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

Of 63 patients with reflux and renal atrophy renal dysplasia was found in 9.5%. Pyelonephritis was apparent in 81% of the atrophic lesions. Urinary obstruction or ectasia was apparent in each case with dysplasia and only 2 were associated with histologic evidence of pyelonephritis. Pyelonephritis appears to be a major causal factor in atrophy occurring in renal units with reflux. Early urinary tract obstruction or distension may predispose to renal dysplasia.
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PMID:Observations on the small kidney associated with vesicoureteral reflux. 54 6

There is one renal disease in which unilateral estimation of GFR is desirable for clinical purposes: chronic pyelonephritis. Considering the possibilities for complications to determine unilateral renal function by ureter catheter just in this group of patients, we tried to estimate unilateral GFR with 66mTc-DTPA after a single injection of 5 mCi i.v. on the basis of blood samples at 90, 110 and 130 min after injection and evaluation of gamma-camera data from 25 to 35 min after administration of the dose. 31 patients were studied. In arenal patients clearance values were 7.5 ml/min (+/- 10.47 ml/min), unilaterally nephrectomized patients showed zero values for the removed kidney. Normal patients had a mean GFR of 107 +/- 17.7 ml/min with a partition between right and left kidney of 54.2 +/- 10 to 52.75 +/- 8.5 ml/min. Patients without urinary tract obstruction and unilateral renal disease had values of 27.1 +/- 11 ml/min for the diseased kidney while the normal kidneys gave a mean value of 59.6 ml/min (+/- 13 ml/min). In the presence of urinary tract obstruction, data could not be correlated to the state of renal function. This shows that unilateral estimation of GFR using 99mTc-DTPA is basically possible, but that it is useless in obstructive kidney disease.
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PMID:Unilateral estimation of glomerular filtration rate with 99mTc-DTPA. 69 96

All cases of persistent renal failure in infants less than 1 year of age were reviewed to determine whether the prognosis has improved equally for infants as for adults. During a ten-year period, 52 infants were treated by applying uniform therapy; 28, more than half, were less than 4 weeks old. All cases were separated into two groups; 19 infants without and 33 infants with congenital renal or urinary tract anomalies. In 20 patients of the latter group, additional serious anomalies of other organs were present. The age distribution was strikingly different: in 18 of 21 infants, renal anomalies were present, as diagnosed on the first day of life. In contrast, only 3 of 11 infants, 4 to 12 months old, had urinary tract anomalies. In infants without renal anomalies, renal failure was caused by hypotension or shock in 10 of 19 cases, by pyelonephritis or sepsis un 6 of 19. Of this group, eight infants (42%) recovered completely, nine (47%) died. Death occurred within one to two days of hospitalization in all but three cases, caused by shock or sepsis. In this group medical problems that are amenable to therapy have caused either renal failure or contributed to the infant's death. In infants with renal or urinary tract anomalies, renal failure was caused by renal dysplasia or agenesis in 16 of 33 infants, by urinary tract obstruction in 12 of 33. Only three patients (9%) recovered, all older than 4 months, 20 (61%) died, and 10 are living with signs of chronic renal failure. Death usually occurred within one week of hospitalization and, in 16 of 20, it was caused by renal failure and multiple additional anomalies. The multiplicity and complexity of the congenital anomalies in most instances precluded effective, lifesaving therapy. Renal failure in infants is still a serious disease accompained by a high mortality rate in which therapeutic possibilities are limited. No improvement in prognosis can be expected in the near future. Pediatrics, 59:987-994, 1977, RENAL FAILURE, CONGENITAL RENAL ANOMALIES, INFANT, ISCHEMIC RENAL DAMAGE.
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PMID:Renal failure during the first year of life. 86 67

Twenty-five patients with severe urinary tract infections were treated with 3 mg of tobramycin/kg per day (given in two doses). Susceptible organisms were Escherichia coli, Proteus, Klebsiella, Pseudomonas, Streptococcus, and enterococcus. Clincal conditions in which treatment produced excellent bacteriological results included a wide range of urological disorders; the most common were pyelonephritis, cystitis, and epididymo-orchitis, Three patients had septicemia, and 12 had an infection that was the result of urinary tract obstruction requiring surgery.
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PMID:Evaluation of tobramycin in severe urinary tract infection. 97 85

A clinical and roentgenographic analysis of 13 patients with pathologically proved xanthogranulomatous pyelonephritis (X-P) has demonstrated that many previously accepted truisms associated with this disease may not be valid. As a result of this study it is suggested that X-P: 1. Does have a prominant female distribution. 2. May arise relatively acutely. 3. Can be associated with a well-functioning kidney. 4. May destroy the kidney and collecting system. 5. Does not demonstrate neovascularity. 6. Can be distinguished angiographically from hypernephroma. 7. May be associated with diabetes. Other important facts were again observed: 1. X-P is still often associated with staghorn calculi and urinary tract obstruction. 2. Proteus mirabilis is the main offending organism.
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PMID:New thoughts concerning xanthogranulomatous pyelonephritis (X-P). 120 Feb 8

The authors report an original technique of transintestinal cutaneous diversion using the jejunum A 10 to 15 cm segment of jejunum is raised from the second loop and is attached to the skin transperitoneally. The stoma lies below the ureterojejunal anastomosis and the two ureters, sutured according to Wallace's technique, are implanted end-to-end into the proximal and extraperitonealised end at the height of the sacral promontory. 29 patients have been treated by this technique for various indications: 21 bladder tumors, 5 neurogenic bladders, 1 bladder exstrophy, 1 cervical cancer, 1 prostatic cancer. 15 patients (52%) had previously received pelvic irradiation. The mean follow-up was 47 months (2-192 months) and the mortality was zero. 4 patients (13.8% developed early complications: 2 cases of urinary tract obstruction and 2 intestinal obstructions requiring 3 operations. 6 patients developed 7 minor late complications (24.1%): 2 cases of pyelonephritis, 4 cases of renal stones, only one of which required an operation, and 1 case of prolapsed stoma. None of the patients developed any alteration in renal function or dilatation of the upper urinary tract after the operation. The addition of sodium bicarbonate was found to be useless, as none of the patients developed any metabolic disorders. Transjejunal cutaneous ureterostomy achieves excellent drainage by means of a short graft with a stoma situated below the level of the ureteric implantation, as reflected by the absence of any long-term deterioration in renal function despite full lumen ureterojejunal implantation without an antireflux device. This technique is simple to perform and is indicated in all situations, particularly after pelvic irradiation. It is associated with low morbidity, no mortality and ensures an excellent long-term result.
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PMID:[Cutaneous trans-jejunal ureterostomy: an original technique used in 29 patients]. 130 75

The term pyelonephritis, which denotes infection of the renal pelvis and of the renal tissue, covers a spectrum of entities, the gravity and hence treatment of which depend upon the organism, its sensitivity to antibiotics, the presence or absence of urinary tract obstruction, and the host's background. The common form affects young females, is due to uropathogenic but multisensitive strains of Escherichia coli, and is easily treated by a 10- to 20-day course of antibiotic(s). In males, children and immunocompromised patients, renal and urinary tract imaging is necessary to determine the cause of the infection, the severity of the lesions and thus to guide the duration of treatment, which comprises antibiotic combinations for several weeks. Pyelonephritis during pregnancy may be serious, and treatment is restricted to certain antibiotics. Aminoglycosides, amino- or carboxypenicillins (alone or associated with clavulanic acid), ureidopenicillins (e.g. mezlocillin, piperacillin), fluoroquinolones (e.g. ciprofloxacin, ofloxacin, pefloxacin), cephalosporins, monobactams (e.g. aztreonam), carbapenems (e.g. imipenem) and the combination of trimethoprim plus a sulphonamide [e.g. cotrimoxazole (trimethoprim/sulfamethoxazole)] offer a wide choice of bactericidal agents which may be used for the treatment of pyelonephritis. However, the selection among them also depends on availability, antimicrobial spectrum, tolerance and cost.
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PMID:Diagnosis and drug treatment of acute pyelonephritis. 138 34

The authors report on 48 patients with calculous pyelonephritis. Urinary obstruction was caused by renal calculi in 21 patients and ureteral calculi in 27. Urine cultures were positive in 87.5% and bacteremia was seen in 70%. The common organisms in urine and blood culture were E. coli, Proteus and Klebsiella. Septic shock occurred in 10 (20.8%) out of 48 patients. Calculous pyelonephritis with urinary obstruction is a very serious condition.
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PMID:Calculous pyelonephritis. 162 52

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

Abdominal ultrasonography was performed on a caprine doe with anorexia, dysuria, and a palpable abdominal mass. Ultrasonography of a large firm mass situated cranial to the pelvic brim revealed a distended urinary bladder, which was confirmed by a dynamic bubble study. The left kidney had a large anechoic renal medulla and dilated renal pelvis and ureter consistent with ureteropyelectasia. Necropsy confirmed the existence of hydronephrosis and hydroureter, as well as cystitis, pyelonephritis, and partial urinary tract obstruction. The cause of the obstructive uropathy was a mass of fibrous tissue that obliterated the uterine cervix and partially obstructed the urethra and left ureter. The cause was presumed to be a cervical trauma from dystocia and forced extraction of a kid, with subsequent chronic fibrosis.
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PMID:Ultrasonographic diagnosis of obstructive uropathy in a caprine doe. 220 3


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