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

The Diaphane-program instituted under the authority of the French Society of Nephrology has been steadily expanding since 1972. By December 1977, about 1500 patients treated in 30 public and private Dialysis Centres were followed up by this system. Full coverage of expenses is provided by the participating Centres. The statistical work presented in this report involves 1572 adult patients treated between June 1972 and December 1976 in 24 dialysis centres. The amount of collected data and the duration of the observation period permit to build up evolutive profiles of the population of patients treated in France by maintenance hemodialysis, of the various techniques and strategies used and of the main complications recorded in the patients. 1. Mean age of patients at start of dialysis is steadily increasing, from 40.1 years in 1972 to 48.2 years in 1976. 2. The predominance of male patients, constant over each year, may be explained by an increased proportion in man of chronic glomerulonephritis and renal vascular diseases. The sex-ratio in patients with chronic pyelonephritis is close to the one recorded in the French population. 3. The regular decrease of the mean plasma creatinine level at time of first dialysis recorded since 1972, is probably related to an earlier start of treatment. However, 10.6 per cent of the patients taken on treatment in 1975-1976 still had a plasma creatinine greater than or equal to 200 mg/100ml. 18.7 per cent had a diastolic blood pressure greater than or equal to 120 mmHg, and exsudative lesions at eye fundi examination were found in 33.5 per cent. The delay in initiating dialysis treatment may account for the frequency of early acute cardiopulmonary complications such as pulmonary oedema and pericarditis and also for the increase in the mortality rate recorded during the first year of treatment: 12.1 per cent instead of 6.2 per cent during the second year. This particularly relevant for the younger age group of patients. 4. There seems to be some social disparity concerning the detection of renal disease and the conditions under which dialysis treatment is started: chronic renal disease is detected at an earlier stage and dialysis treatment initiated for lower values of plasma creatinine and of diastolic blood pressure in patients belonging to the "higher income" group of population. 5. The percentage of patients dialysed twice a week is steadily increasing, whereas the average weekly dialysis time decreases, being about 15 hours in 1976. Day and evening dialysis replace overnight dialysis. Disposable flat-plate dialysers are used increasingly. 6. Episodes of hypotension and cramps are the incidents most frequently recorded during the dialysis sessions. Risk factors evidenced in the occurrence of hypotensive accidents are: the female sex, age greater than or equal to 55 years in males, orthostatic blood pressure drop at the end of previous dialysis, weight loss of more than 4 per cent of total body weight during dialysis...
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PMID:[Dialysis-computer program. IV. Summary report. Epidemiology of complications]. 60 11

The results are discussed obtained from 198 patients with the two most frequently met kidney diseases--chronic glomerulonephritis and pyelonephritis, with a total of 396 renal clearance tests. In 65.7 per cent of the patients with chronic glomerulonephritis decreased values of blomerular filtration (GF) and the renal flow effect (RFE) were established, with a parallel decrease in both clearances in 56.5 per cent and isolated disturbances of GF in 31.9 per cent and of RFE in 11.6 per cent. In the patients with chronic pyelonephritis a parallel decrease of GF AND RFE was found in 66.7 per cent and isolated disturbances of GF in 13.6 per cent and RFE--in 19.7 per cent. The high percentage of parallelly decreased GF and RFE reveals the sensitivity of the method in the diagnosis of early renal functional alterations while the application of only one of the clearances might not detect the existing alterations. The results from the carried out comparative investigations between the isotope clearances and isotope nephrography with 131I--hippuran are also reportentage of the depuration radioisotope tests as compared with ING in the detection of early renal functional laterations. Radiation risk is rendered to a minimum with the use of the "cocktail" of 169U-EDTA and 125I-hippuran.
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PMID:[Clinical possibilities of a method for the simultaneous determination of the GFR and the ERBF using a "cocktail" of 169 EDTA and 125I-hippuran]. 82 56

1. The renal dysfunction in the chronic compensated pyelonephritis means a selective decrease of the maximum osmotic concentration power, the ammonia secretion and the total secretion of hydrogen ions in the glomerular filtration rate, proximal reabsorption of the fluid of the tubule, excretion of osmotically free water and acidity of the urine which can be titrated. 2. The functional distrubances observed in chronic pyelonephritis do not as a whole differ from those disturbances in chronic compensated glomerulonephritis, but in the disease first mentioned there is in every case no decrease of the endogenic creatinine clearance and the maximum water diuresis. 3. The latent chronic pyelonephritis differs from the latent chronic glomerulonephritis by a normal endogenic creatinine clearance and maximum water diuresis and by a decrease of the ammonia and hydrogen ion secretion. These disturbances to a certain extent may be regarded as specific for the chronic pyelonephritis. In comparison with the chronic hypertonic pyelonephritis in the chronic hypertonic pyelonephritis the maximum water diuresis is normal and the titratable acidity is slightly increased. 4. The kind of renal dysfunctions can be of importance for the differential diagnosis between chronic glomerulonephritis and chronic pyelonephritis particularly in the latent forms of the two diseases.
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PMID:[Tubular kidney dysfunction and its etiology in chronic pyelonephritis]. 84 42

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

Although a diminished fractional excretion of sodium (FENa) is the hallmark of acute proliferative glomerulonephritis (APGN), an enhanced natriuresis per glomerular filtration rate (GFR) in the chronic phases of this disease has been reported. We studied this adaptive response utilizing two different split-bladder dog models with unilateral, and a third group of dogs with bilateral Masugi's nephritis. Group I. Six dogs with unilateral nonaccelerated APGN studied a mean of 6 days after induction had a mean base-line APGN/intact kidney GFR of 31/50 ml/min (P less than 0.005) and FENa of 0.2/0.75% (P less than 0.005). Acute volume expansion caused a smaller absolute increase in FENa from the APGN kidney, 1.6%, than from the intact kidney, 4.0%, (P less than 0.01). Maximum tubular secretion of rho-aminohippuric acid/GFR (TmPAH/GFR) measured in three dogs was higher in the APGN kidney than intact kidney, 13.1 vs. 9.3 mg/dl. Subsequent studies on three of the six dogs when the disease had become chronic demonstrated a reversal in the pattern of sodium excretion in response to volume expansion. Group II. Six dogs with accelerated unilateral APGN (dogs presensitized to antibody source) studied a mean of 5 days after induction had a mean base-line APGN/intact kidney GFR of 16/57 ml/min and FENa of 0.22/0.12% (P less than 0.1). Contrary to group I, volume expansion caused a greater absolute increase in FENa from the APGN kidney, 5.8%, than from the intact kidney, 2.9% (P less than 0.05). TmPAH/GFR studied in four dogs was similar for both kidneys, 17.9 and 18.5 mg/dl for the APGN kidney and intact kidney, respectively. Group III. Sequential studies were performed on seven dogs with bilateral nonaccelerated APGN. Initially each demonstrated sodium retention and a smaller absolute increase in FENa in response to volume expansion compared to a predisease control study. With disease progression, volume expansion induced a greater absolute increase in FENa than in the control study. We concluded that (a) the fractional excretion of sodium from the APGN kidney will be less or greater than the contralateral intact kidney or control study depending on the severity and/or chronicity of the disease, possibly as the result of morphologic alterations; (b) the degree of extracellular fluid volume expansion is an important variable influencing similarity of glomerulotubular balance between the APGN and contralateral intact kidney; and (c) the "intact nephron hypothesis" applies in a limited fashion to kidneys with APGN in the absence of volume expansion just as it does for kidneys with chronic glomerulonephritis or pyelonephritis.
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PMID:Functional adaptation of nephrons in dogs with acute progressing to chronic experimental glomerulonephritis. 93 95

The results from the study of the anemia syndrome in 1100 patients are reported (881 with chronic pyelonephritis, 147 with chronic glomerulonephritis and 72 with endemic nephropathy). Out of them 663 were with preserved renal function, 160 - with compensated and 274 - with decompensated nitrogen retention. Anemia was found in 98.7 per cent of the patients with endemic nephropathy, in 59.2 per cent of the patients with chronic glomerulonephritis and in 56.8 per cent of the patients with chronic pyelonephritis. Anemia precedes the manifestations of renal insufficiency in endemic nephropathy. In 36 per cent of the patients with endemic nephropathy it is severe or very severe. Light anemia was found in 44,6 per cent of the patients with chronic pyelonephritis and in those with preserved renal function. Only in the patients with chronic pyelonephritis the values of serum iron are under the normal. The administration of iron preparations in those patients is with good results. In the stage of decompensated renal insufficeincy effect was obtained by often blood transfusions.
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PMID:[Clinical characteristics of the anemic syndrome in chronic renal diseases]. 100 39

A nationwide morbidity study of end-stage kidney disease in Israel revealed a mean annual incidence rate, in the two-year period 1965-1966, of 70 cases per million per year requiring maintenance hemodialysis in the age 15-59 Jewish population. Chronic glomerulonephritis (38%) chronic pyelonephritis (24.9%) and polycystic disease (8.1%) represented the three most common diagnostic entities. It is suggested that the load of new cases on available dialysis units will not increase indefinitely but that an equilibrium will be established between the intake of new candidates and the outflow due to deaths and transplantation.
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PMID:An epidemiologic study of renal failure. I. The need for maintenance hemodialysis. 109 56

Vesicoureteral reflux was observed in 19 of 180 patients (10.5%) with end-stage chronic renal failure. The underlying disease in the patients with reflux was chronic glomerulonephritis in 8.3%, chronic pyelonephritis in 28.5% and renal hypoplasia in 40%. Reflux was bilateral in 13 patients and unilateral in six. Most likely bladder dysfunction due to uremia may have been the cause of the reflux.
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PMID:Vesicoureteral reflux in patients in end-stage chronic renal failure. 110 6

Plasma aldosterone, plasma renin activity, sodium and potassium in the plasma and the urine were determinated under acute stimulation with saline-depletion (furosemide) and under acute suppression with saline infusion in 40 patients with primary hypertension stage I, 19 patients with primary hypertension stages II and III, and 11 patients with renal hypertension (chronic glomerulonephritis and chronic pyelonephritis). The majority of the patients with primary hypertension stage I showed a good stimulation of the plasma aldosterone and the plasma renin activity under acute salt depletion. Three out of the 40 patients with primary hypertension stage I, and 13 of the 19 patients with primary hypertension stages II and III did not show any stimulation of the renin secretion ("low renin hypertension"). In all these patients the plasma aldosterone stimulation remained intact. With infusion of saline all the groups showed suppression of the plasma aldosterone and the plasma renin activity. A good stimulation of the plasma renin activity, demonstrates that in our experiments the renin-angiotensin system cannot be responsible for the increase in aldosterone secretion under salt depletion. Most likely the increase of the plasma aldosterone, in spite of the fixed renin activity, is stimulated by the sodium depletion due to diuretics. In all patients with primary hypertension we did not find an inadequate reaction of the aldosterone secretion under saline infusion. The patients with renal hypertension showed a minimal stimulation and suppression of the plasma renin activity. The plasma aldosterone secretion increased only slightly under sodium depletion and the decrease under saline infusion was statistically not significant. Thus we conclude that these patients show an inadequate reaction of the plasma aldosterone and renin secretion under salt infusion and depletion.
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PMID:[Plasma aldosterone and plasma renin activity in patients with essential and renal hypertension under acute stimulation with saline depletion and acute suppression with saline infusion]. 115 49

In a total of 110 patients with chronic renal failure, 46.4% of the cases had a serum lipase activity exceeding 200 IU, the upper limit of the norm. The degree of reduction of renal function is positively correlated to the frequency of hyperlipasaemia as well as to the elevation of the lipase activity in serum. At a glomerular filtration rate (GFR) of less than 20 ml/min, hyperlipasaemia in chronic glomerulonephritis was found in 75%, significantly more frequent than in chronic pyelonephritis (46.8%). The frequency and degree of hyperlipasaemia was not influenced by haemodialysis. Significantly elevated serum lipase activities were also observed in experimentally produced chronic renal failure in the rat.
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PMID:Serum lipase activity in chronic renal failure. 117 47


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