Code for the ICD 10. Chronic pyelonephritis: causes, symptoms, diagnosis and treatment

In 2007, the International Classification of Diseases was adopted. It included such a disease as chronic pyelonephritis. This was the tenth revision of the list, and therefore it became known as ICD-10. Let us consider in more detail what pyelonephritis is. The codes for ICD-10 of this disease will also be described in the article.

Causes of the disease

One of the most dangerous kidney diseases is chronic pyelonephritis (ICD-10 code No. 11.0) - a pathology of complex inflammatory course. The disease is characterized by a painful symptomatology, occurs when an infectious pathogen enters the urinary tract, which, through the urinary canal, rises to the kidney and penetrates the tissues of the organ.

At the initial penetration of the infection, the immune resistance of the organism is significantly reduced, its secondary manifestation is caused by the formation of microbial colonies developing rapidly, but practically asymptomatically. Call such chronic pyelonephritis obstructive (code in ICD-10 No. 11.1).

The disease in question can not be called exclusively female, but, according to statistics, out of seven patients only one man. The conditioning of such microbial selectivity lies in the complexity with which a pathogenic bacterium has to face, climbing the narrow and long urinary canal of a man. As a rule, even halfway to the treasured kidney the microbe is killed or taken out with the used liquid. The female urinary canal is much wider and shorter, penetration to the organ through it does not constitute special difficulties for the bacterium.

The provoking factors

Low immunity itself is incapable of resisting infection, but if the body is weakened by a concomitant disease or is in a state of special susceptibility, then chronic pyelonephritis (ICD-10 code No. 11) will not keep you waiting.

One of the factors that increase the susceptibility of the organism to microbial contamination may be:

• diabetes;
• Prolonged hypothermia;
• Hereditary factor;
• Frequent infectious diseases;
• pregnancy.

Non-obstructive chronic pyelonephritis (ICD-10 code No. 11.0) often occurs against the background of hidden inflammatory processes, reflux and often becomes a complication of some underlying disease.

Clinical picture

Tubulo-interstitial, not specified as acute or chronic, pyelonephritis (code according to ICD-10 No. 12) appears already at the stage of the microbial colony in the kidneys, when the kidney tubules become clogged up in the microorganisms and the filtering organ ceases to function normally. This causes painful symptoms, which are often perceived for the manifestations of osteochondrosis, lumbar lumbago or a common cold.

With some diseases, many of the symptoms that are characteristic of chronic pyelonephritis appear. Under the ICD-10 code 84.0, for example, such a pathology as the endometrial polyp is ciphered. The clinical picture of this disease is very similar to the manifestations of the considered kidney disease. So, with these pathologies, there are:

• Pulling back pain ;
• General puffiness, especially noticeable in the morning in the nose and under the eyes;
• Chills and fever to 39 degrees;
• Increased blood pressure;
• Foul-smelling urine due to the high content of pus in it;
• Deterioration of sleep and appetite;
• Headaches, muscle pains.

In acute pyelonephritis, therapy is mainly aimed at relieving pain. Promptly taken medications usually help quickly. After getting rid of painful symptoms, patients often drop out on half the course, stop observing the diet. In the absence of treatment, the acute illness (code No. 10) passes into the chronic form of pyelonephritis (ICD-10 code No. 11).

Forms of pyelonephritis

Pyelonephritis of chronic course can take one of the following forms in the form and severity of the clinical manifestation:

• Anemic form - in which anemia is the first place due to intoxication, which adversely affects the production of erythropoietin;
• Hypertensive - characterized by an unstable increase in blood pressure;
• Nephrotic - expressed by serious malfunctions of protein and lipid metabolism in the body;
• Septic - activated at times of severe exacerbations of the disease, with characteristic temperature fluctuations and signs of toxic poisoning;
• Latent - flowing in a latent form, often asymptomatic. This form of the disease exhausts the body and remains undiagnosed for a long time;
• Relapsing - this form has an ever-changing character - from sudden sudden exacerbations to long remission pauses.

Stages of pyelonephritis

The consequence of inferior treatment or lack thereof is usually a gradual overflow of acute pyelonephritis into chronic pyelonephritis (ICD-10 codes No. 11.1 or No. 11.0). It should be understood that the disease, even at the first stage of any of the forms, the phenomenon is irreversible. It is possible to stop its development and prolong remission with competent treatment, but it will not be possible to completely cure the kidneys.

In the decoding of chronic pyelonephritis code for ICD-10, unfortunately, there is no description of the stages of the disease. Therefore, we should dwell on their consideration in more detail.

• I stage - gradual loss of functionality of collecting tubules;
• II stage - aggravated tubular atrophy and proliferation of connective tissue;
• III stage - the death of a large number of renal glomeruli and deformation of the renal tissue resembling the structure of the thyroid tissue;
• IV stage - replacement of the cortical substance of the kidney with connective tissue.

Diagnostics

In the decoding of the pyelonephritis code for ICD-10, etiology and symptomatology are not described. In this regard, in practice, problems often arise in the differentiation of pathologies. To exclude errors in the complex of diagnostic procedures, laboratory tests of urinary sediment are routinely performed using methods such as:

• Kakowski - Addis;
• Sthenheimer - Malbin.

In addition, bacteriuria and a biopsy of kidney tissue are performed to recognize the microbial environment. The general clinical analysis of blood is also taken first, and already on the basis of these primary results, a further diagnostic strategy is built.

If an infectious agent that causes chronic pyelonephritis is identified, an additional code (B95-B97) is added to the ICD-10 code corresponding to the form of the disease.

In the course of diagnosis, the following are also performed:

• X-ray examination for establishing visible changes in the kidneys and determining the tone of the upper urinary tract;
• Rhenografy;
• Scenography;
• Pyelography;
• Histological examination of renal tissue.

The latter method of diagnosis is rarely used, because previous methods of establishing a diagnosis usually allow us to determine the nature of the course of the disease and draw the right conclusion.

Drug treatment of pyelonephritis

During the entire therapy, the patient's condition is controlled by monthly delivery of tests designed not only to assess the patient's medical condition, but also to confirm the effectiveness of the treatment and the good susceptibility of the organism to the prescribed medications. The duration of treatment is rarely less than four months, but relief usually comes much earlier. It is important to bring the course to the end, so as not to allow the disease to rise a step higher.

The treatment is based on broad-spectrum antibiotics that suppress Gram-negative flora, but do not have a toxic effect on the kidneys. To such means carry antibacterial means of fluoroquinolone series: "Cefuroxime", "Ciprofloxacin", "Cefenim", "Norfloxacin".

Treatment with folk methods

Treatment with home remedies of any pyelonephritis is unacceptable and dangerous. However, many folk remedies can be used in conjunction with medical therapy appointed by a doctor. Especially good they help with acute forms of the disease, accompanied by a strong inflammatory process and pain.

• To remove acute symptoms 1 tbsp. A spoonful of cranberry leaves is poured into 250 ml of boiling water and about 10 minutes are pressed on a small fire under the lid. Then the broth should be cooled, drain and take 3 tbsp. Spoon 3 r / day on an empty stomach.
• With severe pain in the loin with pyelonephritis: make a 10% concentrate from the usual edible salt and water, moisten the cotton cloth in it and fasten it on the loin for the whole night. You need to do this every day for 2 weeks.
• The grass of oats is boiled in a ratio of 1:10, then doused under the lid for half an hour, and after cooling, filter and drink 150 ml 2 r / day. You can make a more concentrated solution and add it to the bath when bathing - the effect will be higher when the joint internal and external application of the decoction is combined.

Prevention

For the prevention of pyelonephritis, there are several recommendations that are easy to observe, since they do not contradict the general rules of maintaining the body in a healthy tone:

• It is necessary to try to eliminate from life factors such as alcohol, strong coffee and smoking, and passive smoking is no less dangerous than active.
• It is important to conduct an examination of the entire body for a hidden source of infection. It is not uncommon for bacteria that enter the bloodstream, and then into the kidneys, to start their way from a carious tooth or those inflamed by the sinusitis of the nasopharyngeal sinuses.
• If pyelonephritis is already present in the anamnesis, urine and blood tests should be taken at least twice a year.
• Try to undergo annual sanatorium treatment with mineral waters or mud.

Even expensive treatment will not yield any results against the background of a heavy, malnourished diet with uneven distribution of fats, proteins and carbohydrates. With pyelonephritis, the emphasis is on food of vegetable origin, mostly raw. Of animal proteins allowed white chicken and shallow fish.