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)

The morphological variations of thyroid-like lesions in the kidney in 15 cases with chronic destructive interstitial nephritis as the basic alteration were examined with light microscopy and immunohistological methods. Reflux pyelonephritis was present in some cases. Thyroid-like lesions can develop at any age. "Mature" thyroid-like lesions possess large follicular structures and solid tubular epithelial cell complexes, whereas the follicular structures in "young" thyroid-like lesions are small. The hyaline casts are Tamm-Horsfall protein positive in between one- and two-thirds of the follicles. IgA is present in all follicular lumina. The thyroid-like lesions are the result of a regenerative process. They develop after subtotal parenchymal destruction of remaining tubular epithelial cells from the ascending limb of the loop of Henle, the distal convoluted tubules and the collecting ducts. They are pathognomonic for healed destructive bacterial interstitial nephritis, but can also be observed in analgesic nephropathy, hydronephrosis, and nephronophthisis when these basic diseases are preceded by pyelonephritis.
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PMID:A contribution to the morphology and pathogenesis of thyroid-like lesions in the kidney. 685 20

A case of malakoplakia of the kidney is presented. Purified plasma membranes from the malakoplakia lesions stimulate blast transformation of the patient's autologous lymphocytes indicating the persistence of bacterial antigens which stimulate primarily thymus-derived lymphocytes. The skin test immunologic competence of the patient and the peripheral blood monocyte chemotactic response were normal. The pathologic findings and these immunologic studies are discussed in relation to xanthogranulomatous pyelonephritis and megalocytic interstitial nephritis and the pathogenesis of this disease.
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PMID:Pathologic and immunologic considerations in malakoplakia. 696 87

There are many causes of interstitial nephritis other than pyelonephritis. The term interstitial nephritis does not connote a single etiologic or pathogenetic mechanism; it rather arbitrarily places together a wider variety of renal diseases that have a predilection for early and major involvement of the renal interstitium. The prototype of acute interstitial nephritis is acute pyelonephritis. In addition, there is a drug-related acute interstitial disease that is probably of immunological nature and usually reverses with discontinuance of the offending drug. Chronic interstitial nephritis includes many diverse illnesses. Nonobstructive pyelonephritis occurs but its prevalence is debated. Analgesic abuse nephropathy is not rare and is potentially reversible. Papillary necrosis has many causes and a wide spectrum of clinical presentations. Heavy metals, such as lead, cause interstitial nephritis. Balkan nephropathy occurs in an endemic area and although not bacterial in origin is of unknown cause.
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PMID:Interstitial nephritis. 700 50

Chronic renal failure associated with hypercalcemia and hypophosphatemia was diagnosed in 6 horses. The renal lesions in 5 of the horses were classified as chronic glomerulonephritis and in the sixth, as chronic interstitial nephritis/pyelonephritis. There was no evidence of primary hyperparathyroidism or pseudohyperparathyroidism, thus suggesting that hypercalcemia associated with advanced renal failure in horses is related to a unique role of the equine kidney in calcium homeostasis.
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PMID:Paradoxic hypercalcemia and hypophosphatemia associated with chronic renal failure in horses. 706 1

Light-microscopic and ultrastructural examinations of megalocytic interstitial nephritis, xanthogranulomatous pyelonephritis, and malakoplakia of the kidney were compared. The cases of megalocytic interstitial nephritis and xanthogranulomatous pyelonephritis represent the first reported electron-microscopic studies on human kidney of these diseases. The study confirmed the presence of a polymorphous cellular infiltrate with predominate histiocytes containing crystalloid material in the case of megalocytic interstitial nephritis; a polymorphous cellular infiltrate with histiocytes predominating in the case of xanthogranulomatous pyelonephritis; and macrophages containing Michaelis-Gutmann bodies in the case of malakoplakia. The characteristic sites of involvement within the kidney by each of the three lesions are discussed. It is believed that the lesions are distinct entities, but related to one another, and represent varied and unusual host responses to inflammation.
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PMID:Megalocytic interstitial nephritis, xanthogranulomatous pyelonephritis, and malakoplakia. An ultrastructural comparison. 721 55

The diagnostic work-up of the urologic patient must be tailored to the presenting symptom complex, carefully selecting from the many modilities available, those most likely to establish the diagnosis and extent of the suspected lesions. Intravenous urography is the most rewarding initial procedure for many presenting symptoms, including suspected masses, pyuria, hematuria, and flank pain. Nuclear imaging is particularly effective in differentiating renal lobulations from true masses, in demonstrating parenchymal scarring in chronic pyelonephritis when the IVP is equivocal, and in assessing the decrease in perfusion and function in obstructive nephropathy when the IVP is indeterminate. It is the preferred procedure for acute renal infarction and acute tubular necrosis and has a greater sensitivity of detection for renal trauma than the IVP. Gallium-67 renal imaging appear helpful in the detection of occult pyelonephritis or interstitial nephritis. However, it cannot differentiate focal acute pyelonephritis from abscess or abscess from neoplasm. Ultrasoneography is the initial procedure of choice in the differentiation of cystic from solid renal masses and in anuria or oliguria. When a kidney fails to visualize by IVP or nuclear imaging, it can confirm or rule out obstruction. In upper tract infections, it may demonstrate renal or perirenal abscess. Although retrograde pyelography is performed less frequently in recent years, it remains extremely useful in confirming and relieving obstructive uropathy and in delineating tumors of the collecting system. Computed tomography effectively demonstrates hydronephrosis, renal abscess, tumors, and cysts and retroperitoneal involvement. More experience is needed to judge the efficiency of "dynamic" CT for the quantification of renal function. Renal angiography remains invaluable as a secondary procedure (as opposed to initial screening) in renal trauma, vascular anomalies, and in renal tumors to delineate the anatomy of the arterial supply and possible renal vein involvement.
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PMID:Medical imaging of renal diseases-suggested indication for different modalities. 724 59

In acute obstructive pyelonephritis, obstruction is the most dangerous factor. This danger is for the kidney where pyelocanalicular reflux is responsible for interstitial nephritis and pyonephrosis. A danger also for the life of the patient, since pyelo-venous and pyelo-lymphatic reflux are responsible for septicaemia. During a short period of two years, the authors have been able, thanks to cooperation of all physicians working in their teaching hospital group, to collect 89 cases of acute obstructive pyelonephritis, 29 of them with concomitant septicaemia. By virtue of their resolutely aggressive attitude, relief of urinary tract obstruction was obtained on average only 15 hours after hospitalisation of the patients. Fifty nine of these patients had lithiasis. Despite such rapid care, it should be emphasised that 11 patients died. This reflects the gravity of such retention of infected urine proximal to the upper excretory tract. This gravity is considerably multiplied by the onset of septicaemia. Among the 11 deaths, 9 were in the group of 29 patients with septicaemia, whilst there were only 2 deaths amongst the group of 60 patients with no clinical evidence of septicaemia. In the opinion of the authors, treatment should, whenever possible, include elimination of the obstruction and thorough urinary drainage. In the presence of any apparently isolated septicaemia, it is essential to seek a renal cause. The rapidity of the elimination of obstruction of the urinary tract is the essential step in treatment, antibiotics being only an adjuvant.
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PMID:[Intra-renal purulent retention. Review of two years' experience (author's transl)]. 727 1

This study was carried out to determine the prevalence of hepatitis C virus (HCV) antibodies and the epidemiologic factors associated with HCV infection in patients with chronic renal failure before the onset of ESRD. Sex, age, type of renal disease, level of renal function, and history of blood transfusions and invasive procedures were analyzed in 226 patients with renal disease, compared with a population of 1,244 normal subjects and 124 patients with impaired immunity (patients having autoimmune diseases and receiving chemotherapy treatment). Eighteen seropositive patients with renal disease (prevalence, 7.9%) were found, which was significantly higher than the prevalence in the normal population (1.03% in blood donors, 0.98% in pregnant women; P < 0.001, chi 2). There was no significant association of sex, number of blood transfusions, or history of invasive procedures with the presence of HCV antibodies. The prevalence of HCV antibodies was higher (16.6%) in patients with glomerulonephritis compared with patients diagnosed with interstitial nephritis, pyelonephritis, nephrosclerosis, diabetes mellitus, polycystic kidney, and miscellaneous renal diseases (P < 0.01, chi 2). There was a higher prevalence of HCV antibodies in patients with creatinine clearance lower than 30 mL/min (13%) compared with patients with creatinine clearance higher than 30 mL/min (2.7%) (P < 0.01, chi 2). These data suggest that HCV infection may be associated with the pathogenesis of glomerulonephritis. Alternatively, glomerulonephritis or severe renal insufficiency may increase the likelihood of HCV infection.
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PMID:Epidemiology of hepatitis C virus infection in patients with renal disease. 752 63

Catheter-associated bacteriuria is the most common infection acquired in long-term care facilities. Complications include fever, acute pyelonephritis, bacteremia, catheter obstruction, urinary stones, chronic interstitial nephritis, renal failure, and death. The closed-catheter system has been the only innovation in this traditional method of care that has led to prevention of bacteriuria. Antimicrobial agents rarely are indicated to prevent or treat bacteriuria in long-term catheterized patients, except for those with symptomatic infection. Alternative devices are available and often may be preferable to the indwelling urethral catheter. These patients and their reservoirs of bacteriuric organisms are sources of nosocomial outbreaks. Such outbreaks can be prevented and controlled with attention to catheter hygiene, prevention of patient-to-patient transmission on the hands of caregivers, and possibly use of antimicrobials to diminish bacterial concentrations in the urine.
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PMID:Catheter-associated bacteriuria in long-term care facilities. 798 52

Virtually all diseases affecting the native kidney recur in the kidney transplant with the exception of Alport syndrome, polycystic kidney disease, hypertension, chronic pyelonephritis, and chronic interstitial nephritis. Fortunately, in the majority of patients, recurrence of the original disease has minimal clinical impact, with only approximately 5% of all graft loss occurring as a result of recurrent disease. The primary renal diseases that commonly recur include membranoproliferative glomerulonephritis type II, IgA nephropathy, and focal and segmental glomerular sclerosis. The most common systemic disease that recurs is diabetic nephropathy. Living-related transplantation should be used with caution in patients with the hemolytic uremic syndrome, recurrent focal and segmental glomerular sclerosis, and membraneous glomerulonephritis. Fabry disease and primary hyperoxaluria type I are no longer absolute contraindications to kidney transplantation.
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PMID:Recurrent diseases in the kidney transplant. 802 19


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