Change of pressure in renal pelvis in acute and chronic course of pyelonephritis

: We studied urodynamics of the upper urinary tract in a different course of renal inflammation with consideration of the drainage method. Pressure in the renal pelvis was measured in 64 patients with acute obstructive and non-obstructive, and chronic pyelonephritis in different time of establishment of surgical or transcutaneous puncture nephrostomas and ureteral catheters. We assessed changes in intrapelvic pressure in respiratory (regular and forced respiration) and orthostatic (lying, sitting, standing positions) functional tests. The autonomic status of the body was evaluated by parameters of the spectral analysis of heart rate variability. We have found that intrapelvic pressure increases with progression of renal inflammation. Dynamics of the above indices in patients with acute non-obstructive and obstructive pyelonephritis versus patients with renal colic in the absence of evident inflammation allowed us to specify mechanisms of pressure formation in renal pelvis including inflammatory edema of the parenchyma and nervous-reflectory links of upper urinary tract regulation. Pressure in the renal pelvis may serve an important diagnostic criterion in choice of renal drainage method in pyelonephritis and criterion of inflammation course prognosis.