Chronic pyelonephritis, urolithiasis, kidney amyloidosis DR MEZUT

1. CHRONIC
PYELONEPHRITIS,
UROLITHIASIS, KIDNEY
AMYLOIDOSIS
MUHAMMED MUSTHAFA
KALATHINGAL

2. CHRONIC PYELONEPHRITIS

3. CHRONIC PYELONEPHRITIS
Chronic pyelonephritis is continuing pyogenic
infection of the kidney that occurs almost
exclusively in patients with major anatomic
abnormalities. Symptoms may be absent or
may include fever, malaise, and flank pain.
Diagnosis is with urinalysis, culture, and
imaging tests.Treatment is with antibiotics
and correction of any structural disorders.

4. SIGNS AND SYMPTOMS
Chronic pyelonephritis is a complex renal
disorder characterized
by chronic tubulointerstitial inflammation
and deep segmental cortical renal scarring
and clubbing of the pelvic calyces as the
papillae retract into the scars. It is an
important cause of end-stage renal disease
(ESRD).

5. DIAGNOSIS
The course of chronic pyelonephritis is
exceptionally variable, but the disease generally
advances really slowly. A lot of patients have
sufficient kidney function for ≥ 20 yr after
onset. Regular worsenings of intense
pyelonephritis, although controlled, generally
additional deteriorate kidney structure and
function

6. TREATMENT
If obstruction can not be removed and frequent UTIs
are common, long-term treatment with antibiotics (eg,
trimethoprim/sulfamethoxazole, trimethoprim, a
fluoroquinolone, nitrofurantoin) works and may be
needed forever. Complications of uremia or
hypertension have to be dealt with appropriately.For
XPN, a preliminary course of antibiotics ought to be
provided to manage regional infection, followed by en
bloc nephrectomy with elimination of all involved
tissue.

7. UROLITHIASIS

8. UROLITHIASIS
Renal stones are a common health
condition; in fact, it is estimated that
up to 10% of all individuals will
develop a kidney stone throughout
their lifetime, although some
individuals do not experience
symptoms. Each year, approximately
1 in every 1,000 people is

9. SIGNS AND SYMPTOMS
The exact symptoms of urolithiasis depend on the location and size
of the calculi in the urinary system. General signs and symptoms may
include:
1. Renal or ureteral colic
2. Blood in the urine (hematuria)
3. Urinary tract infection
4. Abdominal pain Stones in the kidneys can obstruct the urinary flow
in the kidneys or the ureters, which can lead to severe flank pain and
possibly blood in the urine. Stones in the bladder can lead to
symptoms such as pain, as well as an increased urge and frequency
of urination.

10. DIAGNOSIS
The diagnosis of urolithiasis involves a medical history and a physical
examination, in addition to appropriate testing methods to identify
the calculi and make the appropriate treatment decisions. Additional
diagnostic tests may include:
1. Urine culture and urinalysis to reveal signs of hematuria, pyuria,
infection and acidity.
2. Complete blood count tests to detect elevated white blood cells
indicative of infection.
3. Intravenous pyelography (IVP) to identify the size and location of
the stone

11. TREATMENT
1. Anasthetic therapy
2.Antispasmodic drugs
3.Reception of a large amount of liquid
4.Treatment of complications
5.Surgical treatment

12. KIDNEY AMYLOIDOSIS
The appearance and deposition of amyloid in
all structural element of renal tissue which
leads to impaired renal function and then to
chronic failure
Amyloid is a pathological protein that is absent
in normal conditions in a healthy person
In this disease the deposition of amyloid in the
kidney is combained with deposition of amyloid
in all organ and tissues

13. KIDNEY AMYLOIDOSIS

14. CAUSES
The cause of amyloid is not fully known
There is genetic defect in the synthesis of
protein with the formation of a
pathological protein
Most often amyloid is formed is formed
on the background of a long course of
chronic infectious and autoimmune
inflammatory diseases

15. SIGNS AND SYMPTOMS
Isolated moderate proteinuria for a long time, which then turns
into isolated massive proteinuria
Hypoproteinemia
Increase in the size of the kidneys with ultrasound and x ray
studies of the kidneys
Detection of amyloid in the mucus membrane of the oral cavity
and rectum and in the parenchyma of the kidneys during the
biopsy
In the final stage of the disease signs of CRF syndrome develop
gradually

16. TREATMENT
Treatment for underlying disease
Pathogenetic treatment
(immunomodulators,unitiol,etc)
Treatment of complications
(CRF,hypertension,etc)