Acute pyelonephritis in diabetes mellitus
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LINGA, Iacov. Acute pyelonephritis in diabetes mellitus. In: MedEspera: International Medical Congress for Students and Young Doctors, Ed. 7th edition, 3-5 mai 2018, Chişinău. Chisinau, Republic of Moldova: 2018, 7, pp. 118-119.
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MedEspera
7, 2018
Congresul "International Medical Congress for Students and Young Doctors"
7th edition, Chişinău, Moldova, 3-5 mai 2018

Acute pyelonephritis in diabetes mellitus


Pag. 118-119

Linga Iacov
 
”Nicolae Testemițanu” State University of Medicine and Pharmacy
 
Disponibil în IBN: 18 noiembrie 2020


Rezumat

Introduction. Diabetes mellitus(DM) is the most common chronic disease after cardiovascular and oncological diseases. The number of patients with DM increases annualy. Because of homeostasis changes, diabetic patients have predisposition to infectious diseases, especial ly for urinary tract infections. Infections of urinary tract affect this group of patients 4 times more often than general population. There are some predisposing factors for apparition of urinary infections, such as high level of glucose in urine, which c reates optimal conditions for colonization and reproduction of microorganisms, diabetic neuropathy, which affects the innervation of urinary tract and leads to vesicoureteral reflux and decreased activity of immune system. Aim of the study. Determination of DM’s importance and its evolution's duration in the pathogenesis of acute pyelonephritis. Research and visualization of clinical manifestations, evolution, diagnosis and treatment of acute pyelonephritis in patients with DM. Materials and methods. For my research I’ve examined patients with acute pyelonephritis from the sections of Urology, Nephrology and Endocrinology from the Sf. Treimea Hospital. The research was based on the prospective and retrospective analysis of the investigation and treatment r esults of 60 cases of acute pyelonephritis, of which 43 patients with pyelonephritis developed after preexistent diabetes and 17 patients with acute pyelonephritis, but no diabetes. The examined patients were hospitalized in treatment facilities between 20 15 and 2017. Results. 86.04% (37 patients) of patients with acute pyelonephritis and DM were in advanced age, 51 60 years and over 60 years. The possibility of developing acute pyelonephritis in this category of patients was closely correlated with the du ration and evolutionary form of DM. Patients with DM had poorly expressed clinical forms of acute pyelonephritis, 21 patients (48,8%) presented no fever, 10 (23.2%) had subfebrility, 37 ( with moderate intensity pain in lumbar area. Blood analysis showed signs of immunosuppression with normal values of leukocytes at 25 patients (58.13%). The results of the paraclinical investigations revealed the presence of neuropathy in 26 patients (60.4%) with acute pyelonephritis and DM. Results of nephrography and scintigraphy revealed the presence of nephropathy in 26 patients (60.4%) and proteinuria at 19(44.18%). At 30 patients (69.76%) infection has developed bilaterally. Conclusions. The possibility of apparition of acute pyelonephritis increases with du ration of DMs evolution. Patients with 5 years and more duration of DM had greater predisposition for pyelonephritis due to chronic changes in organism. Patients with DM had poorly expressed clinical manifestations of acute urinary tract infections. Patien ts with diabetes develop more often bilateral infectious process.

Cuvinte-cheie
diabetes mellitus, acute pyelonephritis