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

Ultrasonography in 52 pregnant women with acute pyelonephritis has been found to be a useful marker of efficacy of aggressive care. Reversal of inflammation in acute pyelonephritis without an associated disease reduced the kidney size and restored urine flow by the end of the 7-9th day of therapy. In pyelonephritis coexisting with nephrolithiasis, reversal of inflammation did not completely restore urine flow until a stone in the urinary tract was passed or surgically removed. The clinical patterns of pyelonephritis were elucidated in congenital renal malformations. The urine flow was completely restored and kidney sizes were maximally contracted postpartum. With an early therapy, the fetal development was appropriate for gestational age. Frequently relapsing pyelonephritis concomitant with toxemia or severe congenital renal disease led to intrauterine growth retardation.
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PMID:[Echographic dynamic control of the urinary system and fetal development in pregnant women with acute pyelonephritis]. 219 93

Serum levels of plasma-derived toxic protein components, the median weight molecules (MWM), have been assayed in 206 women with third-trimester pregnancy and in their newborns. Toxemia of various severity was present in 194 women and had developed in the presence of an extragenital disease in 84.2% (pyelonephritis, glomerulonephritis, essential hypertension, etc.). Concentrations of MWM were found to increase with deterioration of renal function and to correlate with severity of nephropathy. In every second pregnancy with toxemia, interventions included extracorporeal detoxication: ultraviolet-irradiated blood autotransfusion (UIBA) and hemosorption. The rates of intra- and postpartum complications or requirement for surgery were 1.5-2-fold lower in these patients, and their newborns has better neonatal progress. Perinatal mortality of these patients was two times as low as that in the rest of the population (31.9:1000 versus 62.6:1000). The use of UIBA is recommended for mild and moderate toxemia and in combination with hemosorption for severe nephropathy.
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PMID:[The role of middle-weight molecules in the pathogenesis of late pregnancy toxemia]. 222 Dec 67

Accelerated rates of ammonia production by the renal proximal tubule constitute an important adaptation to chronic renal injury. Although serving to maintain net acid excretion, this augmented production of ammonia per nephron results in increased renal cortical levels of ammonia and contributes to progressive renal injury. Ammonia fosters progressive injury via its ability to modify the third component of complement and initiate alternative complement pathway activity. This interaction of ammonia with complement incites inflammation in models of nonimmune chronic renal disease in the rat and may contribute to tissue injury in pyelonephritis involving urease-positive organisms. The long recognized in vivo association between increased renal ammoniagenesis, renal growth, and progressive injury in several models of renal disease has been advanced by the recent demonstration of ammonia as a direct stimulus to growth of renal tubular epithelium in culture. Additionally, evidence from studies of acute ischemic renal injury suggests a contributory role for ammonia in mediating tissue injury in this model. Elevated renal levels of ammonia, therefore, contribute to tubulointerstitial injury primarily through the proinflammatory and growth-promoting properties of ammonia.
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PMID:Role of ammonia in tubulointerstitial injury. 228 94

Our current knowledge of the long-term outcome of uncomplicated urinary tract infections in women is based on a re-evaluation of the criteria for defining pyelonephritis at autopsy, careful description of the causes of renal disease among patients entering dialysis and transplant programs, long term observation of patients, and epidemiologic studies which have attempted to determine the association of bacteriuria with mortality. The weight of the evidence favors the conclusion that although urinary tract infections can produce severe impairment of renal function, this is rare in the absence of a major predisposing factor such as obstruction, calculus, reflux, abnormalities of the voiding mechanism or diabetes. The predisposing lesions, however, may go undetected until heralded by episodes of acute pyelonephritis or by renal failure. Unfortunately, urinary tract infections are so common that it is difficult to distinguish the population at greatest risk. The possible role of renal damage produced by autoimmune mechanisms following infection needs continued study.
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PMID:Natural history of "lower" urinary tract infections. 228 59

We have investigated anemia in patients at different stages of the evolution of three chronic renal diseases: Balkan endemic nephropathy (BEN), chronic pyelonephritis (PN) and chronic glomerulonephritis (GN). A total of 88 patients with creatinine clearances from 9 to 118 ml/min and hemoglobin concentrations from 70 to 160 g/l were studied with regard to the relationship, if any, between erythropoietin production and the type and stage of nephropathy. Anemia in BEN was a particular focus of interest since it had been stated that in BEN, anemia precedes renal failure. Our data neither prove nor disprove this statement. A significant positive correlation between creatinine clearance and hemoglobin concentration was found in all three nephropathies, indicating that in the patients studied the severity of anemia increased with the impairment of renal function regardless of the underlying disease. Serum levels of immunoreactive erythropoietin were in the normal range in 54 patients, moderately increased in 20 and slightly decreased in 14. The erythropoietin level appears to be unrelated to the stage of renal failure or the type of nephropathy. The only exception was the subgroup where the patients with glomerulonephritis and normal renal function had increased serum erythropoietin levels and significantly higher parameters of red blood cell concentration than the patients from the same subgroup with tubulointerstitial nephropathies. In patients with severe renal failure and anemia, serum erythropoietin levels were inappropriately low for the degree of anemia, indicating that erythropoietin plays a role in the pathogenesis of the anemia.
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PMID:Erythropoietin and anemia in the progression of Balkan endemic nephropathy and other renal diseases. 231 25

A prospective study compared the outcome of vesicoureteral reflux and recurrent urinary tract infections in children (3 boys, 62 girls) who received medical prophylaxis or underwent surgical correction of reflux. Thirty-eight children returned for reevaluation 6 to 13 years (average 9.5 years) after entry. There was a marked decrease in prevalence and severity of reflux. At entry, 13 had significant scarring that had progressed at follow-up. New scars were documented by dimercaptosuccinic acid scan at follow-up in eight children on the medical regimen and two who were initially treated with surgical correction of reflux. Four patients with high-grade sterile reflux were followed for 6 to 10 years without the development of cortical scars. Our data support the role of urinary tract infection and vesicoureteral reflux, but not sterile reflux, in the pathogenesis of chronic pyelonephritis and reflux nephropathy.
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PMID:Relation of urinary tract infection and vesicoureteral reflux to scars: follow-up of thirty-eight patients. 232 13

Urinary and blood lipid metabolism was examined during pregnancy complicated by different forms of nephropathies. The pregnant with primary nephropathy and with chronic pyelonephritis showed a significant increase of lipid peroxidation products in erythrocytes while the pregnant with chronic glomerulonephritis showed high-molecular lipoproteids in the urine. A relationship was found of metabolic disorders and indices characterizing the degree of renal lesions in the pregnant.
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PMID:[Lipid metabolism in primary and combined lesions of the kidneys in pregnant women]. 233 Jul 3

In an animal model of chronic nephropathy a large proportion of the apparently normal glomeruli have been shown to be small and without connection to a proximal tubule. The present study examines the degree to which atubular glomeruli are also present in human renal disease. Eleven patients with chronic pyelonephritis (CP) and seven controls were investigated. The number of glomeruli connected to a normal proximal tubule was determined in serial sections and the volumes of individual glomeruli estimated with stereological methods. Only glomeruli with little or no sclerosis were investigated. The volume fractions of proximal tubules and interstitial tissue were estimated using point counting. The results showed that 50% of glomeruli in the CP group were connected to a normal proximal tubule, whereas 35% of the glomeruli were without any recognizable connection to a proximal tubule (atubular glomeruli). The remaining 15% were connected to an atrophic tubule. The mean volume of the glomeruli without a connection to a normal proximal tubule was only half that of glomeruli with a normal proximal tubule. No significant difference was found between the mean glomerular volume in the two groups, but the intraindividual variation of glomerular volumes was larger in the CP group. A significant negative correlation was found in the CP group between the percentage of glomeruli without connection to a normal proximal tubule and the volume fraction of proximal tubules. A significant positive correlation was found between the percentage of glomeruli that were not connected to a normal proximal tubule and the volume fraction of the interstitial tissue. This study shows that atubular glomeruli, which only can be identified in serial sections, constitute a large proportion of glomeruli in chronic pyelonephritis. Their existence could be a major reason for the irreversibility of nonglomerular chronic renal diseases.
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PMID:Atubular glomeruli in patients with chronic pyelonephritis. 233 70

The authors evaluated data of expertise of the quality of observations on 1056 pregnant women with renal diseases (primary nephropathy, chronic glomerulonephritis, acute and chronic pyelonephritis, acute and chronic pyelonephritis, associated nephropathies) as well as data on the dynamic observation of 300 patients carried out according to special methods. On the basis of these findings the authors worked out the strategy, tactics and individual program of dispensarization with consideration of regularities of evolution of renal diseases, risk factors in the course of onset and progression of the disease. An organizational model was worked out of graded dispensarization with the participation of obstetricians, nephrologists, therapists, urologists.
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PMID:[The dispensary care of pregnant women with kidney diseases]. 233 57

Most urinary tract infections occur without either obstruction or vesicoureteral reflux. Children become colonized by their mother's bacterial flora, that within the nursery or by siblings. Bacterial adherence may lead to colonization of the perineum in girls and of the prepuce in boys (if uncircumcised). Nephropathogenic bacteria ascend the urinary tract because of the P-fimbriae of Escherichia coli which adhere to a specific urothelial cell glycolipid. The endotoxin effect on ureteral peristalsis leads to intrarenal reflux, adherence in the kidney and acute pyelonephritis. Complement activation then causes granulocytic aggregation in capillaries with renal ischemia and activates granulocytes to produce the respiratory burst of phagocytosis, which releases superoxide into both phagosomes and the tubular lumen. Bacteria are thus killed as are renal tubules, leading to nephron loss. Untreated, the ischemia and respiratory burst lead to a loss of renal function and scar formation ending as chronic pyelonephritis (or reflux nephropathy).
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PMID:Norwich-Eaton lectureship. Pathogenesis of nonobstructive urinary tract infections in children. 237 23


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