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

We studied the prevalence and the risk factor among the patients of gout in Mexico. Research was conducted in the National Institute of Cardiology and in our private practice. Prevalence of hiperuricemia and gout in the Institute of Cardiology was of 1% (970 out of nearly 100,000 patients). We divided those cases of two subgroups: Reumatology patients (333) and Cardiovascular patients (529). In the first group primary gout was (96.3), and (50.32% in the second. Risk factor was quite different too: nephropathy 9.9%, lithiasis 9.3%, pyelonephritis 2.7%, cardioangiosclerosis 12.9%, aortosclerosis 6.6%, coronary insufficiency 6.3%, myocardial infarction 0.9%, arterial hypertension 24.6% obesity 56.1% and diabetes 9.9% in the Reumatology group; in the Cardiovascular one, nephropathy 14.3%, lithiasis 12.2%, pyelonephritis 7.1%, cardioangiosclerosis 62.7%, aortosclerosis 31.7%, coronary insufficiency 24.9%, myocardial infarction 29%, arterial hypertension 51%, obesity 54.8% and diabetes 20.4%. Among the private practice patients prevalence was of 10.1% (961). In an early age (39 years) in men and a later one for women (53 years). Other characteristics of epidemiology and risk factor are: primary gout 89%, atherosclerosis 5%, coronary disease 4.6%, lithiasis 4.7%, nephropathy 2%, pyelonephritis 1%, obesity 43%, and diabetes 4.6%. In an small group of patients of our private practice we made an exhaustive study of risk factor and the metabolic disorder of lipids. We found the following frequency: 9.3 of nephropathy, 31.2% of lithiasis, 18.7% of pyelonephritis, 68.9% of cardioangiosclerosis, 46.8% de coronary insufficiency, 9.3% of myocardial infarction, 68.7% of arterial hypertension, 68.7% of obesity and 18.7% of diabetes. In the lipid profile we found an increase in triglicerids and prebeta lipoprotein. We have amply discussed the relation between hiperuricemia and pathology considered as a risk factor from the genetic point of view as well as the metabolic and circumstancial aspect. From all that we concluded that risk is multifactorial.
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PMID:[Various epidemiological aspects of hyperuricemia and gout in Mexico: incidence and the cardiovascular risk factor]. 72 44

Chronic atrophic pyelonephritis is associated with vesicoureteric reflux in infancy. Reflux disappears during childhood in 50% of cases. It is more commonly detected in infants (49%) and children (26%) with infection than in adults (4.4%). Severe reflux may persist in adults and is usually (94%) associated with scarring. Patients with end-stage renal failure due to pyelonephritis are much younger than patients with end-stage renal failure due to other causes. The incidence of reflux according to sex is equal in infancy, but after infancy both pyelonephritic scarring and reflux are far more common in females. Infection is the likely cause of progressive scarring in females. Hypertension is associated with chronic atrophic pyelonephritis. Proteinuria is the worst prognostic feature in patients with reflux nephropathy and pyelonephritic scarring. Intrarenal reflux determines the site of scarring. The role of surgical correction of vesicoureteric reflux remains uncertain, but meticulous control of infection appears to prevent progressive scarring.
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PMID:Reflux nephropathy and chronic atrophic pyelonephritis: a review. 73 56

Of 85 adults with end stage renal disease examined consecutively for renal transplantation 25 (29.4 per cent) had vesicoureteral reflux. Of these 25 patients 11 had a nephropathy as the cause of renal failure that was unrelated to reflux (for example glomerulonephritis) and 12 had, in addition to vesicoureteral reflux, a history of urinary tract infections and chronic pyelonephritis, which seems to be significant in the etiology of terminal renal failure in our patients (14 per cent). Only 2 of the 25 patients had severe, sterile reflux: 1 had bilateral megaureter with reflux into 1 side after ureteroneocystostomy and 1 had bilateral grade IV sterile reflux complicated by megacystitis. We had no case of uncomplicated, sterile reflux, which, in our experience, seems to be a rare cause of renal failure.
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PMID:Vesicoureteral reflux in end stage renal disease. 75 25

We studied prospectively 18 patients with sodium-losing nephropathy. In 12 patients (66.7 per cent) the sodium-losing nephropathy was owing to obstructions, challenging the hitherto existing concept that the most common cause of the condition is pyelonephritis. The diagnosis of sodium-losing nephropathy is important in urological practice since sodium repletion in these cases shortens significantly the hospitalization and preoperative waiting time.
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PMID:Sodium-losing nephropathy. 75 50

The relationship between vesico-ureteric reflux and coarse renal scarring (atrophic pyelonephritis) has been studied in swine. Scars were observed to develop where reflux took place into the kidney substance via the renal papillae (intrarenal reflux). They were confined to these regions and were similar in size, distribution and other features peculiar to those found in the human from early childhood onwards. Intrarenal reflux was found to be related to the pressure within the urinary tract as well as to vesico-ureteric reflux. Infection was not an essential factor in scar-formation, but it appeared to intensify the scarring process. The histological findings were a progressive focal interstitial fibrosis confined to the zones of intrarenal reflux, extending from the capsule to the papillary tip, and varying in severity with pressure, time and the extent of intrarenal reflux. Nephron and tubular damage accompanied all grades of fibrosis, with the possible exception of the earliest. In many respects the histological changes closely resemble those due to obstruction, except they are focal in distribution. Added features are the early peripheral lymphocytic aggregations and interstitial fibrosis which appear to suggest that some "irritant"--possibly urine--reaches the interstitium and drains away via the lymphatic system. Many of the phenomena observed were strikingly similar to those present in children with the more severe grades of vesico-ureteric reflux. In some cases a mixture of generalized obstructive nephropathy and focal scarring developed; in others focal scarring took place with normal papillae elsewhere. The results are readily reproducible. The basic questions as to whether it is bladder pressure, or infection, or a mixture of the two which is responsible for scar-formation are discussed.
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PMID:The pathogenesis of reflux nephropathy (chronic atrophic pyelonephritis). 76 85

Renal para-aminohippurate (PAH) clearances were predicted in 16 kidneys of eight hypertensive patients with renal artery stenosis, pyelonephritis, or obstructive nephropathy, without individual ureteral catheterization. Predictions of left or right kidney clearance (CL or CR) were based on roentgenographic renal frontal areas (A), on total PAH clearances (CT), and on individual PAH extractions (E) measured at renal vein catheterization according to the formula (formula: see text). When these patients underwent ureteral catheterization for diagnostic reasons, individual PAH clearances were measured and ranged from 22 to 286 cm3/min. After correction for differences in total PAH clearance on the two occasions, predicted and individually measured values corresponded closely along a line of identity. The 95% confidence limit (+/- 2 SEM) for predictions of individual PAH clearance was approximately +/- 38 cm3/min and for percet of total PAH clearance distributed to left or right kidney, +/- 6%. Individual renal PAH clearances can therefore be predicted at renal vein catheterization with acceptable error. Thus, the substantially invasive procedure of ureteral catheterization is not required to ascertain left and right kidney PAH clearance in patients already at risk from renal disease.
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PMID:Individual renal clearances determined at renal vein catheterization. 84 70

It is described a test for the presence of diffuse nephropathies which is based on the fact that after application 20 ml of the renal diatrizoate X-ray contrast medium Visotrast or of 500 ml of a 10% mannitol solution in patients with preexisting renal diseases appear reversible, diagnostically relevant increases of the alanine aminopeptidase excretion with the urine. In persons with healthy kidneys the excretion of enzymes changes insignificantly. The increased excretion of alanine aminopeptidase is also observed in patients with latent pyelonephritis and is traced back to the increased formation of an osmotic nephropathy in patients with preexisting nephropathies.
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PMID:[Excretion of alanine aminopeptidase in the urine after administration of lysosomotrophic substances in patients with latent or florid pyelonephritis]. 84 46

The symptoms and clinical course of chronic hypokalemic nephropathy are described in 21 patients with longstanding potassium deficiency. In 14 patients (group A) the potassium depletion was caused by malnutrition and/or abuse of laxatives and/or diuretics. 7 patients (group B) suffered from primary (6 cases) or secondary (1 case) aldosteronism. The average duration of potassium depletion was 8.8 years in group A and 3.4 years in group B. Depending on the duration of potassium depletion, chronic renal disease develops which may end in terminal renal failure. Urinalysis is non-specific or negative. The clearance of creatinine slowly decreases. Metabolic alkalosis is a constant finding and in group A occurs with a tendency to hyponatremia and hypochloremia, with the development of metabolic acidosis only in advanced renal insufficiency. In contrast to patients of group B, patients of group A have normal or low blood pressures converting to hypertension, if at all only in the late phase. The cases of group A had secondary aldosteronism (and, correspondingly, a hyperplastic juxtaglomerular apparatus). Although urinary tract infection is a regular finding in advanced stages, the clinical, radiological and histological evidence suggests that bacterial pyelonephritis, if occurring at all, is rather a complication than the cause of the disease. In 5 patients 7 instances of acute renal failure of unknown origin were observed which was lethal in one case. Another patient died from terminal renal failure, a third from an intercurrent pneumonia. Renal histology obtained from 13 patients showed the picture of diffuse chronic abacterial interstitial nephritis.
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PMID:Symptoms and course of chronic hypokalemic nephropathy in man. 87 Feb 67

A rare case of drug induced potassiumpenic nephropathy is reported with a secondarily originated accompanying pyelonephritis in a female patient, aged 36 who has taken frequently, of her own accord, high doses salidiuretics in the course of two years, aiming at body weight reduction and against persistent headache. The clinical characteristic features of the disease are discussed as well as the results from the treatment carried out.
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PMID:[Case of hypokalemic nephropathy]. 91 19

Between 1967 and 1973, 12 home dialysis training centers (HDTC), under contract to the health Resource Administration, Department of Health, Education, and Welfare, reported training 1063 patients. Mean training time was 69 days; mean patient age was 40 yr with a range of 12 to 75 yr. Survival rates were 87% at one year, 74% at two years, 62% at three years, 54% at four years and 52% at five years. Male to female ratio was 3.2; there was no significant survival difference between sexes. Patients under 50 yr of age had significantly greater survival than did patients 50 yr and older. A "good" health status classification, defined by activity tolerance, signs and symptoms at the beginning of home dialysis, was associated with more favorable survival than were lower health ratings. Patients with glomerulonephritis, pyelonephritis and polycystic disease had better survival than did patients with diabetic, hypertensive and other renal disease etiologies. Although 51% of the patients lived 50 to 400 or more miles from the HDTC, their survival was not different from patients living less than 50 miles from the HDTC. Survival rates for patients with less than ten years of education were not significantly different from those with formal education as high as the university graduate level. Forty-seven percent of the patients were restored to full activity. These survival results are comparable with those reported for other modes of dialysis and transplantation and indicate that home dialysis is an acceptable form of therapy for a variety of patients.
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PMID:Analysis and outcome of 1063 patients trained for home hemodialysis. 94 Feb 75


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