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

Manifestations of xanthogranulomatous pyelonephritis in 26 patients closely mimicked those of neoplastic and other inflammatory renal parenchymal diseases. Middle-aged or older women were affected most often. Most patients presented with anemia, chronic febrile illness, a painful tender flank mass and recurrent urosepsis. Some features of nephrogenic hepatic dysfunction were present in 13 patients. Bacterial cultures of renal tissue were almost always positive but the spectrum differed considerably from that of the bladder urine. Urographically, a renal mass lesion was encountered in 62% of the patients, nephrolithiasis in 38% and a functionless kidney in 27%. Angiographically, none of the 4 mass lesions studied was distinguished from hypernephroma. Indeed, a correct preoperative diagnosis was made in only 1 instance. There were 3 stages of xanthogranulomatous pyelonephritis recognized. Treatment consisted of nephrectomy for diffuse or advanced stage disease or both (21 patients), excision of the diseased renal segment for localized and low stage disease (2 patients) and renal biopsy (3 patients). Xanthogranulomatous pyelonephritis did not recur but in some patients bacteriuria continued or hypertension developed.
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PMID:Xanthogranulomatous pyelonephritis: a critical analysis of 26 cases and of the literature. 66 Jul 25

A metabolic study was performed in 28 patients with bilateral recurrent calcium-containing renal staghorn calculi and chronic pyelonephritis ("obstructive nephropathy"). Fourteen had normal GFR and 14 mild renal insufficiency. Ten normal subjects were used as controls. Under basal conditions, polyuria and negative sodium balance were commonly observed in patients with obstructive nephropathy and normal renal function. After an acute acid load (NH4Cl) an acidifying defect, i.e. high values for urine pH and reduced excretion of titratable acid and ammonium, was observed in 64% of patients with normal GFR and in 71.4% of those with renal insufficiency. During intravenous infusion with neutral sodium phosphate, the urine pH changed little but the rate of excretion of titratable acid increased in direct proportion to that of urinary phosphate in both groups of patients. These results, associated with the finding of normal blood pH in almost all patients, lead to the conclusion that an incomplete Type 1 or "distal" renal tubular acidosis is a frequent complication of obstructive nephropathy secondary to bilateral nephrolithiasis. The anatomical abnormalities of renal tubules and collecting ducts and the superimposed interstitial nephritis might be the pathogenetic factors responsible for the acidifying defect and for the impairment in sodium and water conservation.
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PMID:Renal tubular defects in recurring bilateral nephrolithiasis. 95 42

A quantitative renal scintillation camera study has been described for the evaluation of total renal function and the split function of the two kidneys by a noninvasive technic. It requires no patient preparation, is not affected by bowel gas, and no allergic reactions have been reported. Six cases are reported to illustrate its usefulness with renal tumors, neurogenic bladders, pyelonephritis, nephrolithiasis, congenital anomalies, and renal insufficiency.
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PMID:Practical uses of a quantitative renal scintillation camera study. 98 2

Based on the experience of surgical treatment in 124 patients with renal form of primary hyperparathyroidism, the author gives a description of peculiarities of parathyroidectomy technic. Positive results of the treatment were obtained in 32 of 35 patients with spontaneous discharge of concretions. In bilateral nephrolithiasis postoperative recurrences, solitary stones the effect of the treatment depends both on renal surgery and therapy of pyelonephritis, nevertheless postoperative recurrences in these patients were 2.5 times as rare as in routine therapy.
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PMID:[Characteristics of surgical treatment of the renal form of primary hyperparathyroidism]. 101 68

Considerable functional disturbances of the urodynamics, consisting of hypotonia, hypokinesia, and dyskinesia of the pelvis and upper third of the ureters were detected by television excretory pyeloscopy and motion-picture urography in female rabbits after prolonged administration of progesterone and estradiol dipropionate. These findings suggest a role of hormonal imbalance in the pathogenesis of disorders of the urodynamics that are the possible causes of development of pyelonephritis, nephrolithiasis, hydronephrosis, and other diseases of the kidneys in women.
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PMID:Disturbance of the urodynamics of the upper urinary tract as a result of hormonal imbalance. 111 53

The authors established macroscopic hematuria in 13,8 per cent of the examined 1618 renal patients. It is most often met in patients with chronic calculus pyelonephritis and nephrolithiasis (45,2%). In 9,0 per cent of the patients with chronic glomeruloneshrihs and in 14,9 per cent of those with acute glomerulonephritis the painless macroscopic hematuria is the initial clinical manifestation of the disease. The latter is a frequent symptom (40,6%) in patients with congenital kidney anomalies. In 5,8 per cent of the patients with macroscopic hematuria -- the reason is not elucidated.
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PMID:[Clinical importance of macroscopic hematuria]. 122

The purpose of the study was assessment of gentamicin nephrotoxicity with reference to proximal tubule function and glomerular filtration. The study was carried out in 20 patients with nephrolithiasis and chronic pyelonephritis, and 33 patients with respiratory and bile tract infections treated with gentamicin in doses of 2-3 mg/kg/2 h. In 3 patients with nephrolithiasis and chronic pyelonephritis signs of increased nephrotoxicity of gentamicin (according to Schentag criteria) were found. Similar signs were demonstrated in 3 patients with non-urinary tract infections. The abnormalities included increased excretion of low-molecular protein and beta-2-microglobulin (B2m), reduction of B2m reabsorption and lower glomerular filtration. Beta-2-microglobulinuria increase precede by 4-5 days the fall of the glomerular filtration rate which suggests that beta-2-microglobulinuria assessment is an early sign of gentamicin neurotoxicity.
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PMID:[Nephrotoxic effect of gentamicin on the function of the proximal tubules of the nephron and glomerular filtration]. 129 38

The study aimed at evaluating proximal renal tubule function in patients with nephrolithiasis and chronic pyelonephritis, and in patients with infectious diseases treated with gentamicin. The study involved 2 groups of patients: group A--17 patients with nephrolithiasis and chronic pyelonephritis and group B--30 patients with other infectious diseases (pneumonia, biliary tract infections) but with normal glomerular filtration rate. Patients from both groups were treated with gentamicin in a daily dose of 2-3 mg/kg for 7-10 days. Serum and urine creatinine levels were assayed in all patients prior to, 2-3, 7, 10 days, and after the treatment. Patients assigned to group B were divided into two subgroups: B1 included 15 patients with normal beta 2-microglobulinuria, and B2 15 patients with increased renal loss of beta 2-microglobulin and decreased tubular reabsorption of this protein. Significant increase in beta 2-microglobulinuria was seen on the third day of therapy, the decrease in the tubular reabsorption and glomerular filtration rate were noted in all patients on the seventh day of gentamicin administration. Beta 2-microglobulinuria was significantly higher in patients from groups A and B2 in comparison with group B1 in which no dysfunction of the proximal renal tubule was present before gentamicin therapy. A degree of beta 2-microglobulinuria is an early and sensitive indicator of gentamicin nephrotoxicity. The risk of nephrotixic symptoms is particularly obvious in patients with deteriorated function of renal proximal tubuli before the treatment with gentamicin.
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PMID:[Evaluation of selected indicators of the renal proximal tubule function in patients treated with gentamicin]. 149 34

We previously reported that chronic urinary diversion through intestinal segments may have adverse effects on bone and mineral metabolism. This study examined the long-term health of patients managed by urinary diversion (94% by ileal conduit) for neuropathic bladders secondary to myelomeningocele defects and compared them to a control population of myelomeningocele patients managed by intermittent catheterization. Of the patients 93 were studied by personal interview, chart review, morphometric analysis, serum studies and dual-photon bone density determination. Average followup was 23 +/- 6 years in the urinary diversion group and 17 +/- 5 years in the intermittent catheterization group. Fractures occurred in 40% of the patients in both groups. Patients with a urinary diversion had an increased need for surgery to correct spinal curvature (57% versus 40%) and a significantly increased incidence of complications resulting from orthopedic procedures (17% versus 3%, p less than or equal to 0.05). There was also an adverse effect on renal function. The urinary diversion group had an increased incidence of radiographic renal deterioration (57% versus 8%, p less than 0.001), nephrolithiasis (43% versus 2%, p less than 0.001), pyelonephritis (60% versus 21%, p less than 0.001) and intermittent metabolic acidosis (20% versus 5%, p = 0.05). Surgery was required in 37% for stomal complications and in 17% for ureterointestinal stricture. Linear growth was adversely affected by urinary diversion. Patients with urinary diversion had decreased lengths for all morphometric parameters and a greater percentage of them were at or below the 10th percentile standards. Serum electrolytes, liver function studies, vitamin D3 and parahormone showed no differences in the 2 groups. No patient had a significant metabolic acidosis at the time of study. Bone densities were significantly diminished in both groups and not significantly different. This study strongly suggests that urinary diversion through intestinal segments is associated with adverse effects on bone health.
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PMID:Long-term metabolic effects of urinary diversion: a comparison of myelomeningocele patients managed by clean intermittent catheterization and urinary diversion. 156 80

This report describes a 40-year-old man with an unusual form of granulomatous pyelonephritis, associated with nephrolithiasis, resulting in end-stage kidney disease and right pretransplant nephrectomy. The kidney specimen contained a staghorn calculus and showed chronic inflammation with confluent caseating granulomas and multinucleated giant cells, resembling renal tuberculosis. However, neither tubercle bacilli nor other microorganisms were demonstrated in the renal tissue or in urine cultures. Because these findings do not support a tuberculous etiology of the granulomatous pyelonephritis, we conclude that this patient had a pseudotuberculous reaction as a consequence of nephrolithiasis.
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PMID:Pseudotuberculous pyelonephritis associated with nephrolithiasis. 843 11


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