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

The triad of elevated SGOT and lactic dehydrogenase levels, positive blood and urine cultures, and acute renal failure was noted in a patient with severe pyelonephritis. Bilateral medullary necrosis was found on biopsy and at postmortem examination. These findings may help establish a prompt antemortem diagnosis.
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PMID:Nonobstructive pyelonephritis initially seen as acute renal failure. 34 38

Five patients who presented with acute renal failure in association with urinary tract infection are reported. Renal function improved rapidly on antibacterial therapy and no alternative cause for acute renal failure could be identified. None had previously been known to have renal disease but three of the five had taken considerable amounts of analgesics. The unusual severity of renal functional impairment resulting from urinary tract infection in these patients is unexplained but may relate to previous analgesic abuse and/or delay in treatment. Since acute non-obstructive pyelonephritis may result in severe reversible renal failure, this diagnosis must be considered in patients presenting with acute uraemia.
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PMID:Acute renal failure due to bacterial pyelonephritis. 39 60

Acute renal failure occurred during indomethacin therapy in a patient with chronic pyelonephritis. Urinary prostaglandin E2 levels were diminished but returned to normal after discontinuation of drug therapy and recovery of renal function. Prostaglandins may be critical for the integrity of renal function, and the use of prostaglandin inhibitors such as indomethacin and other nonsteroidal anti-inflammatory drugs may be deleterious in patients with underlying renal disease.
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PMID:Reversible acute renal failure induced by indomethacin. 44 22

Substances having the chromatographic behaviour and the bioassay properties of prostaglandins (PGE and PGF) were detected in the urine of 30 patients with kidney disease and 15 healthy subjects. The mean urinary PGE and PGF values in 15 patients with chronic glomerular disease or nephrosclerosis were significantly lower than those of 15 patients with chronic pyelonephritis and other forms of chronic interstitial nephritis, polycystic kidney disease, obstructive nephropathy or diuretic phase of acute renal failure, and of the mean PGE and PGF values found in the healthy subjects. It was suggested that in contrast to disease affecting primarily the renal medulla, chronic glomerular disease and nephrosclerosis are accompanied by a decrease of renal prostaglandin synthesis and/or release.
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PMID:Urinary prostaglandins in kidney disease. 55 98

Malacoplakia of the kidney is a rare histopathologic entity of unknown etiology. Patients may present with a renal mass or with urinary tract infection. The prognosis has been uniformly poor excepting in those patients with unilateral involvement treated by nephrectomy. A 31 year old woman presented with acute renal failure and pyelonephritis. Renal biopsy revealed an interstitial infiltrate of large histiocytic cells with intracytoplasmic PAS-positive granules and calcospherules, findings consistent with malacoplakia. Following antibiotic treatment and dialysis, the patient has had a gradual improvement in renal function.
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PMID:Malacoplakia of the kidney: apparent improvement following medical management. 63 Jul 42

The evaluation of the results of nearly 800 percutaneous renal biopsies, including biopsies in which insufficient renal tissue was obtained or histologic changes were non-specific, indicated that in 85% of the cases a positive diagnosis could be made. The liberal extension of the indication to percutaneous renal biopsy to include oligosymptomatic renal diseases, the nephrotic syndrome and acute renal failure often resulted in therapeutic and prognostic consequences. Renal biopsy does not facilitate the diagnosis of pyelonephritis. Uremia, severe atherosclerosis, small kidneys, advanced age and lack of cooperation are not contraindications to percutaneous renal biopsy nor do they increase its risk. Severe complications are extremely rare and are always secondary to retroperitoneal hemorrhage. Close observation and prompt treatment can always preclude a fatal outcome. Long-term complications are not to be expected. If the technique of percutaneous renal biopsy and its histologic evaluation are efficiently performed, further extension of the indications to biopsy could be medically sanctioned.
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PMID:[Percutaneous kidney biopsy. Evaluation of a diagnostic method]. 71 Oct 98

The kidneys of 18 autopsy cases of myelomonocytic leukemia (MML) were examined for MML-specific features. Nine cases of chronic lymphocytic leukemia (CLL) served as controls. The kidneys of the cases of MML showed macroscopically detectable signs of hemorrhagic diathesis and secondary uric acid diathesis more often than those of CLL. In the MML group most of the kidneys weighed more than the normal average for the corresponding age group, but the average renal weights for the 2 groups were about the same. Renal weight and grade of leukemic infiltration, particularly in MML, revealed no significant positive correlation. In most of the cases of MML there were unevenly distributed poorly defined leukemic, infiltrates in the renal cortex and medulla. The histology resembled that of pyelonephritis. In CLL, on the other hand, the leukemic infiltrates were usually sharply defined and localized in foci in the outer cortex and the corticomedullary border region. Renal dysfunction in cases of MML has been attributed by others to hyperlysozymemia. It was found occasionally but there was no MML-typical morphological substrate in our material. Hyaline droplet change of the tubular epithelium was more frequent and more pronounced in MML than in CLL. However, we also determined that it was nonspecific and that it was not a parameter of cell damage. Tubular hyaline droplet change and the morphological criteria of acute renal failure were not positively correlated with the degree of leukemic infiltration of the kidneys or with the leukemic proliferation as a whole. Instead, they were considered to be signs and symptoms of accompanying or secondary diseases which complicated the leukemia.
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PMID:Pathoanatomical features of the kidney in myelomonocytic and chronic lymphocytic leukemia. 81 Sep 55

We report a case of renal cortical microabscesses which presented as oliguric acute renal failure. Prior to the biopsy the patient was suspected of having acute pyelonephritis with acute tubular necrosis. Biopsy was performed to rule out rapidly progressive glomerulonephritis as a cause of his renal failure. To our surprise, we found multiple small microabscesses in the renal cortiex. Renal cortical microabscesses should be considered as a reversible acute renal failure.
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PMID:Renal cortical microabscesses as cause of reversible acute renal failure. 84 81

In 6 of 24 courses of a disease a nephrotic syndrome appeared under the application of penicillamine. An acute renal failure with exitus letalis developed under the penicillamine therapy of a scleroderma. In the treatment of a mercurial poisoning by penicillamine the nephrotic syndrome increased to a proteinuria of 50 g/24 hours which receded after discontinuation of the remedy. In one group of patients with chronic pyelonephritis could be demonstrated that penicillamine in a primarily damaged kidney must not lead to a secondary glomerular lesion. These findings led to the conclusion that in the appearance of a proteinuria under penicillamine a strong observation of the renal function is necessary, if a continution of the therapy is given from vital indication.
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PMID:[Penicillamine-induced glomerulonephritis]. 84 41

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


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