Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 47-year-old woman with chronic pyelonephritis since 1950 was prepared for hemodialysis or kidney transplantation. Investigation disclosed secondary hyperparathyroidism and an osteolytic lesion in C VII and Th I causing a subluxation. There were minor neurological symptoms and apparent risk of luxation of the cervical spine with resulting injury to the spinal cord. Operation was performed with total parathyroidectomy and excision of the bone tumor, followed by fixation of the cervical spine with bone graft. There were no major complications during the postoperative period and the patient was mobilized four months after the operation.
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PMID:Secondary hyperparathyroidism combined with uremia and giant cell containing tumor of the cervical spine. A case report. 69 45

The parathyroid glands of 14 deceased diabetics were investigated as well as nine control non-diabetics. Various in character and degree histological alterations were observed during the morphological investigations of those glands: mild or better manifested hyperplastic alterations (six cases), microadenoma (one case), focal vasculary determined atrophia (two cases, total atrophia of involutive type (two cases), close to the control alterations (three cases). Hyperplastic alterations are established most frequently in the presence of diabetic nephropathia and azotemia. They could be explained with the development of a secondary hyperparathyroidism, associated with chronic renal insufficiency. In single cases, an effect of the disturbance of the calcium-phosphorus metabolism in diabetes is admitted. Changes in the parathyroid glands, from the type of generalized diabetic microangiopathy, is suspected in one of the deceased patients. Two microadenomas were found in another case, predominantly with dark basic cells. No dependence was established between the morphological alterations and the severity, diabetes form, nor with the presence of pyelonephritis. Certain dependence was established between the age of the deceased and the stage of the azotemia.
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PMID:[Morphological study of the parathyroid glands in diabetes mellitus and its renal complications]. 118 99

The term "renal osteodystrophy" is used to include skeletal disorders of patients with chronic renal failure: osteitis fibrosa, osteomalacia, osteosclerosis, osteoporosis and the frequently associated extraskeletal calcifications. It is the chronic glomerular disease with phosphate retention and resultant hyperphosphatemia on one hand and deficient 1,25 (OH)2 D3 and resultant hypocalcemia on the other to induce secondary hyperparathyroidism. The three most common causes of chronic renal failure in our patients are chronic glomerulonephritis, diabetic nephropathy, hypertensive nephropathy in decreasing frequency, polycystic renal disease occurs in five patients. Other miscellaneous causes include nephrotic syndrome, chronic pyelonephritis, systemic lupus erythematosus, periarteritis nodosa, interstitial nephritis and renal stones. The bone changes are similar in primary and secondary hyperparathyroidism and the incidence of brown tumor is about 3% in the former and 1.5 to 1.7% in the latter. We present one among the 94 dialyzed patients who has long-standing severe chronic renal failure from polycystic kidney disease and develops brown tumor in the mid ulna after 7 years on maintenance hemodialysis. The incidence of brown tumor in our series is about 1.1%. Because of increased longevity of the dialyzed patients, brown tumor from secondary hyperparathyroidism is now more commonly observed. Hyperphosphatemia with serum calcium-phosphate products exceeding plasma solubility of 60 to 75 mg/dl may induce soft tissue and vascular calcification. This explains the much higher incidence of soft tissue calcification in secondary than primary hyperparathyroidism; two of our patients with generalized Monckeberg's type arterial calcification and multiple periarticular calcifications in five patients have been observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal osteodystrophy. 164 77

Data from 500 male and 500 female Sprague-Dawley rats used as controls in studies performed at Huntingdon Research Centre to assess the safety of drugs were sampled at 17, 30, 56, 82, or 108 weeks of age. Plasma urea nitrogen levels remained constant, except in aged males. Aging caused increased proteinuria and decreased urinary concentrating ability, in addition to increased size, weight, and degree of cortical scarring of kidneys. Chronic progressive nephropathy, first seen histopathologically at 30 weeks of age, accounted for these changes and ultimately affected 81% of male and 44% of female rats. One-fifth of two-year-old male rats had diffuse parenchymal damage and a small number also had secondary hyperparathyroidism. Other notable changes included basophilic (often colloid-filled) cortical tubules, mononuclear cell infiltrations, parenchymal and pelvic mineralization, urothelial hyperplasia, and pyelonephritis. Miscellaneous low incidence findings included one lipomatous tumour and generalized lymphosarcoma.
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PMID:Age-related variations in renal structure and function in Sprague-Dawley rats. 376 13

Bone morphological parameters of renal osteodystrophy such as abundance of osteoid surface, osteoid seam width index, calcification fronts, osteoclast activity and trabecular bone volume were studied in 71 patients on maintenance hemodialysis and compared with bone densitometry, laboratory and clinical data. Increased osteoclast activity (hyperparathyroidism) was by far the most common bone morphological finding. Patients with chronic pyelonephritis or polycystic kidney disease had more than double the amount of osteoid than patients with chronic glomerulonephritis. The trabecular bone volume seemed to be increased in most patients in contrast to the cortical bone volume which was decreased, judged from bone densitometry and previously from X-ray. Despite that patients with polycystic kidney disease were older, their trabecular volume was larger than in patients with glomerulonephritis. The bone mineral content evaluated by bone densitometry was low in most patients, and more associated with bone morphological signs of osteomalacia than with secondary hyperparathyroidism. Serum phosphate (S-PO4) and serum parathyroid hormone (S-PTH) seemed to discriminate better between osteomalacia and secondary hyperparathyroidism than serum alkaline phosphatase (S-Alk. phosph.), which was elevated in both groups. Patients who had been bilaterally nephrectomized were no more abnormal than other patients, and they had lower S-Alk. phosph. The abundance of osteoclasts was found to be a predictor of future development of clinical secondary hyperparathyroidism.
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PMID:Studies of bone morphology, bone densitometry and laboratory data in patients on maintenance hemodialysis treatment. 397 74

12 adult patients with medullary sponge kidney (MSK), followed up for 1 to 14 years (mean 7 years) are presented. MSK was initially diagnosed in 4 cases. In 8 cases the initial diagnosis included pyelonephritis, nephrocalcinosis, and nephrolithiasis. Renal calculi (4 patients), urinary tract infection (8) and hematuria (5) were the most frequent symptoms. Renal tubular acidosis was documented in 2 patients and hypercalciuria without hyperparathyroidism in 2. Over the years renal calculi increased in size in 4 patients. Renal function was stable in 11. In one patient with associated, well controlled hypertension, serum creatinin rose from 141 to 298 mumol/l over 14 years.
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PMID:[Medullary sponge kidney. Diagnosis and course in 12 cases]. 397 81

Severe secondary hyperparathyroidism is still observed at present in 5-10% of haemodialysis patients. It requires surgical correction. Fifty-eight haemodialysis patients had neck surgery and their 222 parathyroid glands analysed. The individual gland weight was comprised between 22 and 3880 mg (mean +/- SEM, 689 +/- 62 mg). Mean total parathyroid gland weight per patient was comprised between 2 and 3 g. Schematically, 4 types of gland architecture could be distinguished: diffuse hyperplasia alone; diffuse hyperplasia associated with incipient nodule formation; hyperplasia with pronounced nodule formation; and nodule formations alone. Total gland weight was significantly higher for the latter two histological forms than for the former suggesting transformation with time of pure hyperplasia to nodular hyperplasia. Patients with chronic pyelonephritis had a mean gland weight higher than that of patients with chronic glomerulonephritis (3308 +/- 498 mg versus 1824 +/- 358 mg, p less than 0.01). No relation was found between total gland weight and plasma calcium, phosphate or alkaline phosphatases. However, a weak relation existed between total gland weight and plasma immunoreactive parathyroid hormone. In addition, a negative relation was observed between highest prior plasma aluminium and gland weight when considering only patients with a gland weight less than 2000 mg. Parathyroid gland aluminium content was significantly higher in haemodialysis patients than in nonuraemic patients with primary hyperparathyroidism. A direct relation was found between parathyroid gland and bone aluminium. In conclusion, in haemodialysis patients with evolving hyperparathyroidism initially diffuse gland hyperplasia appears to be associated progressively with nodule formation. Circulating immunoreactive parathyroid hormone is positively related to total gland weight.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Hyperparathyroidism secondary to renal insufficiency: anatomo-clinical relations and the potential role of an aluminum overload]. 648 74

The authors report 17 personal cases of lithiasis of the upper urinary tract discovered in the course of pregnancy. They discuss the diagnostic and therapeutic problems, taking into account the double risk of mother and foetus. The essential diagnostic sign is renal colic, with or without fever. Spontaneous excretion of these calculi is possible, but in 8 of the 17 cases, a ureteric catheter had to be passed or an operation was required. Neither the delivery nor the health of the infants delivered seemed to be harmed by this renal calculi disease. The authors recall that the most common cause of non-obstetrical abdominal pain in the course of pregnancy is in fact urinary calculi. The incidence is about 1 cases of lithiasis per 1,000 pregnancies. It appear that a physiological hyperparathyroidism of pregnancy is responsible for a hypercalciuria which could be a factor favouring the development of lithiasis during pregnancy. The important point is to know how to distinguish those forms of pyelonephritis of pregnancy which are due to a stone obstructing the upper urinary tract, as any purulent retention in the upper tract can lead to a pyonephrosis, a bacteraemia or even a septicaemia. The presence of the foetus makes interpretation of a plain abdominal film difficult. In any case, its indication is questionable, whenever the urine is septic, particularly with Proteus.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Lithiasis of the upper urinary tract and pregnancy]. 663 Oct 37

Fifty-eight patients on intermittent haemodialysis underwent parathyroidectomy because of severe secondary hyperparathyroidism. Mean individual parathyroid gland weight was 689 +/- 62 (SEM) mg. Mean total gland weight per patient was between two and three grams. Increasing nodule formation within hyperplastic glands appeared to develop with increasing time of duration of hyperparathyroidism. Patients with chronic pyelonephritis had a higher gland weight than those with chronic glomerulonephritis. A direct relationship was found between gland weight and circulating immunoreactive parathyroid hormone, but an inverse relationship between gland weight and plasma aluminium concentration. The higher the parathyroid gland aluminium, the higher was the bone aluminium concentration.
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PMID:Secondary hyperparathyroidism in chronic haemodialysis patients: a clinico-pathological study. 665 93

Between 1996 and 1997, 86 patients were treated for terminal renal failure by hemodialysis at Maribor Teaching Hospital. Among them were 12 with iPTH over 900 pg/ml and symptoms of bone disease. In these patients bone biopsy was carried out with the aim of determining the type of renal osteodystrophy (RO) and establishing a possible correlation with the clinical picture, with densitometry and laboratory results. Histomorphologically, 6 patients fulfilled the criteria for secondary hyperparathyroidism (HT) - 3 with analgetic nephropathy (AN), one with chronic pyelonephritis (CPN), one with vascular nephropathy (VN), one with chronic glomerulonephritis (CGN). Six patients fulfilled the criteria for mixed osteodystrophy (MO) - 3 AN, 2 CGN, one VN. According to laboratory findings and bone mineral density (BMD), a statistically significant difference between HT and MO was present only in AP (Table 1). The most frequent diagnosis in patients with iPTH >900 pg/ml was analgetic nephropathy.
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PMID:Patients with analgetic nephropathy on chronic hemodialysis have a high incidence of severe secondary hyperparathyroidism. 987 7


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