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 six year-old girl presented with acute oliguric renal failure, secondary to acute, non-obstructive pyelonephritis. Evidence for pyelonephritis as the cause of renal failure included: the evolution of typical changes on serial intravenous pyelograms, an acute interstitial inflammatory exudate on percutaneous renal biopsy, and gram-positive cocci on gram stain of the biopsy tissue. Although a specific causative organism was not conclusively identified, enterococcus was isolated from the initial catheterized urine specimen. The patient recovered from the acute illness but was left with impaired renal function, hypertension, and cortical scarring. Acute, non-obstructive pyelonephritis can produce acute renal failure in children and must be considered in the differential diagnosis of this syndrome.
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PMID:Acute renal failure secondary to acute pyelonephritis. 91 54

Eight cases are reported of female children presenting with hypertension and found to have primary vesicoureteral reflux with chronic pyelonephritis. In 6 patients renal function was essentially normal while 2 had azotemia and progessive renal deterioration. As a result of early surgical intervention in the form of antireflux procedures, occasionally combined with unilateral nephrectomy for renin-dependent lesions, 5 of the 8 had complete disappearance or amelioration of hypertension with stabilization of renal function. The interactions of each member of the triad--vesicoureteral reflux, pyelonephritis, and hypertension--are reviewed with emphasis on pertinent pathophysiologic concepts regarding their roles in the production of progressive renal deterioration.
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PMID:Hypertension as complication of vesicoureteral reflux in children. 93 78

Twenty-six patients with radiological unilateral chronic pyelonephritis, 36 patients with bilateral chronic pyelonephritis, 14 patients with papillary necrosis and nine patients with obstructive atrophy have been followed from five to 135 months for a total of 374 patient years. Serial changes in renal function and pyelographic appearances have been correlated with bacteriuria, analgesic ingestion, blood pressure and reflux. The calculated survival rate at five years was 95 per cent for patients with bilateral pyelonephritis and 92 per cent for patients with papillary necrosis. The ten-year survival rate was 86 per cent and 56 per cent respectively. The survival rate for patients with unilateral pyelonephritis and obstructive atrophy was 100 per cent at five and ten years. Bacteriuria was not associated with deteriorating renal function determined by serial plasma creatinine estimations. Although all patients in whom there was some radiographic change had bacteriuria on later review, other factors, including excess analgesic intake, reflux and stones were recognized in most. There was a high incidence of analgesic ingestion among patients whose renal function declined and in whom there was some change in serial radiographs. The prevalence of hypertension among patients with normal renal function was 12 and 28 per cent for patients with unilateral pyelonephritis and bilateral pyelonephritis respectively. There was a significant increase in both blood urea and plasma creatinine in all patients with hypertension (diastolic pressure greater than 90 mm Hg) and a much higher prevalence of hypertension in patients whose plasma creatinine exceeded 1.3 mg/100 ml. Thrity per cent of patients with unilateral pyelonephritis and 50 per cent with bilateral pyelonephritis had vesicoureteric reflux of varying degrees. There was no evidence to suggest that major degrees of reflux (grade 3) was associated with further renal damage. These observations indicate the benign course of the majority of patients with radiological pyelonephritis. Control of blood pressure, and analgesic intake will help to preserve renal function whilst prevention of symptomatic urinary infection by long term low dose therapy will reduce morbidity.
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PMID:A prospective study of patients with radiological pyelonephritis, papillary necrosis and obstructive atrophy. 94 Sep 21

Renal colic always involves pelvic hypertension and severe urodynamic disturbances which result in fornical reflux, urine leakage to renal interstitial tissues, to tissues of the renal sinus, and sometimes to the retroperitoneal space. If the urinary tract is infected, renal colic may lead to acute pyelonephritis and generalized infection, as well as to bacteriemic shock. Of great importance in the origin of retroperitoneal fibrosis are fornical refluxes. Since renal colic is the most frequent cause of pyelorenal reflux, patients with renal colic should be promptly given appropriate treatment aimed at eliminating or at least lowering pelvic hypertension.
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PMID:Renal colic and associated pyelorenal reflux as a cause of some diseases. 96 97

The case of a young boy developing hypertension 3 years after removal of a small kidney due to pyelonephritis and vesico-ureteral reflux. Discovery in the artery of the remaining kidney of a limited coarctation without any of the lesions usually responsible for hypertension. Cured by enlargement angioplasty with a 5 year follow-up. This case is interpreted as an example (to our knowledge the only case in the literature) of hypertension, the mechanism of which is that revealed by Schlegel's experiments.
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PMID:[Hypertension due to limited coarctation of the right renal artery occurring 2 years after left nephrectomy for a "small kidney". 5 year cure obtained by enlargement angioplasty (author's transl)]. 96 40

A total of sixteen patients with urethral stricture and/or perineal urinary fistulae (water-can perineum) complicating gonorrhoea were seen at the Special Treatment Clinic, University College Hospital, Ibadan, Nigeria. The patients were aged between 25 and 80 years, and the latent period between the time of original attack of gonococcal infection and the development of complications varied from 4 to 50 years. The rate of divorce or marital separation is high among these patients with late sequelae of gonorrhoea. The factors responsible for the present higher incidence of early and late complications of gonorrhoea among patients in Nigeria and other tropical countries compared with their counterparts in Europe and North American include: (a) Lack of medical facilities in most rural areas; (b) Inadequate treatment of veneral diseases, including the urban areas where self-medication is practised on a large scale by the general population; (c) Illiteracy and ignorance of venereal diseases. The cases of watering-can perineum reported here, and the subsequent chronic pyelonephritis and hypertension, reinforce the plea for early and energetic treatment of acute gonorrhoea in Africa as well as large-scale control measures by the health authorities.
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PMID:Gonococcal urethral stricture and watering-can perineum. 100 18

The analysis of 450 closed puncture biopsies of the kidneys permits to conclude that the employment of this method in a cardiological hospital provides rather valuable information on the state of the renal tissue in cases of various diseases entailing the arterial hypertension syndrome. The incidations for kidney biopsy include arterial hypertension, developing against the background of the nephrotic syndrome of varying genesis, clinically distinct glomerulonephritis (to precise its morphological variant), various forms of renovascular hypertension, and in some cases -- hypertensive form of pyelonephritis. Important complications such as macrohematuria and pararenal haematoma were observed in 25 cases. The employment of kidney biopsy in a cardiological clinic helped to make the diagnosis of the lesion underlying arterial hypertension, to choose the adequate method of treatment and to improve the prognosis of the disease.
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PMID:[Experience with conducting transcutaneous kidney biopsy in a cardiology clinic]. 101 56

Because of epidemiological, clinical, pathomorphological, and etiological criteria the Balkan-nephropathy is suggested to be a particular form of chronic interstitial nephritis with super-imposed pyelonephritis in about 30 p.c. of the patients. A basic scheme illustrates the origin and the development of the endemia as well as etiology and clinical course of the disease. Another scheme shows pathogenesis and pathomorphogenesis of the nephritis. This analysis about the characteristics of the endemic Balkan-nephropathy allows for the clarification of the triad: endemic occurrance, familial susceptibility, and mosaik like morbidity. The following important aspects of the disease are given: rarely occuring hypertension, facultative leukuria, and bacteriuria, smooth nephrocirrhosis. Prophylactic and therapeutic prospects are given.
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PMID:[Balkan-nephropathy, a particular form of interstitial nephritis (author's transl)]. 109 38

42 patients aged over 40 years at the time of nephrectomy (between 1961 and 1972) for unilateral renal disease and arterial hypertension were re-investigated. The WHO criteria for normotensive and hypertensive blood pressure levels were used. Systolic and diastolic pressures returned to normal after nephrectomy in 15 patients, systolic pressure alone in nine. Systolic and diastolic pressures remained unchanged in twelve. When grouped by histological criteria, only patients with small pyelonephritis kidney improved significantly, while those with pyelonephritis, arteriolosclerosis and renal-artery stenosis did not. It is concluded that patients aged over 40 years who have hypertension associated with unilateral renal disease may benefit from nephrectomy, especially if they have a small pyelonephritic kidney.
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PMID:[Treatment of renal hypertension by nephrectomy in persons over 40 years of age]. 111 54

A long-term study of 17 patients with paroxysmal nocturnal hemoglobinuria revealed an unexpectedly high incidence of functional and anatomic renal abormalities. All patients demonstrated varying degrees of hematuria and proteinuria distinct from hemoglobinuria. All patients also had granular casts in multiple urinalyses. Evaluation of renal function revealed hyposthenuria, abnormal tubular function and declining creatinine clearance. Radiologically, one or more of these demonstrated enlarged kidneys, renal cortical infarcts and thinning, papillary necrosis, acute renal atrophy, retroperitoneal hematoma and ureteral infarction, which were confirmed by autopsy studies. Hypertension developed in 7 patients. Urinary tract infection was uncommon and no patient had a clinical history compatible with chronic or acute pyelonephritis. Contrary to usual opinion our compatible clearly showed evidence of frequent and widespread renal pathology in paroxysmal nocturnal hemoglobinuria most likely due to repeated microvascular thromboses similar to the venous trombosis involving other organs in this disorder. Since most of these patients present initially to urologists knowledge of this entity is mandatory.
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PMID:Urologic manifestations of paroxysmal nocturnal hemoglobinuria. 114 29


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