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

The renal vascular response to graded doses of acetylcholine, dopamine and phentolamine, assessed by xenon washout and selective arteriography was used to define the relative contribution of fixed and reversible vascular abnormalities to increased renal vascular resistance in patients with essential or secondary hypertension. The increase in blood flow induced by acetylcholine and dopamine was blunted strikingly in patients with advanced nephrosclerosis, chronic pyelonephritis and polycystic kidney disease and was normal in the kidney contralateral to a significant renal artery stenosis. Conversely, the response to both was potentiated in 9 of 13 (69%) patients with mild essential hypertension. Equivalent potentiation of the response to acetylcholine was induced in normal subjects by increasing renal vascular tone pharmacologically with angiotensin. Phentolamine infused into the renal artery also increased renal blood flow significantly in 6 of 9 (67%) patients with mild essential hypertension, but in none of 15 normal subjects, over a dose reange that paralleled that for alpha-adrenergic blockade. Changes in the selective renal arteriogram were in excellent accord: potentiated response to acetylcholine, phentolamine or dopamine was associated with reversal of the small vessel abnormalities visualized in the arteriogram. The reduced blood flow response in advanced nephrosclerosis or parenchymal disease was associated with a reduced angiographic change during dilator infusion. The results suggest a quantitatively important, functional renal vascular abnormality--perhaps mediated by the sympathetic nervous system--in many patients with mild essential hypertension. Conversely the renal vascular abnormality associated with advanced nephrosclerosis or renal parenchymal disease is largely fixed and is probably due to organic changes.
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PMID:Renal vascular tone in essential and secondary hypertension: hemodynamic and angiographic responses to vasodilators. 23 62

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

Vesicoureteric reflux was found unexpectedly during routine investigations before renal transplantation in 12 patients with chronic glomerulonephritis and in one with hypertensive nephrosclerosis. They had all received long term hemodialysis treatment for nine to 106 months (mean 47 months) at the time of micturating cystourethrography (MCU). Four of the patients had previously had a normal MCU indicating that reflux developed after onset of end stage renal failure. The cause of reflux is obscure. It was not related directly to defunctioning of the urinary tract as several patients had daily urine volumes in excess of 300 ml. Infection, another potential cause, was uncommon in patients with reflux. Histology of the excised ureters showed abnormality in most cases with loss of the normal mucosal folds and submucosal cellular infiltrate and fibrosis. These changes are also unexplained. In this group of patients nephroureterectomy for reflux in anticipation of renal transplantation was associated with considerable morbidity. A minimal estimate of the incidence of reflux in chronic glomerulonephritis was 11%. We suggest that in this group and in patients with renal diseases other than chronic pyelonephritis reflux alone does not constitute sufficient indication for nephroureterectomy before transplantation to warrant the risks of major surgery.
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PMID:The significance of vesicoureteric reflux in non-pyelonephritic patients supported by long term hemodialysis. 89 Oct 48

Whether chronic interstitial nephritis (pyelonephritis) mainly results from kidney infection is widely debated. We studies 101 patients with interstitial nephritis, selected from 320 patients with newly diagnosed chronic renal disease, for frequency of etiological factors. Eleven had no etiologic factor(s) identified; 89 had clearcut factor(s): anatomic abnormalities 31, analgesic abuse 20, hyperuricemia 11, nephrosclerosis 10, stones 9, sickle cell disease1, tuberculosis 1, multiple causes7. Bacterial infection (present in 27%) was found only with another preceding primary cause of renal damage. Analgesic abusers frequently denied drug ingestion; 15% had urinary tract infection and 20% classical papillary necrosis. Two had family histories of analgesic abuse with nephropathy. We conclude that interstitial nephritis is a common form of chronic renal disease, is seldom idiopathic, rarely results from bacterial infection alone in adults, and frequently results from analgesic abuse in the United States.
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PMID:Chronic interstitial nephritis: etiologic factors. 111 62

Following acceptance to a renal dialysis therapy program, 13 patients underwent serial examination of the serum complement system for periods of 6 to 12 months. Serum levels of C3 and C4 were examined at monthly intervals before the first dialysis of each month. The patients suffered from various primary renal diseases, including glomerulonephritis, obstructive uropathy with chronic pyelonephritis, nephrosclerosis and chronic nephropathy of undetermined nature. Levels of serum C3 were depressed at some time during the study period in all patients. Serum C4 levels were normal. The depression of serum C3 levels was significant and prolonged in nine patients. There seemed to be no relationship between the nature of the basic disease and the depression of serum C3 levels. Caution should be exercised in attributing depressed C3 levels to a particular type of underlying renal disease in patients on renal dialysis.
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PMID:Levels of serum complement components in patients undergoing renal dialysis. 114 Sep 50

Fourteen patients with severe hypertension have been given i.v. diazoxide in a dosage of 5 mg/kg b.wt. The material comprised 2 patients with malignant nephrosclerosis, 4 with chronic nephropathy and severe reduction of renal function, 1 patient with chronic pyelonephritis, 1 with renovascular hypertension and 6 patients with essential hypertension and in malignant phase. All patients attained a controllable blood pressure. Eight patients remaining needed only one injection, while the remaining patients required 2-5 injections, and concomitant furosemide therapy. The retinopathy improved in most patients and renal function was unchanged in the azotemic patients. No serious adverse effects were seen, except one hypotensive episode. Diazoxide is easy to handle, dosage can be predetermined, monitoring is simple and we find diazoxide to be a valuable drug in severe hypertension.
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PMID:Diazoxide in the management of severe hypertension. 119 11

With the aim of determining the relative prevalence of the diseases underlying chronic renal failure (CRF) in a large homogeneous black tropical population, the autopsy records of the Obafemi Awolowo University Teaching Hospital over a four year period were studied. Out of a total of 702 cases coming to autopsy during this period, 66 (9.4%) died as a result of CRF. The highest number of cases of CRF fell within the 31-40 year age group with a male/female ratio of 1.28:1. Chronic glomerulonephritis was responsible for 40.9% of cases, malignant nephrosclerosis 16.6%, benign nephrosclerosis 7.6% while endstage renal disease (ESRD) was responsible for 15.4%. A miscellaneous group of diseases was responsible for 19.7%, about half of which was due to chronic pyelonephritis. Rarer causes of CRF were diabetic nephropathy, multiple myeloma, systemic lupus erythematosus and analgesic nephropathy.
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PMID:The pathological basis of chronic renal failure in Nigerians. An autopsy study. 149 21

A prospective study involving 1,980 patients aimed at defining the pathological basis of endstage (chronic) renal failure in Nigerians was carried out over a six-year period in Benin City, Nigeria. Using information derived from intravenous pyelography, ultrasonography, renal biopsies and autopsies, it was found that 43% of cases of chronic renal failure were due to hypertensive nephrosclerosis, 33% due to obstructive uropathy and 18% due to chronic glomerulonephritis. Chronic atrophic pyelonephritis was a rare finding. The frequency and severity of essential hypertension in Nigerians and their propensity to go into renal failure are similar to what obtains in American blacks. In a society which cannot afford regular dialysis and transplant facilities, there is need for early detection and adequate treatment of essential hypertension.
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PMID:The pathological basis of endstage renal disease in Nigerians: experience from Benin City. 227 31

150 patients dying from renal cell carcinoma are studied in order to reveal the background disease, incidence and character of the nephrosclerosis and the possible morphogenetic link between nephrosclerosis and carcinoma. Renal cell carcinoma is found to develop in 82.7% of cases in the kidneys with signs of nephrosclerosis. The diffuse nephrosclerosis developing in connection with the hypertension disease, atherosclerosis, diabetes mellitus, chronic pyelonephritis, nephrolithiasis is the most important. Proliferation of the canaliculi epithelium with the appearance of undifferentiated cells are regularly found in the nephrosclerotic areas. The disturbance of the epithelium differentiation is followed by the development of dysplasia the phenotypical variants of which are similar to those of renal cell carcinoma. Adenomas are found in 11.3% of cases of renal cell carcinoma which may originate from the adenomas developing against the background of nephrosclerosis.
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PMID:[Background and precancerous processes in renal cell carcinoma]. 280 41

Glomerulonephritis patients transplanted with cadaver kidneys had a significantly higher one-year graft survival when immunosuppressed with cyclosporin rather than standard therapy (80% versus 59%, p less than 10(-5]. For nephrosclerosis patients the corresponding rates were 70% and 59% (p greater than 0.05); and in those with antecedent diabetes mellitus, polycystic kidney, and pyelonephritis the differences were negligible. In glomerulonephritis patients, but not in the other groups, cyclosporin was additive to the effect of transfusions and of HLA-A, B and HLA-Dr matching.
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PMID:Preferential effectiveness of cyclosporin in patients receiving kidney transplants after glomerulonephritis. 285 55


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