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

The diabetic neurogenic paralytic bladder is characterized by marked residual urine, secondary infection, pyelonephritis, sepsis, and azotemia. Initial manifestations were studied in diabetic patients with and without neuropathy and in nondiabetic controls, all without symptoms referable to the urinary tract. The nondiabetic controls and the diabetics without neuropathy were urologically normal. Eighty-three percent of the diabetic patients with neuropathy had objective evidence of neurogenic bladder involvement; however, there was no residual urine, infection, pyelonephritis, sepsis or azotemia. The disparity between early and late bladder involvement is determined by the factor of residual urine, which is the measure of advancing bladder neuropathy leading to decompensation. Progressive decompensation of the asymptomatic diabetic bladder may be a cause of the increased frequency of renal infection in diabetic patients.
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PMID:Development of urinary bladder dysfunction in diabetes mellitus. 735 22

Chronic renal infection (Chronic bacterial pyelonephritis) is a cause of tubulo-interstitial nephropathy (nephritis); TIN. The disorder causes end-stage renal failure in about 2% of the patients who are treated by dialysis. However, Chronic bacterial pyelonephritis is a relatively benign condition that seldom leads to renal function loss. The affected kidney shows non-specific histological pictures similar to that seen with other diseases producing TIN. Clinical symptoms are of ten vague. Obstructive uropathy (eg, stones, benign prostatic hyperplasia) is frequently present. The affected kidney, which is almost unilateral, shows atrophy and scarring of variable degree. Significant pyuria and bacteriuria may or may not be found. Depending on the stage of the disease, the serum creatinine and blood urea nitrogen may be normal or elevated. Contributing obstructive uropathy should be corrected. The patients must be followed closely, urinary tract infection must be controlled and complications (eg, hypertension, azotemia) must be identified promptly and treated adequately.
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PMID:[Interstitial nephropathy due to chronic bacterial pyelonephritis]. 756 35

A total of 83 patients with chronic renal failure (CRF) at azotemia stage (S. I. Riabov's classification) complicating pyelonephritis were treated: 19 patients received symptomatic standard therapy (group 1), 29 patients received combined therapy with enterosorption (group 2), 35 patients received combined treatment with plasmapheresis (group 3). The efficacy of the treatments was controlled by platelet tests (platelet, coagulative hemostasis, fibrinolytic plasma activity) and parameters of kallikrein-kinin system. Treatment results in group 1 are characterized as poor: insignificant improvement of uremia, DIC syndrome against unchanged inhibition of kallikrein-kinin system. Group 2 patients achieved moderate response: uremia reduced to normal azotemia values, DIC syndrome and inhibition of kallikrein-kinin system reduced. Patients of group 3 got disappeared DIC syndrome and normal kallikrein-kinin system against high azotemia.
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PMID:[Changes in the hemostatic system indices of patients with chronic kidney failure under the influence of enterosorption and plasmapheresis]. 798 57

Surgical aid in acute hemorrhage due to cancer of the urinary bladder was rendered within 1986-1994 to 65 patients (53 males and 12 females) aged 30-50, 51-60, 61-70 and over 70 years (10, 11, 24 and 20 cases, respectively). The majority had the disease stage T2 and T3. In 42 (64.6%) patients with profuse hematuria complicated by bladder tamponade an urgent resection was performed: segmental in 22, hemiresection in 8, open bladder electroexcision of the tumor in 10 patients. 2 patients had sigmoid cancer with bladder involvement managed by subtotal resection of the bladder and resection of the sigmoid colon. Nephro- or cystostomy was performed because of grave condition (purulent pyelonephritis, azotemia) in 23 patients (35.4%). Total postoperative lethal outcomes made up 33.3% (14 patients): 6 patients died early after surgery, 8 patients 6 months to 8 years later. 27 patients (64.3%) are alive. Of them 10 are 5-8-year survivors. These patients had cancer stage T2 and T3 with tumor location on the lateral wall. In three 4-year survivors there were tumor recurrences 2 and 3 years after surgery which were treated by transurethral resection and electroexcision on the open bladder. Long-term outcomes of urgent surgery show that different kinds of resection of the bladder may be effective in the treatment of acute hemorrhages from bladder tumors.
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PMID:[The late results of organ-preserving operations in acute hemorrhages in patients with bladder cancer]. 867 44

Xanthogranulomatous pyelonephritis is an uncommon variant of chronic pyelonephritis that predominantly affects middle-aged women. Patients usually present with fever, back or flank pain, flank mass, and the constitutional symptoms of fatigue, malaise, weight loss, and anorexia. Rarely, they may present with a draining sinus. There is usually a history of urinary tract infection, obstruction, or instrumentation. Other abnormalities include anemia, leukocytosis, abnormal liver enzymes, pyuria, and hematuria. Mild azotemia may be present, but frank renal failure is rare. Urine and renal tissue cultures are frequently positive. The most commonly isolated bacterial pathogens are P. mirabilis and E. coli, but other organisms have also been implicated. A CT scan is the best radiologic imaging technique to discover the extent of inflammation as well as any involvement of adjacent structures. Lipid-laden macrophages called xanthoma cells characterize the disease at the microscopic level. Nephrectomy is curative. Careful preoperative evaluation will guide surgical planning in choosing an approach that provides adequate exposure of the affected tissue and facilitates subsequent care of the patient.
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PMID:A middle-aged woman with back and flank pain. 881 29

An 8-year-old spayed female ferret was examined for diffuse generalized alopecia, erythema, erosions, crusts, and ulcerated plaques that were nonresponsive to long-term administration of corticosteroids. Cutaneous epitheliotropic lymphoma was diagnosed on the basis of histologic examination of skin biopsy specimens. Neoplastic cells were determined to be of T-lymphocytic origin by results of immunohistochemical staining with a rabbit anti-CD3 monoclonal antibody. Additional laboratory abnormalities detected included anemia, azotemia, isosthenuria, pyuria, and bacteriuria. Treatment included isotretinoin and amoxicillin trihydrate plus clavulanate potassium administered orally, and oatmeal-based shampoos. Isotretinoin was tolerated well and cutaneous lesions resolved after 60 days of treatment, but pretreatment azotemia worsened and the ferret was euthanatized. Necropsy revealed cutaneous epitheliotropic lymphoma, pyelonephritis, and interstitial nephritis. Renal disease most likely was caused by immunosuppression secondary to chronic treatment with corticosteroids and aging. Isotretinoin, although not curative, may be useful for the palliative treatment of cutaneous epitheliotropic lymphoma in ferrets.
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PMID:Cutaneous epitheliotropic lymphoma in a ferret. 887 Jul 42

Four cats developed fibrosis within the retroperitoneal space following renal transplantation. In human transplant patients, retroperitoneal fibrosis is an uncommon complication following surgery and may be secondary to operative trauma, infection, deposition of foreign material in the operative field, urinary extravasation, and perirenal hemorrhage caused by trauma to the allograft. Possible causes of fibrosis in the cats of this report include abdominal inflammation associated with allograft rejection, pyelonephritis, and septic peritoneal effusion. All of the cats of this report were readmitted to the veterinary teaching hospital following renal transplantation because of recurrence of azotemia 1 to 5 months after transplantation. Abdominal ultrasonography revealed a 2- to 4-mm-thick capsule surrounding the allograft in 2 of 4 cats, hydronephrosis in 4 cats, and hydroureter proximally in 2 cats. An exploratory laparotomy was performed in all cats to remove the fibrotic tissue causing the ureteral obstruction. Normal renal function was restored in all cats following surgery. Histologic evaluation of biopsy specimens revealed smooth muscle (3 cats) and fibrous connective tissue (4). All 4 cats, regardless of the cause, responded well to surgical resection of the scar tissue that was causing a ureteral obstruction. None of the cats had recurrence of obstruction following surgery.
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PMID:Retroperitoneal fibrosis in four cats following renal transplantation. 1236 1

The patient was a 77-year-old man who underwent radical cystectomy and ileal conduit urinary diversion due to bladder cancer in 1989. A stenosis of the right uretero-ileal anastomosis occurred in 1992, and of the left uretero-ileal anastomosis in 1999. These were treated with indwelling of a ureteral stent and percutaneous nephrostomy, respectively. He was admitted to our hospital for progressive renal dysfunction due to frequent pyelonephritis. We performed a reconstruction of the ileal conduit urinary diversion and after the removal of the bilateral ureteral stent he complained of nausea and general malaise. The laboratory data showed hyponatremia, hyperkalemia and azotemia, which were diagnosed as complication liked jejunal conduit syndrome. He was treated with hydration and salt supplementation. With regard to this case, we considered that a long ileal conduit close to the jejunum and renal dysfunction caused the complication liked jejunal conduit syndrome. Careful observation and follow-up laboratory examination should be performed if the patient has renal dysfunction and a long conduit near the jejunum is used for the ileal conduit.
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PMID:[A case report of complication liked jejunal conduit syndrome induced by reconstruction of ileal conduit]. 1510 28

A 37-yr-old female Asian elephant (Elephas maximus) presented with anorexia, restlessness, and dark-colored urine. Urinalyses showed hematuria, leukocyturia, isosthenuria, proteinuria, granular casts, and no calcium oxalate crystals. Bloodwork revealed azotemia. Urine culture revealed a pure growth of Streptococcus zooepidemicus resistant to sulfamethoxazole-trimethoprim but susceptible to cephalosporins. A presumptive diagnosis of pyelonephritis was made based on bloodwork, urinalysis, and urine culture. The animal was treated with intravenous ceftiofur, and intravenous and per rectum fluids were given for hydration. The elephant's attitude and appetite returned to normal, the abnormal blood parameters resolved, and urinary calcium oxalate crystals reappeared after treatment, supporting presumptive diagnosis. Follow-up ultrasonography revealed an abnormal outline of both kidneys with parenchymal hyperechogenicity and multiple uterine leiomyomas.
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PMID:Diagnosis and treatment of presumptive pyelonephritis in an Asian elephant (Elephas maximus). 1552 98

Tubulointerstitial nephritis (TN) is a heterogenous disease, where disturbances of the interstitial tissue and renal tubules are found. Different immunological and nonimmunological mechanisms initiated by infectious and non-infectious factors may lead to TN. A case of 13-years-old girl with primary diagnosis of acute pyelonephritis is presented. The abdominal pain, headache, pain in lumbar region and intermittent fever with loss of appetite were observed in this girl a few weeks before admission. Microcytic anemia, proteinuria and glucosuria, azotemia and elevated markers of inflammatory response were found. In ultrasound examination heterogenous cortex echogenicity of both kidneys and disturbances in parenchymal blood flow were observed. In renal scintigraphy the discriminated catch index was found. Kidney biopsy revealed the edema of the interstitial space with mononuclear and lymphocyte infiltration. The diagnosis of TN was established upon the history, clinical examination, results of laboratory tests, kidney imaging and biopsy. After steroid and doxycycline treatment an improvement and normalization of the results of laboratory tests were observed. It seems to be justified to consider Yersinia infection as a cause of acute tubulointerstitial nephritis.
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PMID:[Yersiniosis as a cause of acute tubulointerstitial nephritis and acute renal failure--case report]. 1606 90


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