Hirose T
Department of Urology, Sapporo Medical University School of Medicine.
Nihon Rinsho. 1995 Aug;53(8):1963-8.
Chronic renal infection (Chronic bacterial pyelonephritis) is a cause of tubulo-interstitial nephropathy (nephritis); TIN. The disorder causes end-stage renal failure in about 2% of the patients who are treated by dialysis. However, Chronic bacterial pyelonephritis is a relatively benign condition that seldom leads to renal function loss. The affected kidney shows non-specific histological pictures similar to that seen with other diseases producing TIN. Clinical symptoms are of ten vague. Obstructive uropathy (eg, stones, benign prostatic hyperplasia) is frequently present. The affected kidney, which is almost unilateral, shows atrophy and scarring of variable degree. Significant pyuria and bacteriuria may or may not be found. Depending on the stage of the disease, the serum creatinine and blood urea nitrogen may be normal or elevated. Contributing obstructive uropathy should be corrected. The patients must be followed closely, urinary tract infection must be controlled and complications (eg, hypertension, azotemia) must be identified promptly and treated adequately.
慢性肾感染(慢性细菌性肾盂肾炎)是肾小管间质性肾病(肾炎)即TIN的一个病因。该病症在接受透析治疗的患者中约2%会导致终末期肾衰竭。然而,慢性细菌性肾盂肾炎是一种相对良性的病症,很少导致肾功能丧失。受累肾脏呈现出与其他导致TIN的疾病相似的非特异性组织学表现。临床症状往往不明确。常伴有梗阻性尿路病(如结石、良性前列腺增生)。受累肾脏几乎为单侧性,呈现出不同程度的萎缩和瘢痕形成。可能会发现显著的脓尿和菌尿,也可能未发现。根据疾病阶段,血清肌酐和血尿素氮可能正常或升高。应纠正导致梗阻的尿路病。必须密切随访患者,控制尿路感染,及时发现并充分治疗并发症(如高血压、氮质血症)。