Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two identical twins suffering from end stage renal failure due to chronic pyelonephritis received cadaver renal allografts from one donor. Immune status was measured in both by in vitro responses to vegetable mitogens and by reactivity in mixed lymphocyte culture with a random volunteer. Both patients underwent rejection episodes at different times; these were of differing severity. Reactivity to PHA and in MLC was minimal during rejection and increased following recovery in spite of continued high levels of immunosuppression. In contrast, reactivity to pokeweed mitogen and concanavalin A increased at the time of rejection and fell with recovery. The changes seen in the twins, while qualitatively similar, differed in magnitude and timing. It is concluded that environmental factors as well as histocompatibility play a part in influencing immune responsiveness, and that studies of immune responsiveness should be interpreted with caution in the management of renal allograft recipients.
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PMID:Immunological responses in identical twins with renal transplants from a common donor. 13 25

A 31-year-old woman developed multiple synchronous in situ carcinomas of the cervix uteri, vulva and perineal skin, six years after successful renal transplantation for chronic renal failure due to chronic pyelonephritis. During this time she had been continuously treated with immunosuppressive drugs (azathioprine and prednisolone). The lesions were treated by local excision and there was no evidence of recurrence nearly two years after the primary treatment. The case history is compared to others recently described and highlights the risk of epithelial as well as lymphomatous malignancies in renal transplant recipients.
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PMID:Simultaneous in situ carcinoma of the cervix, vulva and perineum after immunosuppressive therapy for renal transplantation. 32 Oct 3

Urinary tract infection is a common disorder of childhood which frequently causes no symptoms. Bacteriological proof should always be obtained because symptoms may be misleading. The diagnosis of a first infection should lead to radiological investigation. Routine tests to localize the site of infection are not yet available but their use in the future in conjunction with increased awareness of the factors leading to pyelonephritis should help to identify children at risk from renal damage. Two thirds of children with urinary infections have normal lower urinary tracts or only minor abnormalities and may be treated for symptomatic infections with intermittent antibiotics. The risk of renal damage from infection is virtually confined to the remainder: children with obstructive uropathy, preschool children with severe vesicoureteric reflux, and those with pre-existing chronic renal failure. It remains to be shown by controlled therapeutic trials whether renal scarring can be prevented by long-term chemoprophylaxis or surgical correction of reflux. Until the results of current trails are known, children with reflux or impaired renal function should be treated medically in the first instance and screening of healthy children for covert bacteriuria should probably be confined to the preschool age-group.
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PMID:The management of urinary infections in children. 32 22

The surgical riks were analyzed in 305 patients with end stage renal failure who underwent bilateral nephrectomy through midabdominal approach in preparation for kidney transplantation. The over-all mortality rate was 3.6 per cent. Age was the most significant risk factor in the mortality. Patients less than fifty years of age had an operative mortality rate of 3.1 per cent while those more than fifty years had an operative mortality of 11.1 per cent. Other pertinent risk factors were preoperative complications of renal failure and additional surgical procedures at the time of bilateral nephrectomy. The leading causes of death were those of cardiovascular complications and infection. The morbidity rate was 58.7 per cent being major in 18 per cent and minor in 40.7 per cent. Bilateral nephrectomy is recommended selectively in patients with (1) chronic pyelonephritis with urinary tract infection, (2) major vesicoureteral reflux, (3) immunologically active glomerulonephritis, (4) severe hypertension uncontrollable by adequate dialysis, and (5) extremely large or infected polycystic kidneys.
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PMID:Mortality and morbidity in pretransplant bilateral nephrectomy: analysis of 305 cases. 35 90

The clinical, pathological and radiographic findings of 135 cases of xanthogranulomatous pyelonephritis have been reviewed. It is a form of renal suppuration and obstruction most commonly seen in middle aged women although all ages and both sexes may be affected. There is no race predilection. Gram-negative organisms are usually present and bilateral involvement has not been reported. The most common offending organism is Proteus mirabilis. Hepatic dysfunction is seen and appears to normalize with removal of the XGP process. Preoperative angiography may increase the accuracy of differentiating this disorder from hypernephroma and may aid the surgeon in planning his approach to kidney resection depending upon the staging of XGP. Chronic renal failure is not usually a feature of XGP and nephrectomy is curative without any incidence of recurrence.
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PMID:Xanthogranulomatous pyelonephritis (XGP): a local disease with systemic manifestations. Report of 23 patients and review of the literature. 43 2

Four families with a variety of renal tract abnormalities including reflux, cortical scars, atrophy and duplex systems are described. Cystometrograms in eight with reflux and scars did not show any evidence of outflow high pressure systems. Tissue typing was carried out in a proportion of affected and unaffected family members, and with the addition of another reported family that had been tissue typed, showed an increase in A9, B8 and homozygosity in the families with these abnormalities. A retrospective survey of transplanted patients with tissue type A9 showed a higher prevalence of pyelonephritis and associated abnormalities than other diseases leading to end stage renal failure.
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PMID:Renal reflux, scarring, cystometrography and tissue types. 54 98

A urographic pattern of renal clubbing and scarring was found in 182 scarred kidneys of 110 adult patients. Homolateral vesicoureteric reflux was demonstrated by reliable techniques in 90/135 scarred kidneys. Urinary tract infections occurred in 75 patients. Hypertension developed in 20 patients with normal renal function and was not related to the extent of scarring. Chronic renal failure occurred in 30 patients with diffuse bilateral scarring. Four patients showed histologic changes of chronic pyelonephritis. Two hypertensive patients had a typical histologic pattern of Ask-Upmark kidney (segmental hypoplasia). Development of renal scars in adulthood was demonstrated in 2 cases.
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PMID:Renal clubbing and scarring in adults: a retrospective study of 110 cases. 55 64

Study of case-notes and autopsy reports of patients with renal disease suggests that analgesic nephropathy is responsible for at least 12 per cent of cases of chronic renal failure, Between 1970 and 1975 eight new cases of analgesic nephropathy were seen annually in a population of three-quarters of a million. This is equivalent to an incidence of 490 new cases per year in England and Wales. Fifty-five patients with analgesic nephropathy were followed from one to 84 months for a total of 190 patient years. Changes in renal function were correlated with bacteriuria, hypertension and analgesic consumption. One-third of the cases had been misdiagnosed and analgesic abuse was only revealed by thorough examination of case-notes and autopsy records, together with careful questioning of patients and relatives. A number of cases had been classified as chronic pyelonephritis. The calculated survival rate at five years was 44 per cent. Mortality was related to the level of analgesic consumption and the degree of renal failure at the time of diagnosis. The prognosis was poor if serum creatinine at presentation was greater than 400 mumol/l. There was no significant correlation between deterioration in renal function and bacteriuria or hypertension. Forty-two per cent of the patients were taking analgesics for arthritis; 27 per cent had rheumatoid arthritis. Most had been taking large quantities of analgesic mixtures containing phenacetin. Renal papillary necrosis was present in only 26 per cent on intravenous urography but was found in all those examined at autopsy. Twenty thousand, two hundred and twenty-nine autopsy reports were examined for the presence of renal disease. Renal papillary necrosis was found in 0.41 per cent, and could be attributed to analgesic nephropathy in 24 per cent. In patients under 65 years of age analgesic nephropathy appeared to be a more frequent cause of death than chronic pyelonephritis. The report indicates the need for careful enquiry about analgesic consumption in all patients with renal disease, and emphasizes the importance of early diagnosis and cessation of analgesics in suspected cases of analgesic nephropathy.
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PMID:Analgesic nephropathy: an important cause of chronic renal failure. 67 50

In patients with chronic renal failure due to glomerulonephritis, pyelonephritis or polycystic kidneys the urinary clearance of free chloramphenicol (C(CHL)) was depressed proportionally to GFR (C(In)). The ordinate intercept of the regression line of C(CHL) on C(In), however, consistently was positive (+3 to +5 ml/min). The fractional excretion of chloramphenicol in renal failure increased from its normal value of 50 percent as an exponential function of the decrease of GFR, and as a linear function of the fractional excretion of water or of sodium. Dietary sodium restriction had no influence on C(CHL) in the patients, while water diuresis, in normal subjects, enhanced the urinary excretion of chloramphenicol. The data suggest that chloramphenicol is reabsorbed by back-diffusion and that increases of the rate of flow of urine and tubular fluid prevent back-diffusion.
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PMID:The effects of functional adaptation of residual nephrons on the urinary excretion of drugs. 73 57

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


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