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

Chronic pyelonephritis is the most common renal disease of old age. The number of registered cases of this disease is below current diagnostic possibilities, since chronic urinary tract infection and chronic pyelonephritis still too rarely play a role in differential diagnostic considerations. Because of the insecure reliability of anamnesis and complaints reported by the patients the uroscopic examination of the urine and bacteriologic diagnostics are of special importance. These examinations can be carried out in general medical practice and they will lead to a diagnosis of chronic pyelonephritis with relatively high probability.
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PMID:[Chronic pyelonephritis of older and old patients--a diagnostic problem in general medical practice (author's transl)]. 4 16

Kidneys obtained by nephrectomy from 85 patients with chronic nephropathy were examined by bacterial culture and by immunofluorescence for a content of E. coli antigen. A panel of 10 E. coli 0-antisera, representing the strains most commonly causing urinary tract infection, and antiserum against common enterobacterial antigen (CA), were used. Bacteria could be cultured from the nephrectomy specimens in 24 cases, mainly in cases of obstructive chronic pyelonephritis, analgesic nephropathy and congenital renal disease. By immunofluorescence, type-specific 0-antigen was found in whole bacteria and amorphously in macrophages, CA only in whole bacteria. Whole bacteria could be visualized in 12 cases, macrophages only in two cases. Amorphous bacterial antigen was no observed outside phagocytizing cells. On the basis of these results, it seems unlikely that progression of the renal lesions in chronic renal disease is due to persistant bacterial antigen in the absence of viable bacteria. Chronic pyelonephritis, defined as an interstitial nephritis due to the effects of bacterial infection in the renal parenchyma and pelvic mucosa, appears always to be a secondary manifestation following obstruction or primary renal disease, such as analgesic nephropathy or congenital renal disease.
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PMID:Bacteria and bacterial antigen in the kidney in human chronic renal disease. Bacteriological and immunofluorescence Studies. 34 94

The frequency of chronic pyelonephritis is often overestimated. Chronic pyelonephritis is probably always a secondary disease in cases with obstructive changes in the ureters or other primary renal damage. The influence of chronic infection on the progression of renal insufficiency is still not well understood today. Underlying disease and infection should always be taken into consideration in the treatment of chronic pyelonephritis.
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PMID:[Chronic pyelonephritis in adults (author's transl)]. 55 Oct 81

The excretory urograms performed on 1716 children and 3480 adults have been examined to find the incidence and complications of renal duplication. Ninety-five patients with duplication were found, unilateral in 79 and bilateral in 16 patients. It was equally common on each side and twice as common in females as in males. Non-duplex kidneys had a mean of 9.4 calyces and duplex kidneys had a mean 3.7 upper and 7-6 calyces in lower moieties. In patients without renal disease and with unilateral duplication the two kidneys were equal in size in 39%, and the duplex was smaller in 10%. Twenty-seven per cent of the duplex kidneys examined showed evidence of disease compared to 3% of the non-duplex kidneys-a significant difference (P less than 0-001). Saddle reflux is the only abnormality unique to duplication and was seen in one patient. Extravesical ectopic ureter and ureterocoeles are known to be associated with renal duplication, but in this series ureterocoeles were found only on the non-duplex side. The duplex kidney in children is more susceptible to reflux than is the non-duplex kidney, and this leads to both ureteric and pelvi-calyceal dilation, and to chronic pyelonephritis in the duplex side in those children who develop urinary tract infections. Chronic pyelonephritis was found in 22% of patients under 15, significantly more often than in adults (P less than 0-001), although the incidence of duplication was unchanged. It is concluded that there is no real increase in the number of children with duplex kidneys having urinary tract infections, and the vast majority of duplex kidneys do not become diseased.
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PMID:The incidence and importance of renal duplication. 100 Aug 96

Chronic pyelonephritis, especially that caused by the most common invader E. coli, corresponding satisfactorily to the pathophysiology of the human disease is difficult to reproduce. We have developed a pattern of infection with which we succeeded reliably in producing a chronic E. coli pyelonephritis. This was achieved by inserting a plastic catheter into the renal pelvis. A suspension of E. coli was injected via the catheter into the renal pelvis of 32 rabbits. This pattern of infection takes a chronic progressive course and, in all cases, results in typical macroscopic and histological changes in the kidney. The bacterial excretion in the urine remains unchanged over a period of months. With the experimental procedure described, the pathogenesis and pathophysiology of chronic E. coli pyelonephritis can be clearly studied. Drugs currently used on patients can be tested for their effectiveness in long-term application.
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PMID:A new method for producing a chronic E. coli pyelonephritis in rabbits. 110 18

Early recognition, adequate treatment, close observation, and systematic follow-up over a long period are essential to renal salvage in the child with vesicoureteral reflux. The decision whether and when to operate is made on a balance of factors by the pediatrician-urologist team. Among 236 patients with reflux diagnosed during childhood, reflux was stopped in 55 per cent of those treated medically and in 98 per cent of the more severe cases who were treated by ureteral reimplantation. Chronic pyelonephritis appeared or worsened during medical management in 12 per cent; no child showed new pyelonephritic scars or worsening of pyelonephritis after ureteral reimplantation.
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PMID:The practical management of vesicoureteral reflux in children. A review of 12 years' experience with 236 patients. 126 89

Chronic pyelonephritis (c.p.) is by definition an infectious tubulo-interstitial nephritis. It has to be differentiated from other etiologic forms of tubulo-interstitial nephritis. Therefore strict morphological criteria are needed for diagnosis. The characteristic lesion is a large cortico-medullary scar overlying a dilated chronically inflammed calyx. The macroscopic aspect and the histologic survey picture are more important than histologic details. A diagnosis on renal biopsies is therefore not warranted. Vesico-renal reflux and papillary morphology play an important pathogenetic role. Beside the more common focal scar a diffuse form of scarring can be observed. A limited number of conditions only have to be considered in differential diagnosis. The Ask-Upmark kidney seems to be a special form of c.p. related to urinary tract infection and reflux in early infancy. Pelvi-calyceal lithiasis without superimposed infection causes a picture very similar to a pyelonephritic scar. A reliable differentiation between c.p. and analgesic nephropathy may cause problems in endstage kidneys with sloughed off papillae. Various mechanisms of renal damage such as bacterial infection, immunological mediated inflammation, leakage of urinary constituents into the interstitium especially Tamm-Horsfall-protein and ischemia have to be considered. Despite the frequency of urinary tract infections chronic progressive pyelonephritis is rare. Predisposing factors are needed for progression of the disease. These include congenital or acquired urinary tract obstruction, vesico-renal reflux and papillary damage with intrarenal obstruction to the urinary flow. Other important factors are focal and segmental glomerulosclerosis and hypertension.
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PMID:[Chronic pyelonephritis and its differential diagnosis. A disease changing with time]. 248 12

The incidence of morphological and functional changes of the upper urinary passages and the kidneys obtains 78% in chronic prostatitis. The predominant localisation of the inflammation in the prostate and of the changes on the upper urinary passages and the kidneys on the same side confirms the importance of the chronic prostatitis in the pathogenesis of pathological conditions of the uropoetic system. Chronic pyelonephritis and nephrolithiasis can be proved in 24.5 and 78% of the patients with chronic prostatitis, respectively. Thus, the incidence of these diseases is significantly higher in patients with chronic prostatitis than in patients without such a disease. In 47% of the patients with chronic pyelonephritis and nephrolithiasis a latent chronic prostatitis can be proved, when an exact diagnosis was made.
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PMID:[Condition of the kidneys and upper urinary tract in patients with chronic prostatitis]. 355 32

Chronic pyelonephritis, which is largely diagnosed via imaging procedures, is characterised by defined parenchymal scars that become manifest in the excretory urogram as contour recessions of the kidney and result in deformations of the calyces and papillae. The authors describe other renal diseases, dysplasias, variations from the standard, and artifacts resulting in similar signs on x-ray film, thus leading to the wrong diagnosis of chronic pyelonephritis. The essential differential diagnostic criteria are explained.
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PMID:[Chronic pyelonephritis as a false interpretation in the excretory urogram]. 401

Chronic pyelonephritis is secondary to urinary tract infection associated with vesico-ureteric reflux or obstructive uropathy. Pyelonephritis scarring almost always occurs in early childhood and is linked to the concomitant presence of urinary tract infection and renal papillae allowing intrarenal reflux. When bilateral, pyelonephritis scarring may lead to end-stage renal disease. Destruction of the renal parenchyma occurs over years and is often accompanied by arterial hypertension and proteinuria. Surgical correction of vesico-ureteric reflux does not prevent further renal scarring. Since sterile reflux does not appear to be harmful, it is important to diagnose vesico-ureteric reflux early and prevent urinary tract infection by administering chemoprophylaxis during the first seven years of life.
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PMID:[Importance of vesico-ureteral reflux in the pathogenesis of chronic pyelonephritis]. 634 Jan 86


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