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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It is apparent that the split function study and renal vein renin determination are complementary and afford valuable information for selecting patients with potentially curable renovascular hypertension. The split function study, when interpreted with the recently defined split function ratio, offers the clinician a highly accurate means of diagnosing significant renal ischemia. Because the split function ratio shows the disparity between the ischemic and contralateral kidney to a greater degree, the chance of misdiagnosis due to laboratory or physician error is minimized. The split function study, however, is of limited value in patients with pyelonephritis since the water- and salt-losing characteristics of the pyelonephritic kidney may mask significant renal ischemia. In these patients, as well as those with a nonfunctioning kidney or hydronephrosis, the renal vein renin determination is the test of choice. In addition, the added morbidity of the split function study is not warranted in a patient with an elevated peripheral renin which, for interpretation, requires an accurate 24 hour urine for sodium, a renal vein renin ratio outside the range of patients with essential hypertension (renal vein renin ratio greater than 1.7) and evidence of suppression of renin secretion from the contralateral kidney. If, however, the renin determination does not afford convincing evidence of significant renal ischemia in a patient with radiographic evidence of renal arterial stenosis, a split function ratio definitely should be determined to more completely define the pathology. The attendant morbidity of a carefully performed split renal function study does not approach the morbidity and mortality associated with unnecessary surgery or inadequately treated hypertension.
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PMID:Ureteral catheterization studies. 115 55

1. Thirty-two per cent of cases examined by I.V.P. showed evidence of disease (20 per cent hydronephrosis, 12 per cent chronic pyelonephritis). 2. The incidence of V.U. reflux on micturating cysto-urethrography was 13 per cent. V.U. reflux is associated with chronic pyelonephritis in a high proportion of cases as would be expected. A normal pyelogram does not exclude V.U. reflux as mentioned by Cobb (1966). 3. Patients with complete paralysis show a significantly high incidence of chronic pyelonephritis, hydronephritis and V.U. reflux. 4. In case of unilateral hydronephrosis and chronic pyelonephritis there is a striking predilection for involvement of the right kidney. The cause for this is not evident but possibly the fact that the right ureter is shorter than the left is a factor.
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PMID:Changes in the upper urinary tract as demonstrated on intravenous pyelography and micturating cysto-urethrography in patients with spinal cord injury. 120 14

The diagnosis of hydronephrosis is made by excretory urography with late films and retrograde pyelography. Renal arteriography in hydronephrosis permits exact evaluation of vascular supply and parenchymal thickness. In three cases selective arteriography was performed because of a non-functioning kidney or suspected space-occupying lesion. The combination of arteriogram and urogram--if necessary together with percutaneous puncture--allows to differentiate between hydronephrosis, avascular tumors, renal cysts, polycystic renal disease, renal abscess, subcapsular renal hematoma, fibrolipomatosis, xanthogranulomatous pyelonephritis, and tuberculosis.
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PMID:[Angiographic differential diagnosis of hydronephrosis (author's transl)]. 120 46

In a review of 156 total or partial nephrectomy specimens from patients over the age of 12 years, renal dysplasia was found 14 times. The cases were divided initially into five groups on the basis of the predominant pathological changes, namely (1) dysplasia (14 cases), (2) chronic pyelonephritis (31 cases), (3) calculous inflammation (58 cases), (4) hydronephrosis (35 cases), and (5) miscellaneous (18 cases). The diagnosis of dysplasia was made on gross and microscopic criteria and included 12 of segmental dysplasia, one of total dysplasia, and one multicystic dysplastic kidney. The principal differential diagnosis is from the irregularly scarred chronic pyelonephritic kidney. The criteria for the separation of the two are emphasized and, in particular, the distinction from those pyelonephritic kidneys with aglomerular scars. A high incidence of anomalies of drainage was found in association with dysplasia, but such were not always present. It was not thought that intrarenal reflux in infancy was an aetiological factor. Six of the cases presented with urinary infection, but only two had hypertension. It was thought that acquired glomerular damage was more important in the aetiology of hypertension than segmental glomerular agenesis.
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PMID:Renal dysplasia in nephrectomy specimens from adolescents and adults. 123 28

1. The evaluation of renal masses has become an increasingly important topic because of the increasing incidence of kidney cancer, the improved cure rate of renal carcinoma with the proper preoperative diagnosis, and the proliferation in renal mass diagnostic methodology. 2. A variety of benign entities can produce an abnormal renal mass with attendant difficulties in being distinguished from malignant neoplasms. Among these benign lesions are: simple renal cysts, polycystic kidneys, congenital variations in renal size and shape, segmental renal hypertrophy, renal infarcts, intrarenal hematomas, renal hamartomas, renal leiomyomas, renal adenomas, renal angiomas, renal fibrolipomatosis, hydronephrosis of a duplicated collecting system, renal abscesses, and xanthogranulomatous pyelonephritis. 3. Nephrotomography, nephrosonography (ultrasound), adrenalin renal arteriography, selective magnification renal arteriography, renal venography and cavography, lymphangiography, renal scintillation scanning, abnormal levels of enzymes in blood and urine, immunologic studies (circulating antibodies and tumor-associated antigens), percutaneous needle aspirations, and retrograde renal brushing have all increased the diagnostic accuracy of determining the etiology of renal masses. None of these diagnostic procedures is infallible. A judicious combination of procedures gives the most reliable diagnostic results. 4. A search continues for (a) chemical agent(s) or a chemical profile in the blood or urine which is (are) specific for renal carcinoma, but as yet this is an investigational area and not a practical clinical reality.
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PMID:Evaluation of renal masses including retrograde renal brushing. 125 Dec 98

The rapid-sequence intravenous urogram (IVU) has tended to fall from favour for investigating hypertension because of its perceived imprecision for detecting renovascular disease. However, no study has examined the value of the IVU as a screening test in appropriately selected patients. We have analysed the diagnostic yield of the rapid-sequence IVU in hypertensive patients selected for features suggesting renal or renovascular disease in a retrospective review of case records from a hypertension clinic. The IVU was abnormal in 27% (95% CI 21-32%) of 241 consecutive patients. The most common abnormalities were chronic pyelonephritis (6%); proven renovascular disease (5%); stone (4%); possible renovascular disease and simple cyst (each 3%); hydronephrosis (2%); and tumour and active tuberculosis (each 1%). The IVU led to intervention aiming to correct hypertension in 5% (95% CI 2-8%) of patients, and revealed an abnormality needing intervention in its own right in 4% (95% CI 2-6%). The IVU led to unnecessary invasive investigation in 3% of cases. Individual abnormalities could not be predicted from the clinical or laboratory features. The initial investigation in hypertensive patients with suspected renal or renovascular disease should be a general purpose test able to detect a wide range of abnormalities. The rapid-sequence IVU is the only single test capable of satisfying this requirement. In patients with features suggesting renovascular disease, a normal rapid-sequence IVU excludes renovascular disease with 93% probability, but is an imperfect screening test since it fails to diagnose about 20% of cases. Renal arteriography should be done despite a normal IVU when it is essential to exclude renovascular disease.
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PMID:Investigation of selected patients with hypertension by the rapid-sequence intravenous urogram. 135 Dec 13

In studies primarily designed to evaluate the effectiveness of chitosan as a treatment for cyclophosphamide-induced hemorrhagic cystitis in the rat, renal papillary necrosis and pyelonephritis were observed. Cyclophosphamide alone produced relatively mild renal changes. The combination of cyclophosphamide and intravesical instillation of acetic acid induced renal papillary necrosis (38 to 83% incidence) along with pyelonephritis, hydroureter and hydronephrosis. Chitosan, instilled in place of acetic acid, partially inhibited the induction of renal papillary necrosis. It appears that the presence of vesico-ureteral reflux with or without associated hydroureter and hydronephrosis is a prerequisite for cyclophosphamide-induced renal damage.
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PMID:The effect of cyclophosphamide administration on the kidney of the rat. 148 76

Ureteral diversions may be complicated by strictures, hydronephrosis, pyelonephritis, lithiasis, fistulas, etc. In the last 10 years, 103 patients with 133 urological postoperative complications underwent percutaneous treatment. Most of the patients had been treated by percutaneous antegrade drainage; afterwards, stricture dilatation, ureteral stenting and stone extraction were performed. In one case a Strecker metallic stent was employed. We have successfully treated 101 of 133 complications (75.9%), with only 27 failures (20.3%). Five cases (3.8%) of lithiasis did not require percutaneous treatment. The good results obtained, the absence of major complications, the low cost and the little discomfort for the patients confirm the leading role of percutaneous treatment in complicated ureteral diversions.
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PMID:[Interventional radiology in the treatment of the complications from interventions on the lower urinary excretory tract]. 150 24

A case of retrocaval ureter with recurrent pyelonephritis is presented with discussion of these clinical entities. An excretory urogram and retrograde ureterogram disclosed pronounced hydronephrosis as well as a dilated proximal part and reversed J-shaped appearance of the right ureter. The compressed retrocaval portion of the ureter was resected and an end-to-end anastomosis was performed anterior to the vena cava. Due to the progressive kidney damage leading to severe hydronephrosis, a rapid radiological diagnosis should be made to replace the retropositioned ureter.
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PMID:Retrocaval ureter with recurrent pyelonephritis. 152 33

An abnormality of blood vessels was noted in a biopsy of a renal transplant. This took the form of apparent development of a new artery inside and concentric with the old, with elastic laminae and a muscular media, separated from the old internal elastic lamina by poorly cellular tissue. In a systematic study of material from another 119 renal transplants, 13 nephrectomy specimens for chronic pyelonephritis and hydronephrosis, 28 renal biopsies showing interstitial nephritis, and 18 renal biopsies showing small vessel vasculopathy of accelerated hypertensive type, similar arterial changes were seen in another 10 renal transplants that showed chronic vascular rejection, 1 case of chronic interstitial nephritis, and 3 cases of vasculopathy, 2 with accelerated hypertension and 1 with systemic sclerosis. One renal transplant also showed apparent development of new muscular veins inside old veins. Immunohistological study for smooth muscle actin confirmed that the apparently new arterial and venous structures contained smooth muscle cells. The arterial abnormality may be called arterialisation of intrarenal arteries. This change appears to be not rare, is distinctive, and has scarcely been previously recognised or reported as a response of intrarenal blood vessels to damage.
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PMID:Arteries and veins formed within renal vessels: a previously neglected observation. 156 60


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