Chronic pyelonephritis, chronic pyelonephritis is an important clinical type in the renal system.
Chronic pyelonephritis pathogenesis
Chronic pyelonephritis
If urinary tract obstruction, deformity and immune function and other susceptible factors persist, antimicrobial therapy failed to completely control the formation of acute pyelonephritis of the renal pelvis inflammation or small abscess can leave a small scar, causing renal obstruction , Resulting in recurrent disease and chronic delaying.
Some people think that the incidence of chronic pyelonephritis may have an autoimmune involvement.Many patients in the acute pyelonephritis urine culture found pathogens, and in later chronic processes, urine culture but no pathogens, and the disease is still gradually Into chronic pyelonephritis .Predict kidney infection, the body produced anti-Escherichia coli antibodies, and renal tissue with these bacteria have common antigen .After the disappearance of pathogens, this antibody continues to react with renal tissue antigen, Thus causing renal damage.It has been found that a tubular antigen (Tamm-Horsfall protein, called THP), and Escherichia coli have antigenicity, anti-Escherichia coli antibodies can simultaneously anti-tubular epithelial cells THP , Which may be related to the occurrence of chronic inflammation of the renal interstitium.
Chronic pyelonephritis pathogenesis
Modern research found that any chronic kidney disease, renal cell stroma in the infiltration of inflammatory cells, may be caused by cytokine release caused by renal tissue damage, chronic pyelonephritis may also be related to the occurrence and development.
The presence of L-type bacteria makes the treatment of pyelonephritis more difficult. These bacteria, first discovered by Lister, are named L-form bacteria and are formed by the action of antimicrobial agents or by the action of antibodies, complement, lysozyme Membrane rupture, only the original pulp, hidden in the hypertonic area of the medulla continue to survive, the general antibacterial drugs can not be completely destroyed until its living environment improved, L-type bacteria and restore the prototype, continue to grow and reproduce, So that pyelonephritis relapse, resulting in persistent refractory disease.According to the survey of urine culture-negative chronic pyelonephritis, about 20% can find L-type bacteria.
