so we call it an irreversible factor. The treatment for CRF complicated with renal infections is pretty tricky, reasons are:

1. Blood flow of kidneys with Chronic Renal Failure patients is pretty small, so it takes a long time for antibacterial attaining an effective concentration in kidney tissues, which would resulting in the tendency of bacteria’s drug-resistance.

2. The pathologic bacteria of Chronic Renal Failure complicated with renal infections are often caught while in hospital, that’s why the drug-resistance strains are pretty much.

3. There are plenty of contradictions when using the antibacterial. For instance, reduction of using antibacterial is needed in order to avoid systemic drug toxicity. But after the reduction, the concentration of antibiotic in kidneys can’t finish the task to killing bacteria, so the curative effects are not good.

4. There are several antibiotics which should use with caution or be forbidden, because they may have renal toxicities. Those drugs have strong renal toxicities and should be taken with caution. Azotemia would be aggravated by using the tetracycline drugs; using nitrofurantoin might cause neuritis and other toxic symptoms in renal failure, so they shouldn’t be used especially for Chronic Renal Failure patients.

5. Due to drug excretory function degenerates, the longer the treatment is, the easier the accumulation will be. Some of the patients are eager to cure the diseases by taking uninterrupted medicines. Well, it doesn’t work. Conversely, it can lead to the invasion of resistant bacteria or even causes 2 or more bacteria mixed infections, which makes the treatment more difficult.

With the appearances of unceasing new antibacterial drugs and continuous update of therapies in recent years, the clinical recovery cases of Chronic Pyelonephritis increases. According to some reports, 31-42% of bacteriuria can be eliminated after taking standard bacterial treatment in six weeks. Meanwhile, the success rate of surgery increases among patients with Chronic Pyelonehpritis which complicated with abnormality, obstruction or vesicoureteral reflux. Among those 147 cases of Chronic Pyelonephritis patients, 49 with more than 13 years medical histories did not become Chronic Renal Failure until now. In conclusion, the persistent and recurrent of Chronic Pyelonephritis patients would lead to CRF in the end. But it can be corrected if treated timely.

2 comments:

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