Pyelonephritis is a non-specific inflammatory disease of the infectious nature at which a cup-making system and an interstitial tissue are affected. In 20% of cases, this pathology develops the secondary in the background of acute inflammation. Most often, the defeat is bilateral. The risk group includes young girls and women, which is associated with lighter penetration of microbes from the urethra and bladder. In chronic pyelonephritis code on the ICD-10 - N11.

Pyelonephritis

Varieties diagnoses

All urologists know about Pyelonephritis. Allocate the following varieties of this pathology in children and adults:

1. Chronic obstructive (code N11.1).
2. The unstructive caused by the reflux (urine cast from ureters). Code of ICD-10 - N11.0.
3. Uncomfortable etiology (code N11.9).
4. Infectious.
5. Non-infectious.

If a person has a pyelonephritis, the code on the ICD-10 will depend on the etiology of the disease and the results of instrumental and laboratory studies.

Features of chronic pyelonephritis

This disease most often has a microbial (bacterial) nature. Chronic kidney inflammation causes coils, intestinal chopsticks, protea, sinny sticks and other bacteria. This pathology precedes acute pyelonephritis. The predisposing factors for the development of pyelonephritis chronic (on the ICD-10 code N11) are:

• untimely and incorrect therapy of acute inflammation;
• foci bacterial infection (tonsillitis, inflammation of prostate, otitis, inflammation putty sinuses nose, urethritis, cholecystitis);
• difficulty of urin outflow;
• stones;
• irrational (monotonous) nutrition;
• narrowing of ureters;
• reflux;
• tumors;
• a benign prostatic hyperplasia;
• diabetes;
• immunodeficiency states;
• intoxication of the body;
• childbirth and the beginning of sexual life;
• congenital features of the development of urinary bodies (Diverticulus, Spermotocele).

Chronic pyelonephritis

The disease proceeds not as bright as acute pyelonephritis. The exacerbations arising mainly in the cold season are replaced by remission. For chronic pyelonephritis, the following symptoms are characteristic:

1. Subfebrile temperature.
2. Gravity in the lower back.
3. It's a dull pain.
4. Violation of the process of urination (soreness, rapid micakes).
5. Headache.
6. Fast fatigue during work.
7. Malaise.
8. Signs arterial hypertension. Characteristic to hypertensive form pyelonephritis. Patients have sharp rise arterial pressure, attacks of hypertensive crisis, strong headache, shortness of breath, nausea and dizziness. Sometimes there is pain in the heart.
9. Positive symptom of the concussion of the lower back (Pasternatsky).
10. Signs of anemia.
11. Sleep disturbance.
12. Edema. Appear in running cases. They arise mainly in the morning. Soft swelling, symmetrical, movable, pale, warm to the touch, are localized on the face and lower limbs. They quickly appear and also quickly disappear.

Objective signs of the disease are the presence of protein in the urine (proteinuria), excess normal indicators leukocytes, the presence of cylindrical epithelium and bacteria. Sometimes blood appears in the urine. Often the disease is found already at the stage of chronic renal failure.

Stages of tubula interstacional pathology

Tubulu interstitial nephritis In the ICD-10 is registered without stages. There are only 3. The following violations are characteristic of them for stage 1:

• infiltration of leukocyte tissues;
• atrophic changes in collective channels;
• the intact of kidney glomers.

In 2 stages of the disease, sclerotic changes are observed. Part of the interstitial tissue is replaced by Rubatova. The hyalineization of the glomers and the defeat of the vessels occur. At 3, the kidney stages decrease in volume and wrinkled. The surface of it becomes a bug art. At this stage, symptoms of renal failure are strongly pronounced.

Chronic pyelonephritis during pregnancy

The classification separately selects the gestational form of the disease. Chronic pyelonephritis in pregnant women occurs much more often than the rest of the population. This is due to hormonal changes and decrease in immunity. Pregnant women decreases the tone of urethra, ureters and bubble, which facilitates the penetration of infection. An important factor is that during the nose of the fetus, many drugs are contraindicated, which makes it difficult to treat acute pyelonephritis and contributes to the transition of the disease in a chronic form.

The development of the disease contributes to the increase in pressure on the urinary authorities an increased uterus and a violation of the outflow of Urin. Pyelonephritis (ICB-10 N11 code) in pregnant women often proceeds asymptomatic. Complaints are observed only during exacerbations. Changes are detected when conducting a general urine analysis.

Chronic inflammation of the kidneys during pregnancy can lead to the following consequences:

• arterial hypertension;
• renal failure;
• gestosu (toxicosis).

Chronic pyelonephritis during pregnancy

You still seem to return the potency impossible

Chronic and acute pyelocytes, pylitis and cystopelonephritis can adversely affect potency. To avoid this, you need to be treated in a timely manner. Comprehensive therapy Includes:

1. Compliance with a strict diet with a restriction of salt. Patients are recommended to eat dairy products, Vegetables, fruits, berries (watermelons), drink juices, fruits and herbal decoctions. From the menu, alcoholic beverages, coffee, salting, smoked, spices, fatty and sharp dishes are excluded.
2. Receiving antibacterial agents. They are shown in the aggravation phase. Pyelonephritis is used fluoroquinolones (nolicin), penicillins (amoxyclav), cephalosporins (supraks, ceftriaxone), aminoglycosides and nitrofurans (furadonin).
3. Application symptomatic means (antihypertensive, spasmolitics).
4. Physiotherapy (SMT therapy, ultrasound impact, adoption of chloride baths).

Glomerular diseases - a group of pathologies having similar functional, structural and clinical features And flowing with preferably lesion of the shorts of the kidneys. The classification is based on the leading syndrome - jade, nephrectic or hematuric division. And how is the glomerulonephritis on the ICD 10?

Basics of medical classification

The main goal International Classification Diseases is a systematic registration, analysis, interpretation and comparison of data on diseases and problems associated with health among residents different countries. Short alphanumeric codes are replaced by doctors from around the world. Long and comprehensive names of various pathologies in the documentation. This allows you to make brief and efficient reports on morbidity, prevalence and mortality from any known humanity to humanity.

According to the ICD 10, all diseases are conditionally divided into grade 21 on preferential damage to organs. So, kidney pathologies and urinary tract Belongs class XIV.

Glomerulonephritis: Clinical and Morphological Features

Glomerulonephritis is not a separate disease, but a whole group of pathologies combined by a number of general traits reflecting the reaction of the kidneys on an infectious inflammatory defeat. The main pathogenetic moment in the development of GG is damage to the kidney glomers. It leads to the following violations:

• isolated Urinary Syndrome - Proteinuria, Hematuria various degrees severity;
• oligulia is a decrease in the volume of daily diuresis;
• reducing the speed of glomerular filtration.

As the disease progresses, an inflammation occurs and functional disorders Channel work. IN clinical picture This is manifested by violations of the transport of ions and a decrease in the concentration ability of the kidneys. The terminal stage of the disease is accompanied by renal failure And Uremia.

How class is classified by the ICD

All glomerular diseases in the ICD have alphanumeric codes starting with latin letters N:

• N00 - acute jade syndrome (including acute glomerulonephritis);
• N01 is a fast-moving jade syndrome (nephritis, glomerulonephritis and other forms of glomerular disease with the appropriate flow);
• N02 is a steady recurrent hematuria;
• N03 - chronic nephritical syndrome (including HGN);
• N04 - nephrotic syndrome (including lipoid nephrosis, congenital form of pathology);
• N05 - nephritical syndrome (glomerulonephritis) uncomfortable;
• N06 - proteinuria (isolated);
• N07 - hereditary forms of nephropathy (Alport's disease, amyloid nephropathy, family amyloidosis).

The most common forms of pathology include acute and chronic glomerulonephritis.

Acute glomerulonephritis is encoded as N00. At the heart of this pathology, there is an infectious-allergic process: the attack of the kidney glomers by immune complexes "antigen antibodies", formed by the bacterial (more often streptococcal) or viral infection.

Chronic glomerulonephritis has a code on MKB 10 N03. It is characterized by a progressive diffuse damage of the functional apparatus of the kidney with an outcome in their sclerosis and failure. It is formed as a consequence of acute in absent or ineffective treatment.

If necessary, the above code is complemented by the third order of numbers denoting the clinical and morphological features of the disease. Acute or chronic glomerulonephritis happens to:

• minor changes (.0);
• focal (segmental) changes - hyaline, sclerosis (.1);
• diffuse membrane changes (.2);
• diffuse mesangial proliferative changes (.3);
• diffuse endocapillary proliferative changes (.4);
• diffuse mesangiocapillary changes (.5).
• extracapillary changes (.7).

Additionally, they allocate a special form of diffuse mesangiocapillary glomerulonephritis - the disease of the dense sediment (.6). Clushing inflammation with other changes is encoded by a number. 8, unspecified - .9.

Urinary tract infection - This is an infection that occurs on any section of the urinary system - from perinephral fascia to the outer opening of the urethra. (Carolin P., Cacho M.D. 2001).

Infection urinary tract (IP) classified as follows (EAU, 2008):

1. Type of pathogen (bacterial, fungal, mycobacterial);

2. Localization in urinary tract:

a) diseases of the lower urinary tract (urethritis, cystitis)

b) diseases of the upper urinary tract (acute and chronic pyelonephritis)

3. The presence of complications, Localization of imp and combinations:

a) uncomplicated infection of the lower departments of urinary tract (cystitis)

b) uncomplicated pyelonephritis

c) complicated imp with pyelonephritis or without pyelonephritis

d) Uruppsis

e) urethritis

e) special forms (prostatitis, orchitis, epidididimitis)

It is necessary to take into account age (elderly patients), the presence of concomitant diseases (including diabetes et al.), Immunity condition (immunocompromentized patients)

Uncomplicated impAs a rule, successfully treatable adequately selected antibacterial therapy.

Complicated imp It is more difficult to antimicrobial therapy and, in some cases, require the intervention of the urologist, since they can lead to severe mine-septic complications.

Classification of ICD 10.

N 10 - acute tubula-interstitial nephritis (includes acute pyelonephritis)

N 11.0 - chronic tubula-interstitial nephritis (includes unstructive chronic pyelonephritis, reflux-associated)

N 11.1 - Chronic obstructive pyelonephritis

N 11.8 - other chronic tubula-interstitial jade (includes the unstructive pyelonephritis)

N 11.9 - Chronic tubul-interstitial nephritis uncomfortable (includes unspected pyelonephritis)

N 12 - tubula-interstitial nephritis not defined as acute or chronic (includes pyelonephritis)

N 15.9 - Tubul-interstitial kidney disease Uncomfortable (includes the kidney infection unspected)

N 20.9 - Urinary stones Uncomfortable (calculous pyelonephritis)

N 30.0 - acute cystitis

N 30.1 - interstitial cystitis (chronic)

N 30.8 - Other Cystitis

N 30.9 - unspecified cystitis

N 39.0 - Urinary tract infection without localization

Diagnosis wording

In the formulation of the diagnosis, an international classification of reviews 10 reviews, indicating in chronic forms of the nature of the flow (recurrent, latent), phases of the disease (remission, aggravation) and kidney functions (stage of chronic kidney disease).

Given the generally accepted international terminology, as well as the fact of a often occurring common ascending infection and the difficulties of a clear definition of the localization of inflammation, it is advisable to use the term "urinary tract infection (IP).

We give examples of the wording of diagnoses and the corresponding ICB-10 codes:

MainDs.: Imp, chronic pyelonephritis, recurrent, aggravation, HBP 1 tbsp. (N 11.8)

MainDs.: Imp, acute right-sided pyelonephritis. (N 10) Complication: Paranephrites on the right.

MainDs.: Imp, sharp cystitis. (N 30.0)

Epidemiology

Urinary infection remains one of the important causes of diseases in various age groups. Imp It is quite widespread, about 7 million outpatient appeals, more than 1 million hospitalizations on Imp are annually registered. Economic costs make up more than one billion dollars. 20-50% of women tolerate Impat least once in life. Risk Imp Women are more susceptible, but the risk increases with age Imp and its complicated flow and women, and in men (IDSA. 2001). In Russia, the most frequent urinary tract disease is acute cystitis (OC) - 26-36 million cases per year, and men have only 68 episodes at 10,000 aged 21-50 years. Acute pyelonephritis (OP) is also more common in women, and in all age groups. The frequency of the OP is significantly higher than the OC and is 0.9 - 1.3 million cases annually. In women, the risk of PM is 30 times higher than in men, including in connection with a pregnancy from 4-10%. In postmenopausis Imp develops in 20% of patients. The incidence of urkutsk diseases of urinary tract in 2007 amounted to 6022 per 100,000 adults,

and mortality - 8 per 100,000 permanent population

Currently identified the main at-risk groups, clinical formsThe diagnostic criteria of implies have developed effective ways to control infection in complicated and uncomplicated cases, including in risk groups.