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

The risks of acute pyelonephritis in infants concern microbial invasion and parenchymal damage. There is a high rate of septicemia and of urinary malformations in children under 1 yr of age; in addition, the kidney is a growing organ with a high risk of scarring. Such parenchymal injury may lead to arterial hypertension, and renal failure when bilateral. Vesicoureteric reflux must be evaluated by ultrasound and cystogram; long-term renal scarring needs to be assessed by scintigraphy or pyelography when children are 7 yr old. Short- and long-term risks could be limited by early intravenous biantibiotherapy.
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PMID:[Urinary tract infections in infants: medical management]. 166 85

The authors observed 812 patients with nephrolithiasis who underwent 876 sessions of shock-wave lithotripsy on Sonolith-3000 lithotriptor supplied with an ultrasonic system of the stone localization. The size of nephroliths ranged from 0.7 to 4.2 cm. Large-size nephroliths required repeated sessions and pretreatment establishment of the stent. The procedure proceeded without anesthesia. Subsequent renal colic was reported in 126 (15.5%), an exacerbation of pyelonephritis in 45 (5.5%), subcapsular hematoma in 4 (0.5%) of the patients. 790 patients showed clinical response (97.3%), with a complete destruction of the stone in 446 (54.9%) and partial one in 344 (42.4%) cases. 27 subjects were treated in outpatient setting. According to the authors, lithotripsy is contraindicated in urinary tract obstruction below the stone, renal failure, chronic pyelonephritis in the active phase of inflammation, marked impairment of cardiac rhythm.
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PMID:[Extracorporeal shockwave lithotripsy on the Sonolith-3000 apparatus]. 175 17

The severity of anemia in patients at different stages of the evolution of two tubulointerstitial nephropathies, Balkan endemic nephropathy and chronic pyelonephritis, was compared to clarify the previous observations that anemia appears earlier and is more severe in Balkan endemic nephropathy than in other renal diseases. The role of erythropoietin insufficiency as the cause of anemia in endemic nephropathy was studied as well. The severity of anemia increased with the impairment of renal function in endemic nephropathy and was similar to anemia in chronic pyelonephritis. However, in patients with endemic nephropathy at the initial stage of renal insufficiency significantly lower red cell concentrations were found compared with control subjects from the endemic region. In contrast, patients with pyelonephritis did not have decreased red cell concentrations at the early phase of their renal failure, suggesting that earlier appearance of anemia is characteristic for endemic nephropathy. To confirm this finding a study involving larger number of patients would be necessary. The serum erythropoietin levels, inappropriately low for the degree of anemia in patients with renal failure, were unrelated to the type of tubulointerstitial nephropathy.
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PMID:Anemia in Balkan endemic nephropathy. 176 34

196 cases with vesicoureteral reflux (VUR) from multiple centers were analysed to examine the relationship between VUR and reflux nephropathy. The high correlation (p less than 0.01) was observed between reflux and renal scarring. Even in cases in whom VUR was not demonstrated at the time of testing, renal scarring of various degrees was recognized, suggesting either co-existed hypoplastic kidney or pre-existed infection. The renal scarring, but not VUR, had a significant correlation with proteinuria and hypertension. Retrospective analysis shows that the surgical treatment was closely related to the degree of renal scarring but not to the degree of reflux. Renal scarring progressed even when reflux did not become worse, which is probably accounted for by the presence of pyelonephritis. Although frequency of pyelonephritis decreased significantly (p less than 0.01) from 0.60 +/- 0.89 to 0.084 +/- 0.305 times/patient. year after anti-reflux surgery, renal scarring progressed in 13 kidneys (5.8%). Seven of the 13 kidneys became worse due to the surgical failure. The scar progression was recognized in the remaining six kidneys (three patients) including adult cases despite the successful surgical correction of reflux. Our study points to the urged need for a prospective clinical trial designed for the study of the pathological and clinical background of progressive renal failure in VUR.
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PMID:[Vesicoureteral reflux and renal scarring. Report of cooperative study of "Progressive renal disease" of Ministry of Health and Welfare]. 187 71

Out of 432 patients placed on the treatment with hemodialysis (HD) for terminal renal failure (TRF) at the All-Union Nephrologic Center from January 1, 1978 to December 31, 1987, 17 patients manifested partial recovery of renal function, which enabled dialysis treatment to be discontinued for a time. Among the 17 patients with noticeable improvement of renal function, 8 presented with lupoid rapid-progressing glomerulonephritis (RPGN), 2 with RPGN associated with hemorrhagic vasculitis, 1 with idiopathic RPGN, 4 with chronic glomerulonephritis (CGN), 1 with chronic pyelonephritis, and 1 with polycystic kidneys. In 11 patients with RPGN, the rate of renal failure progression, expressed by the regression coefficient, was much higher among those in whom HD treatment was discontinued that in the group of patients without renal function recovery. In the 4 patients with CGN, renal function was recovered after the correction of marked disorders of purine metabolism, whereas in the 1 patient with chronic pyelonephritis and in the 1 with polycystic kidneys after urinary infection elimination. According to the ultrasonography data, out of the 17 patients with partial recovery of renal function, the size of the kidneys turned out normal in 14 patients.
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PMID:[The partial recovery of kidney function in chronic uremia patients during hemodialysis treatment]. 194 49

From 1970 to 1987, 32 male and female patients with the prune belly syndrome were evaluated. Of these patients 11 died as neonates or infants, and autopsy in 9 revealed 6 cases of diffuse and severe renal dysplasia. In the 10 surviving patients renal insufficiency developed and a total of 13 nephrectomies and renal biopsies were performed. Renal dysplasia was noted in 9 specimens, but unlike the infant kidneys, the dysplastic changes involved less than 25% of the parenchyma in most cases. Renal failure in these 10 patients was caused by pyelonephritis and obstruction. In our estimation perinatal renal failure in patients with the prune belly syndrome results from renal dysplasia caused by an in utero insult, while in older patients pyelonephritis and obstruction are the causes. Careful treatment of reflux, obstruction and urinary tract infections may decrease the incidence of renal failure in patients with the prune belly syndrome who survive infancy.
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PMID:Development of renal failure in children with the prune belly syndrome. 201 82

Forty patients with end-stage renal failure, who had undergone simultaneous bilateral native nephrectomy before a subsequent renal transplant operation, were reviewed with particular reference to the indications and surgical approach for bilateral nephrectomy and to the complications of the procedure. The main indications for bilateral nephrectomy are hypertension resistant to medical therapy, persistent symptomatic renal infection, severe renal protein loss and occasionally polycystic kidneys or bilateral renal tumours. In this consecutive series of 40 patients both kidneys were removed because of chronic pyelonephritis with reflux (n = 28), glomerulonephritis with reflux (n = 9) and uncontrolled hypertension (n = 3). Surgical morbidity was less in patients who had bilateral nephrectomy performed through bilateral vertical lumbotomy incisions. There was no surgical mortality.
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PMID:Bilateral nephrectomy before transplantation: indications, surgical approach, morbidity and mortality. 202 44

An analysis of 10,159 normal spontaneous vaginal deliveries was performed to examine racial differences in mean birth weight of infants whose mothers were without antepartum or intrapartum medical complications of pregnancy. The study was limited to black and white infants of low-income mothers who were inborn, singleton, and weighed greater than or equal to 500 gm at birth. High-risk maternal transfer patients and patients with hypertension, toxemia, bacteriuria, pyelonephritis, renal failure, diabetes, anemia, polyhydramnios, oligohydramnios, prolapsed cord, vaginal bleeding, placenta previa, abruptio placentae, prolonged rupture of membranes, maternal fever on admission, amnionitis, sexually transmitted diseases, or fewer than five prenatal care visits were excluded. When statistically significant differences in demographic characteristics were controlled, black infants had an average birth weight 181 gm less than that of white infants.
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PMID:Birth weights of infants of black and white mothers without pregnancy complications. 203 72

Fifty women with pyelonephritic renal scarring were prospectively followed for five years and the changes in renal function were related to blood pressure control, plasma renin activity, urinary albumin excretion and the incidence of urinary tract infections (UTI). Five patients (10%) developed end stage renal disease. All these patients had bilateral disease, proteinuria and anti-hypertensive treatment at presentation. The mean +/- SD glomerular filtration rate (GFR) of all patients with renal scarring was 74 +/- 27 ml/min x 1.73 m2 at presentation which was significantly lower than the GFR in 55 patients with a recent episode of acute pyelonephritis (p less than 0.001) and 10 healthy controls (p less than 0.001). GFR and age corrected GFR decreased significantly during follow-up (p less than 0.001) and p less than 0.02 respectively). The decrease in GFR was significantly higher in patients with bilateral scarring, in patients on blood pressure treatment and in patients with an episode of symptomatic UTI during follow-up. Eight patients (16%) had antihypertensive treatment at presentation and another 11 patients (26%), of whom 10 had bilateral scarring, developed hypertension (greater than 140/90 mmHg) during follow-up. Seventy-five per cent of all patients had symptomatic UTI and 40% had an episode of acute pyelonephritis during follow-up. In conclusion, patients with pyelonephritic scarring have a high incidence of UTI and are at high risk of developing renal failure and hypertension. It is essential that recurrent episodes of symptomatic UTI are treated promptly and that blood pressure is monitored carefully in these patients.
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PMID:A five-year prospective follow-up of women with non-obstructive pyelonephritic renal scarring. 204 74

Twelve cases of xanthogranulomatous pyelonephritis (XGPN) complicated by urolithiasis in upper tract were presented in this study. Fifty-four cases of XGPN, including 12 cases of this study, reported in China were clinically analysed in the article. All cases were with one suffered kidney, 57.4% of the cases had both XGPN and urolithiasis, 27.8% had the history of urinary infections, 99.0% had function-impaired kidney or renal failure. XGPN was frequently mis-diagnosed as renal cancer, renal tuberculosis and renal abscess etc. The diagnosis and treatment of XGPN are discussed.
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PMID:[Xanthogranulomatous pyelonephritis complicated by urolithiasis in upper urinary tract]. 226 45


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