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

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

Escherichia coli is the most frequent cause of pyelonephritis. Its possible virulence factors include the ability to adhere and colonize the urinary tract, an important initiating factor in all urinary tract infections (UTIs). The importance of P fimbriae in this adhesion is stressed and the evidence for its importance in pyelonephritis is presented in epidemiologic studies of patients, as well as in animal studies. It appears that both host receptor density and the nonsecretor state is responsible for susceptibility to urinary tract infection. Vesicoureteral reflux can be responsible for ascending upper tract infection, but infection with P-fimbriated E coli may lead to ascending pyelonephritis without reflux because of the paralytic effect of lipid A on ureteral peristaltic activity. Renal ischemia leads to renal damage following infection by reperfusion damage due to the release of superoxide. Experimentally, this ischemic damage can be prevented by allopurinol, a xanthine oxidase inhibitor. The acute inflammatory response can produce renal damage because of the respiratory burst of phagocytosis, which while killing phagocytosed bacteria also damages renal tubules. An amelioration of the inflammatory response by treatment with superoxide dismutase or corticosteroids has been shown to modulate renal damage. Vaccination with P fimbriae has been shown experimentally to prevent the initiation of the disease. However, since vaccines are not clinically available, the clinical and animal studies on therapy of acute disease are stressed. Acute pyelonephritis during the first 3 years of life more often produced the renal damage that could lead to end-stage renal disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Etiology and pathophysiology of pyelonephritis. 167 Sep 5

The paper presents the data confirming the hypothesis on the involvement of the congenital enteroviral infection in etiology of chronic nephropathy manifesting in children in the presence of influenza-like and acute respiratory infections diseases. 100 relevant children were examined. Family history indicated a high risk of enteroviruses inheritance from mothers who were chronic carriers in 19 out of 20 children with pyelonephritis or interstitial nephritis (95%), in 17 out of 23 children with transitory nephropathy (73.9%) and 16 out of 57 patients without nephropathy (28.1%). Coxsackie enteroviruses (A and B) occurred in the urinary sediment in 82.3, 68.4, 29.5% of the patients from the groups under comparison, respectively. In children free of nephropathy the viruses manifested primarily in the seasons with the highest prevalence of the enteroviral diseases, in those with nephropathy Coxsackie viruses detection rate was not season-related. Recognition of enteroviruses (Coxsackie B, as a rule) was significantly related to the risk of the transmission from the mother. Persistence of the viruses in the cells of the urinary system of children with congenital viral infection seems to run subclinically for a long time. Influenza and other acute respiratory diseases promoted activation of the endogenic infection which resulted in transitory nephropathy or interstitial nephritides.
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PMID:[The significance of a congenital enterovirus infection in the pathogenesis of transient intrainfectious nephropathy and interstitial nephritis detected in children with influenza-like and acute respiratory diseases]. 175 18

The severity of anemia in patients at different stages of the evolution of two tubulointerstitial nephropathies, Balkan endemic nephropathy and chronic pyelonephritis, was compared to clarify the previous observations that anemia appears earlier and is more severe in Balkan endemic nephropathy than in other renal diseases. The role of erythropoietin insufficiency as the cause of anemia in endemic nephropathy was studied as well. The severity of anemia increased with the impairment of renal function in endemic nephropathy and was similar to anemia in chronic pyelonephritis. However, in patients with endemic nephropathy at the initial stage of renal insufficiency significantly lower red cell concentrations were found compared with control subjects from the endemic region. In contrast, patients with pyelonephritis did not have decreased red cell concentrations at the early phase of their renal failure, suggesting that earlier appearance of anemia is characteristic for endemic nephropathy. To confirm this finding a study involving larger number of patients would be necessary. The serum erythropoietin levels, inappropriately low for the degree of anemia in patients with renal failure, were unrelated to the type of tubulointerstitial nephropathy.
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PMID:Anemia in Balkan endemic nephropathy. 176 34

Over the last 16 years, 214 autopsies were done at the Department of Pathology and Forensic Medicine, Slavonski Brod Medical Centre, on people from an area recognized as endemic for Balkan nephropathy in the county. Balkan endemic nephropathy was diagnosed pathoanatomically and histopathologically in 94 of these cases, and in none of 1040 autopsies on people from a nonendemic area. The most striking pathological finding in all advanced cases of the disease was a marked reduction in kidney size and weight; in one extreme case, the organ weighed only 20 g. The process is invariably bilateral, but there are considerable differences in the degree of involvement in each pair. Although the pathoanatomical changes, including lung oedema and haemorrhage and fibrinous pericarditis, are seen in the majority of cases, they are not considered to be specific for Balkan endemic nephropathy, since they are well recognized signs of long-standing primary uraemia. The relevance of the peculiar finding of sulfurous yellow discoloration and hardened subcutaneous adipose tissue, seen frequently post mortem, is unknown and should be investigated in more detail. Histopathologically, fibrosis and atrophy of kidney cortex, with tubular degeneration, are the most consistent findings. Lesions characteristic of pyelonephritis were superimposed over the picture of 'pure' Balkan endemic nephropathy in a considerable number of cases.
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PMID:Some pathomorphological features of Balkan endemic nephropathy in Croatia. 182 Mar 51

Although genitourinary tract disorders are common in acquired immunodeficiency syndrome (AIDS), little attention has been paid to their manifestations on computed tomographic (CT) scans. The authors reviewed the CT scans of 86 patients infected with the human immunodeficiency virus for CT manifestations of primary or secondary involvement of the genitourinary tract. Genitourinary tract abnormalities identified in the 86 patients included nephromegaly in 34 (40%), hilar adenopathy in 30 (35%), bladder wall thickening in 19 (22%), medullary hyperattenuation in 12 (14%), renal calcifications in seven (8%), adnexal masses in five (6%), hydronephrosis in four (5%), pyelonephritis in three (3%), renal abscesses in three (3%), and solid renal masses in three (3%). Although these abnormalities are seen on CT scans in many other diseases, in the AIDS patient they often indicate the presence of an AIDS-related renal disease or involvement of the genitourinary tract by an AIDS-related neoplasm or infection.
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PMID:Retroperitoneal and pelvic CT of patients with AIDS: primary and secondary involvement of the genitourinary tract. 185 38

196 cases with vesicoureteral reflux (VUR) from multiple centers were analysed to examine the relationship between VUR and reflux nephropathy. The high correlation (p less than 0.01) was observed between reflux and renal scarring. Even in cases in whom VUR was not demonstrated at the time of testing, renal scarring of various degrees was recognized, suggesting either co-existed hypoplastic kidney or pre-existed infection. The renal scarring, but not VUR, had a significant correlation with proteinuria and hypertension. Retrospective analysis shows that the surgical treatment was closely related to the degree of renal scarring but not to the degree of reflux. Renal scarring progressed even when reflux did not become worse, which is probably accounted for by the presence of pyelonephritis. Although frequency of pyelonephritis decreased significantly (p less than 0.01) from 0.60 +/- 0.89 to 0.084 +/- 0.305 times/patient. year after anti-reflux surgery, renal scarring progressed in 13 kidneys (5.8%). Seven of the 13 kidneys became worse due to the surgical failure. The scar progression was recognized in the remaining six kidneys (three patients) including adult cases despite the successful surgical correction of reflux. Our study points to the urged need for a prospective clinical trial designed for the study of the pathological and clinical background of progressive renal failure in VUR.
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PMID:[Vesicoureteral reflux and renal scarring. Report of cooperative study of "Progressive renal disease" of Ministry of Health and Welfare]. 187 71

The activity of N-acetyl-beta-D-glucosaminidase (NAGase) activity was determined in urine of patients with pyelonephritis and glomerulonephritis. Determination was done with the non-commercial "Boehringer-Mannheim" test reagents for research purposes only. The protein concentrations were measured in the same samples. The obtained results were compared with results obtained in the control group and the significant increase (p less than 0.001) in NAGase activity was found in both groups of patients. At the same time normal protein values were found in 33% of all cases. It can be concluded that NAGase is a more sensitive parameter for early detection of renal disease.
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PMID:[Changes in N-acetyl-beta-D-glucosaminidase in the urine of patients with pyelonephritis and glomerulonephritis]. 189 73

Use of microangiography is now essential for the study of microcirculation in various organs. Renal microangiographic studies have been reported in rats, rabbits, dogs, human beings, and mice. However, we could not find any report on use of the technique in cattle, despite high incidence of renal disease in that species. The perfusion technique used in mice was improved over that of our previous report, and was applied to normal and diseased bovine kidneys. For the microangiographic technique, composition of the contrast medium, pressure of the injection, duration of perfusion, and washing of kidneys with heparinized saline solution before perfusion are important. In cattle, 1- to 2-mm-thick sections of the kidneys were generally necessary to observe renal vasculature: arcuate and interlobular arteries, afferent arterioles, and glomerular capillaries. In normal bovine kidneys, the angiographic and microangiographic findings were easily recognized as normal, compared with those of normal mice. In affected bovine kidneys, which histologically represented glomerulonephritis and pyelonephritis, angiography and microangiography revealed corresponding findings.
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PMID:Application of renal microangiography to normal and diseased kidneys of cattle and mice. 202 Dec 44

In 107 infants with 182 antenatally diagnosed urinary tract anomalies, 24 had either unilateral (12) or bilateral (12) vesicoureteric reflux (VUR). The VUR was more common in boys (male to female ratio, 16:8) and usually severe (grades IV [16], III [10], II [4], and I [6]). Intravenous pyelography showed the changes of atrophic pyelonephritis in 10 refluxing units, and in another two with an associated pelviureteric junctional hydronephrosis. Lateral ectopia of the ureteric orifices was noted in six of these 10 refluxing renal units. Isotopic renography showed a reduction in function in nine of the 14 patients examined, ranging between 9% and 41%. (45% and above was considered within the normal range). Only two patients developed a urinary infection before intravenous pyelography or isotopic renography was performed, suggesting that renal changes noted were primary rather than secondary. Findings support the hypothesis that foetal VUR may be a contributing factor in the causation of atrophic pyelonephritis (foetal reflux nephropathy) observed in these patients.
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PMID:Reflux nephropathy secondary to intrauterine vesicoureteric reflux. 218 15


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