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

In order to study the effectiveness of unilateral nephrectomy as a treatment for chronic unilateral pyelonephritis, 15 consecutive patients who had undergone this operation were followed up. The patients had been operated on 8.9 years (mean) earlier. All of the 15 patients had had recurrent urinary tract infections prior to the operation, 11 of them had had pyelonephritis for between 1 and 19 (mean 6.7) years. One patient only had had a verified episode of urinary tract infection during the follow-up period. All 15 patients were hypertensive prior to the operation. At the time of follow-up, 7 patients were normotensive without drugs, and 2 were normotensive with a reduced dosage of antihypertensives. The mean systolic blood pressure went down from 180 to 150 mm Hg, and the mean diastolic pressure from 109 to 88 mm Hg. This operation can thus be recommended in selected cases of unilateral chronic pyelonephritis with hypertension.
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PMID:Nephrectomy in unilateral chronic pyelonephritis. A long-term follow-up study. 221 Sep 73

The rate of Na-Li countertransport was studied in inpatients with essential hypertension (n = 59), chronic diffuse glomerulonephritis (n = 30), chronic pyelonephritis (n = 26), renovascular hypertension (n = 15) and in those with associated renovascular hypertension and essential hypertension (n = 4). Multiple regression analysis has demonstrated that age, body weight and blood plasma lipids do not make any significant contribution to dispersion of the counter transport rate. The mean rate of countertransport in patients with essential hypertension turned out much higher than that in patients with secondary hypertensions. Repeated examinations have shown that in every man, the countertransport rate remains unchanged for 1.5 yr. It is not affected either by hypotensive therapy or surgical treatment. In inpatients with secondary hypertension and low rates of countertransport, high arterial pressure (AP) drops after surgical treatment of the kidneys, renal vessels or adrenals. Surgical treatment of patients with secondary hypertension and high rates of countertransport does not lead to any material decrease of AP. It is assumed that the rate of Na-Li countertransport can be used for diagnosing associated secondary hypertensions and essential hypertension and prediction of AP lowering after surgical treatment.
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PMID:[Na-Li countertransport and the diagnosis of hypertension and combined hypertension and renal artery stenosis]. 221 10

Differential diagnosis between essential hypertension and secondary arterial hypertension (AH) that developed in the presence of chronic pyelonephritis was made in 12 patients with AH and the urinary syndrome (leukocyturia and bacteriuria). With that purpose in view for revealing functional renal asymmetry, a study was made of the effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) in each kidney separately based on computation of 99Tc-DTPA and 131I-hippuran clearances. Some patients in whom AH was later regarded as essential manifested practically equal values of the ERPF and GFR from both sides, with the real characteristics of the latter ones being little different from the respective populational values calculated by computer bearing in mind the body surface of those patients. The other patients' group showed, along with a decrease of the total ERPF and GFR, a dramatic asymmetry of the intrarenal hemodynamics of both ERPF and GFR, which is fairly characteristic of chronic pyelonephritis. This allows the syndrome of AH to be regarded in those patients as secondary.
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PMID:[The determination of the separate intrarenal hemodynamics and its place in the diagnosis of nephrogenic arterial hypertension]. 221 11

In one regional perinatal network between 1982-1987, 101,506 women delivered infants greater than 500 g, of which 1253 were twin pregnancies (1.2%). This latter group was compared statistically with a 5% random sample of the singletons (N = 5119). The results showed that the women with twin pregnancies were slightly older, had a higher parity, gained more weight during the gestation, and had a heavier body weight at delivery. Twin pregnancies were complicated by increases in hypertension (odds ratio 2.5; 95% confidence interval 2.1-3.1), abruption (odds ratio 3.0; 95% confidence interval 1.9-4.7), and anemia (odds ratio 2.4; 95% confidence interval 1.9-3.0). There was no increased risk of pyelonephritis, placenta previa, or diabetes mellitus in mothers with twins. The twin pregnancies delivered earlier and the infants were smaller, had lower Apgar scores, and were at increased risk for congenital anomalies. Fetal and neonatal mortality rates were significantly increased in the twin infants; the perinatal mortality rates for twin A and twin B were 48.8 and 64.1, respectively, compared with 10.4 per 1000 births for the singleton controls. When the twin infants A and B were of similar weight, they had a similar perinatal mortality (odds ratio 1.0; 95% confidence interval 0.6-1.8). For infants less than 2500 g, twins A and B had lower fetal and neonatal mortality rates than did singletons, but twins heavier than 2500 g were at increased risk of perinatal death.
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PMID:A case-control study of 1253 twin pregnancies from a 1982-1987 perinatal data base. 230 Mar 44

Excretion patterns of kidney related urinary proteins such as lysosomal beta-N-acetylglucosaminidase (beta NAG), brush-border Ala-(Leu-Gly)-aminopeptidase (AAP), gamma-glutamyl transpeptidase (GGT), and alkaline phosphatase (AP) as well as of IgG, albumin, and alpha-1-microglobulin, were assessed in patients with chronic glomerulonephritis (n = 53), pyelonephritis (n = 27), systemic lupus erythematodes (n = 5), and patients with essential arterial hypertension (n = 18). Excretion of tubular marker enzymes and serumproteins (related to urine creatinine concentration = protein creatinine index) in spontaneously voided second morning urine was significantly higher as compared to the controls (n = 2). Alpha-1-microglobulin was markedly elevated in both pyelonephritis and glomerulonephritis indicating disturbance in tubulointerstitial handling of microglobulins also in cases with primary glomerulopathy. Rise of albumin, IgG, and alpha-1-microglobulin as well as of tubular kidney markers AAP, AP, GGT, and beta NAG in cases with arterial hypertension without preexisting nephropathy support the hypothesis of a defect in charge and size permselectivity in these patients which is probably due to an increase in glomerular capillary perfusion pressure and hyperfiltration.
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PMID:Kidney- and serum derived proteins in urine of patients suffering from renal diseases or arterial hypertension. 247 9

Chronic pyelonephritis (c.p.) is by definition an infectious tubulo-interstitial nephritis. It has to be differentiated from other etiologic forms of tubulo-interstitial nephritis. Therefore strict morphological criteria are needed for diagnosis. The characteristic lesion is a large cortico-medullary scar overlying a dilated chronically inflammed calyx. The macroscopic aspect and the histologic survey picture are more important than histologic details. A diagnosis on renal biopsies is therefore not warranted. Vesico-renal reflux and papillary morphology play an important pathogenetic role. Beside the more common focal scar a diffuse form of scarring can be observed. A limited number of conditions only have to be considered in differential diagnosis. The Ask-Upmark kidney seems to be a special form of c.p. related to urinary tract infection and reflux in early infancy. Pelvi-calyceal lithiasis without superimposed infection causes a picture very similar to a pyelonephritic scar. A reliable differentiation between c.p. and analgesic nephropathy may cause problems in endstage kidneys with sloughed off papillae. Various mechanisms of renal damage such as bacterial infection, immunological mediated inflammation, leakage of urinary constituents into the interstitium especially Tamm-Horsfall-protein and ischemia have to be considered. Despite the frequency of urinary tract infections chronic progressive pyelonephritis is rare. Predisposing factors are needed for progression of the disease. These include congenital or acquired urinary tract obstruction, vesico-renal reflux and papillary damage with intrarenal obstruction to the urinary flow. Other important factors are focal and segmental glomerulosclerosis and hypertension.
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PMID:[Chronic pyelonephritis and its differential diagnosis. A disease changing with time]. 248 12

Retrospective analysis of the urinary infection course involved 55 elderly patients. The patients were divided into groups basing on the clinical diagnosis. These groups included patients with obstructive chronic pyelonephritis and the patients with lower urinary infections. It was found that reinfections occur in the elderly patients with both upper and lower urinary infections while recurrence is seen in case of the upper urinary infections. Bacteriuria is significantly more frequent in the obstructive chronic pyelonephritis than in other urinary infections. This form of bacteriuria is frequently accompanied by exacerbations than in bacteriuria of periodic origin. Arterial blood hypertension is frequent in the elderly with urinary infections but its incidence does not correlate with the localization of the infection. Decompensated renal failure in the course of the urinary infections in the elderly is nearly always combined with arterial blood hypertension.
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PMID:[Retrospective studies of urinary infections in the elderly]. 249 Feb 99

Pathophysiological characteristics and long-term prognosis were studied retrospectively in 69 malignant hypertensives associated with grade III or IV retinopathy and the diastolic blood pressure greater than 120 mmHg. Thirty three (48%) cases had essential hypertension (EHT) as the underlying disease, 26 (38%) as chronic glomerulonephritis (CGN), and the remaining 10 (14%) as others including chronic pyelonephritis, renovascular hypertension, hydronephrosis, multiple calyceal diverticula, and unknown original disease. The role of the renin-angiotensin system in malignant hypertension was investigated by measuring plasma renin activity (PRA) and determining the blood pressure response to angiotensin (ANG)II antagonist, (Sar1, Ile8) ANG II. Basal PRA was significantly higher in the EHT group than the CGN group, and the ANG II antagonist-induced reduction of blood pressure was only evident in the former group. The regression analysis revealed that PRA was linearly correlated with both mean blood pressure (MBP) and serum creatinine prior to antihypertensive treatment in the EHT group but not in CGN patients, although there was inverse correlation between PRA and serum sodium in both groups. Therefore, the renin-angiotensin system seems to play a significant role in elevating blood pressure and deteriorating renal function in malignant hypertension developed from EHT, while it is less important in that from CGN. The 5-year survival rate was 90% in total 69 patients with malignant hypertension, while the 5-year renal survival rate defined as the probability of surviving without maintenance hemodialysis was 37%, indicating that the treatment with hemodialysis as well as antihypertensive drug therapy contributed to an improvement of prognosis of malignant hypertension. The EHT group showed a poor prognosis for life compared with the CGN group, while in the latter group most patients rapidly developed endstage renal failure. Although the pretreatment serum creatinine levels were matched, the renal function more rapidly deteriorated after development of malignant hypertension in the CGN group than did in the EHT group, indicating renal survival rate to be shorter in the former group. Hence, underlying diseases may affect the long-term prognosis of malignant hypertension. The results obtained from this study suggest that the pathophysiological characteristics of malignant hypertension are different and its long-term prognosis is varied by underlying diseases such as EHT and CGN.
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PMID:[Pathophysiology and prognosis in malignant hypertension: comparison by underlying diseases]. 251 35

There are indications that there is an increased risk of chronic renal failure (CRF) in the Negroid race, yet few studies have been carried out in the native 'black' environment. A clinico-pathological study of 100 consecutive Nigerian subjects with CRF, seen over a 3-year period, is presented. Primary chronic glomerulonephritis (CGN) accounted for 50, accelerated hypertension for 25, and various aetiological entities for a further nine; these included, chronic pyelonephritis (two), diabetic nephropathy (two), calculous nephropathy (one), toxaemia of pregnancy (one), renal dysplasia (one), tuberculosis (one) and polycystic disease in the ninth subject. In 16 cases, no definitive aetiological diagnosis could be made. Combinations of the following features, protracted hypertension, proteinuria, significant analgesic intake and gouty arthritis, were observed. CGN and accelerated hypertension still remain the leading causes of CRF, while diseases such as diabetes mellitus and chronic pyelonephritis do not contribute significantly to CRF in Nigerians. Recognition of the early features and the causes of CRF would considerably reduce the prevalence of this condition.
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PMID:Diseases causing chronic renal failure in Nigerians--a prospective study of 100 cases. 254 87

Renal functional and structural studies were performed in 46 patients with arterial hypertension: out of them 12 had hypertensive disease, 13, chronic pyelonephritis, 21, a hypertensive type of chronic glomerulonephritis. In each case, the clinical diagnosis was evidenced by one of the invasive techniques. Dynamic computed tomography was conducted by the original methods; the findings were analyzed by taking into account time-density curves which made it possible to gain an insight into the status of blood flow and filtration in each individual kidney. Computed tomography and dynamic computed tomography revealed that hypertensive disease was characterized-by normal volume and thickness of the renal cortical layer and symmetric time-density curves, whereas a hypertensive type of chronic glomerulonephritis featured lower renal cortical layer thickness, reduced renal volume, symmetrically decrease amplitudes of the first and second peaks of the time-density curve, chronic pyelonephritis showed asymmetric time-density diagrams due to the lower density areas in the afflicted kidney.
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PMID:[Hypertensive disease and renal hypertension (structural and functional studies of the kidneys using dynamic computerized tomography)]. 261 78


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