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 24,015 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Few urinary screening studies have been performed to determine the incidence of urinary abnormalities in antiretroviral therapy-naive, HIV-infected outpatients. From published data, the incidence appears to be high, particularly when compared with populations outside sub-Saharan Africa. In South Africa, urinary screening in antiretroviral therapy clinics is not routinely practiced. The aim of this descriptive study was to screen antiretroviral therapy-naive, HIV-infected outpatients attending the HIV clinic for urinary abnormalities, namely leukocyturia, microscopic hematuria, and microalbuminuria/proteinuria. This study showed that 84% of the screened population had AIDS (CD4 count < 200 cells/ mm3), and the incidence of abnormalities on urinary dipstick testing was high: 30% had leukocyturia, 33% had microscopic hematuria, and 44% had microalbuminuria/proteinuria. In patients with leukocyturia, an infective organism was cultured in only 29.1% of cases, predominantly Escherichia coli (70%) with sterile leukocyturia comprising the remainder. There may be an association with tuberculosis (TB) or sexually transmitted infections (STI) in the sterile leucocyturia group, but this remains to be confirmed. In those with a culture positive result the most common organism was E. coli (70%), which exhibited 90% resistance to cotrimoxazole, demonstrating that cotrimoxazole prophylaxis is not effective to prevent urinary tract infection in this group. On the basis of these findings, it has been proposed that urinary screening be considered standard of care in HIV clinics in South Africa. An algorithm has been proposed for use in antiretroviral therapy clinics in South Africa to guide clinicians regarding the cost-effective management of urinary dipstick abnormalities.
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PMID:Urinary screening abnormalities in antiretroviral-naive HIV-infected outpatients and implications for management--a single-center study in South Africa. 1948 82

Urinary tract infection (UTI) is a leading cause of serious bacterial infection in young children. Vesicoureteral reflux (VUR), a common pediatric urologic disorder, is believed to predispose to UTI, and both are associated with renal scarring. The complex interaction of bacterial virulence factors and host defense mechanisms influence renal damage. However, some renal parenchymal abnormalities associated with VUR are noninfectious in origin. Long-term, renal parenchymal injury may be associated with hypertension, pregnancy complications, proteinuria, and renal insufficiency. Optimal management of VUR and UTI is controversial because of the paucity of appropriate randomized controlled trials; there is a need for well-designed studies. The recently launched Randomized Intervention for children with VesicoUreteral Reflux (RIVUR) study hopefully will provide insight into the role of antimicrobial prophylaxis of UTI in children with VUR.
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PMID:Update on childhood urinary tract infection and vesicoureteral reflux. 1961 56

Dipstick urinalysis is a very useful diagnostic tool in primary care when used in a specific context (urinary complaints, follow-up of systemic diseases, or pregnancy), but not as a screening instrument. Urine collection in appropriate conditions, together with a correct interpretation of dipstick results, reduces the use of microscopic urinalysis and urine culture. Leucocyturia and positive nitrits indicate the presence of a urinary tract infection and do not generally require additional tests. Persistent haematuria or proteinuria need to be further explored (microscopic urinalysis and 24h urine collection). Presence of crystals in the microscopic urinalysis reflects the precipitation of the substance eliminated in the urinary tract, but does not systematically indicate a disease.
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PMID:[Urinalysis: what a primary care physician needs to know]. 1985 16

Autosomal dominant polycystic kidney disease (ADPKD) is not well described in black Africans while some data suggesting the disease is exceptional in this race. A retrospective study of patients with ADPKD followed in nephrology department of a teaching hospital in Dakar (January 1, 1995 to December 31, 2005) was therefore undertaken. Prevalence of ADPKD was one in 250. Mean age was 47 + or - 5 years with a predominance of male (57%). High blood pressure (HBP) was present in 68% of patients. Other renal manifestations were flank pain, hematuria and proteinuria. Majority of patients had impaired renal function at time of diagnosis. Extra-renal cysts were essentially found in liver (45.5%), pancreas and seminal vesicles. Main complications: ESRD (51%) occurred within a 6 year mean period, urinary tract infection (13%) and cerebral haemorrhage (2%). HBP control, in general needed 2 or more antihypertensive drugs. Fourteen patients died, ten patients had been on haemodialysis and four others died from uremic complications. In conclusion, ADPKD in black African adults is not rare and probably underdiagnosed. Early HBP and ESRD are likely more frequent than in other races. Earlier ultrasound detection and strategies to preserve renal function should be offered to at-risk individuals to improve outcomes.
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PMID:Patterns of autosomal dominant polycystic kidney diseases in black Africans. 2006 98

Pediatric nephrology is not a priority medicine in developing countries, but it should improve along with the development of both preventive and curative simple measures since the mortality rate is still important. This can be applied to the management of urinary tract infection, acute nephritis and some other cases of acute renal failure. The identification and management of chronic kidney diseases is mainly based on blood pressure measurement, proteinuria screening and plasma creatinine assessment. However renal replacement therapy (i.e., dialysis and transplantation) is highly expensive and its access is therefore limited to selected growing countries. The improvement in the care of renal children therefore requires better medical knowledge, nurse training and population information.
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PMID:[Pediatric nephrology in developing countries]. 2009 63

Urinary tract infections (UTI) cause a great number of morbidity and mortality. These infections are serious complications in pregnancy, patients with diabetes, polycystic kidneys disease, sickle cell anaemia, kidney transplant and in patients with functional or structural anomalies of the urinary tract. The aim of this investigation was to determine a dominant causative agents of UTI and some of the clinical and laboratory characteristics of acute community-acquired UTI in adult hospitalised patients. We studied 200 adult patients with acute community-acquired UTI hospitalised in the Clinic for Infectious Diseases Tuzla from January 2006 to December 2007. The patients were divided into two groups: a group of patients with E. coli UTI (147) and a group of patients with non-E. coli UTI (53). In these two groups, the symptoms and signs of illness, blood test and urine analysis results were analysed. Our results have shown that the patients with E. coli UTI frequently had fever higher than 38,5 degrees C (p<0,0001), chills (p=0,0349), headache (p=0,0499), cloudy urine (p<0,0001), proteinuria (p=0,0011) and positive nitrite-test (p=0,0002). The patients with non-E. coli UTI frequently had fever lower than 38,5 degrees C (p<0,0001) and urine specific gravity <1015 (p=0,0012). There was no significant difference in blood test results between patients with E. coli and non-E. coli UTI. These clinical and laboratory findings can lead us to early etiological diagnosis of these UTI before urine culture detection of causative agents, which takes several days. Early etiological diagnosis of the E. coli and non-E. coli UTI is necessary for an urgent administration of appropriate empirical antibiotic treatment. This is very important in prevention of irreversible kidney damage, prolonged treatment, complications, as well as recidives and chronicity of the illness.
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PMID:Clinical and laboratory characteristics of acute community-acquired urinary tract infections in adult hospitalised patients. 2019 31

This study determined the reliability of dipstick urinalysis for detection of protein, glucose, blood and nitrites in non-random urine samples from 300 people aged > 50 years attending a health centre for check-up. The gold standards were fasting blood glucose for glucosuria and the sulfosalicylic acid method for urine protein. Microscopic examination of urinary sediment and urine culture were also performed for positive dipstick results for haematuria and nitrites. The sensitivity, specificity and positive and negative predictive values of the dipstick test for detection of protein were 80.0%, 95.0%, 22.2% and 99.6% and for glucose were 100%, 98.5%, 87.0% and 100% respectively. Dipstick urinalysis can be a reliable screening method for diagnosis of urinary tract infection and diabetes mellitus but not for proteinuria.
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PMID:Accuracy of dipstick urinalysis as a screening method for detection of glucose, protein, nitrites and blood. 2021 48

Nephrourologic malformations in Turner syndrome are frequent, its diagnosis and follow-up is important in order to diminish the morbidity of this disease. The aim of this retrospective study was to analyze the nephrourologic pathology in 72 girls with Turner syndrome followed between 1989 and 2008 at Garrahan Hospital. The prevalence of nephrourologic involvement was 33% (24 patients). The most frequent findings were urinary system malformations, isolated (10 pacientes, 42%) or associated with renal malformations (9 patients, 37%); 5 patients (21%) had only renal malformations. Fifty percent of patients developed complications (8 urinary tract infection, 2 proteinuria and 2 arterial hypertension); however, none progressed to chronic renal failure. The prevalence of nephrourologic involvement was 33% and a half of these girls developed complications, our findings show the need of routine nephrological follow-up of girls with Turner syndrome and nephrourologic malformations.
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PMID:[Nephrourologic pathology in girls with Turner syndrome]. 2067 95

Cystic kidney disease is an important cause of chronic renal failure. Since the utilization of imaging techniques in the diagnosis of diseases has become widespread, cystic kidney disease is now being increasingly diagnosed. This study is designed to determine the prevalence and pattern of cystic kidney disease at the Nephrology Unit of University of Ilorin Teaching Hospital (UITH), Ilorin. All consecutive adult patients seen in the Nephrology Unit of UITH during a ten-year period (January 1999-December 2008) were studied for the presence of cystic kidney disease. The results were analyzed with specific reference to age, gender, annual incidence, type of cystic disease, location of cyst, mode of presentation, complications and prognosis. A total of 67 out of 436 renal patients (15.4%) studied had cystic kidney disease. A progressive annual increase in the number of cases was noticed. The age-range was 20-83 years with a mean of 47.4 +/- 16.2 years and the peak incidence was in the third and sixth decades with male to female ratio of 1.3:1. The types of cystic kidney disease identified in the study were: 26 simple cysts (38.8%), 35 polycystic kidney disease (53.3%) and six multicystic kidney disease (8.9%). The most common mode of presentation was abdominal pain followed by hypertension, urinary tract infection, chronic renal failure and palpable abdominal mass, in decreasing order. Our study indicates that cystic kidney disease is not an uncommon problem among our renal patients and the incidence is on the increase. Although, routine screening of family members with cystic kidney disease still remains a contentious issue because the knowledge may evoke anxiety in terms of employment and insurance, screening of symptomatic cases or those that develop hypertension, hematuria and proteinuria is strongly recommended.
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PMID:Prevalence and pattern of cystic kidney diseases in Ilorin, Nigeria. 2106 Feb 2

Kidney transplant recipients (KTR) have a good outcome of pregnancies. However the mother and the child are increasingly at higher risks of complications compared to the general population. The management of these pregnancies is associated with greater challenges and is better if managed by both the obstetrician and the transplant physician. Kidney transplant is available in few centres in Nigeria and the post transplant population is increasing, but to our knowledge no report on pregnancy management in KTR has been published. We present a 25 years old Nigerian who had a live related kidney transplant and later had 3 consecutive pregnancies and review the relevant literature. She was placed on oral contraceptive pills for 2 years after transplantation. She enjoyed a stable allograft function with no rejection episode, no proteinuria, had a good blood pressure control and pelvic ultrasound scan was essentially normal. She conceived her first pregnancy 26 months post transplant however she developed spontaneous abortion at 3 months gestation. She conceived her second pregnancy 33 months post transplant which was supervised by the obstetrician and the transplant physician. She had complications including urinary tract infection, anaemia and dyslipidaemia and delivered a live baby girl weighing 2.4 Kg by spontaneous vaginal delivery at 36 weeks gestation. She conceived her 3rd pregnancy 8 months later which was also carried to term and had a vaginal delivery of a live baby girl weighing 2.55 kg. This report highlights the successful management of pregnancies in KTR and the challenges faced in a poor resource setting.
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PMID:A report of three consecutive pregnancies in a kidney transplant recipient and the challenges in their management in a poor resource setting. 2111 11


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