Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The objective of this study was to elucidate the incidence and clinical features of renal dysfunction and urogenital system disorders in 956 patients with chronic obstructive lung disease (COLD) and/or coronary heart disease (CHD). COLD was diagnosed in 346 patients (group 1), COLD and CHD in 402 (group 2), CHD in 211 (group 3). The methods included X-ray studies (survey and excretory urography), functional diagnostics (ECG, Doppler cardiography, assessment of external respiration, abdominal, renal, and bladder ultrasound, measurements of residual urine, transrectal and transabdominal examination of prostate). The glomerular filtration rate was estimated using Cockcrofft-Gault and MDRD formulas and Rerberg- Tareev method, renal hemodynamics by duplex scanning of renal arteries. Inflammatory urogenital diseases were most frequently diagnosed in group 2 (chronic cystitis 83.8%, chronic pyelonephritis 73.9%). Diabetic nephropathy common in this group (25.4%) was related to the high prevalence of diabetes mellitus in these patients (37.8%) compared with 26.3 and 29.9% in groups 1 and 3 respectively. Ischemic renal disease occurred in every tenth patient of group 2 or much more frequently than in groups 1 and 3. This suggests additive COLD and CHD effect on the atherosclerotic process. The combination of these diseases was responsible for a large fraction of patients with chronic renal insufficiency in group 2 (45%). It is concluded that concomitant urogenital pathology in patients with COLD results in mutual aggravation of the clinical course of the two diseases and requires additional examination and obligatory medicamentous correction.
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PMID:[Urogenital pathology in patients with chronic obstructive lung disease and ischemic heart disease]. 1906 54

Acute poststreptococcal glomerulonephritis (APSGN) is the most common form of postinfectious nephritis worldwide. The relationship between inflammation and arterial stiffness has been described elsewhere, but there have been no studies that have analyzed the association between arterial compliance and APSGN. The aim of this study is to assess brachial-ankle pulse wave velocity (baPWV) in pediatric patients with APSGN, and the value of baPWV in predicting the outcome. We evaluated 16 children diagnosed with APSGN, 11 children with acute pyelonephritis (APN), and 25 healthy individuals in our hospital. The baPWV of all candidates was measured. In addition, follow-up of the APSGN group was conducted for baPWV, blood pressure and biochemical parameters. Significantly increased baPWV was observed in the APSGN group at initial diagnosis (P<0.001), in comparison with the APN group and healthy controls. Of these, 13 patients received sequential measurement of baPWV. Overwhelmingly, baPWV was rapidly normalized in 11 patients, whereas 2 boys presented with persistently higher baPWV. During the follow-up period of 2-3 years, both had consistency of proteinuria, and consequently, they progressed to either chronic renal insufficiency or end-stage renal disease (ESRD). In conclusion, the results demonstrate that APSGN involves not only the kidney, but also the arteries outside the kidney. Acute arterial stiffness might persist in patients who do not recover, but develop chronic kidney disease (CKD).
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PMID:Acute reversible changes of brachial-ankle pulse wave velocity in children with acute poststreptococcal glomerulonephritis. 2159 44

The article gives the analysis of frequent clinical situations arising in empiric therapy of pyelonephritis alone and accompanied with other severe diseases such as decompensated diabetes mellitus, chronic renal insufficiency, HIV infection. The choice of antibacterial drugs for empiric therapy of pyelonephritis is based on the results of the tests for antibiotic resistance of pyelonephritis causing agents, pharmacokinetic and pharmacodynamic studies. Present-day standards and recommendations of leading centers of pyelonephritis empiric therapy are reviewed.
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PMID:[Current status of antibiotic resistance of pyelonephritis causing pathogens]. 2096 91

Urinary tract infections (UTIs) in children are commonly seen in the emergency department and pose several challenges to establishing the proper diagnosis and determining management. This article reviews pediatric UTI and addresses epidemiology, diagnosis, treatment, and imaging, and their importance to the practicing emergency medicine provider. Accurate and timely diagnosis of pediatric UTI can prevent short-term complications, such as severe pyelonephritis or sepsis, and long-term sequelae including scarring of the kidneys, hypertension, and ultimately chronic renal insufficiency and need for transplant.
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PMID:Pediatric urinary tract infections. 2178 79

Studies undertaken in recent years have improved our understanding regarding the consequences and management of febrile urinary tract infections (UTIs), which are amongst the most common serious bacterial infections in childhood, with renal scarring a frequent outcome. In the past pyelonephritic scarring of the kidney, often associated with vesico-ureteral reflux (reflux nephropathy) was considered a frequent cause of chronic renal insufficiency in children. Increasing recognition as a consequence of improved antenatal ultrasound, that the majority of these children had congenital renal hypo-dysplasia, has resulted in a number of studies examining treatment strategies and outcomes following UTI. In recent years there is a developing consensus regarding the need for a less aggressive therapeutic approach with oral as opposed to intravenous antibiotics, and less invasive investigations, cystourethrography in particular, following an uncomplicated first febrile UTI. There does remain a concern that with this newer approach we may be missing a small subgroup of children more prone to develop severe kidney damage as a consequence of pyelonephritis, and in whom some form of intervention may prove beneficial. These concerns have meant that development of a universally accepted diagnostic protocol remains elusive.
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PMID:Pediatric febrile urinary tract infections: the current state of play. 2212 70

We report the results of a medium-term follow-up study of 52 patients with bilateral, massive primary vesicorenal reflux (PVRR) with renal damage at presentation. Ten infants between 2 and 5 months of age, with a total of 19 renal units, had a temporary vesicostomy followed by ureteral reimplantation after 12-15 months; 42 patients with 81 renal units had primary ureteral reimplantation. The postoperative observation period covered 9.5 years on average (20 months - 21.5 years). The study showed that: (1) urinary specific gravity remained reduced in about 61% of patients; (2) proteinuria improved significantly, in a direct proportion to the favorable evolution of renal function; (3) the frequency of acute pyelonephritis decreased significantly from 98% to 23%. Postoperatively, 27 patients (51%) had one or more episodes of urinary tract infection (UTI) and 12 (23.0%) still had episodes of acute pyelonephritis. (4) At follow-up 7 patients (13.5%) had stable hypertension, while 3 others had unstable hypertension (19.2%); 8 had chronic renal insufficiency or end-stage renal disease. When only adolescents more than 12 years old were considered, the incidence of hypertension increased to 34.4% (10.29). (5) Some renal scarring developed despite successful antireflux surgery, and parenchymal growth, which was severely impaired prior to surgery, restarted although it remained below - 2 standard deviations from the mean. (6) In the overall series glomerular filtration rates (GFR) significantly improved after successful surgery. However, this improvement was much more evident in patients operated upon within the 1st year of life and in those who had had a temporary vesicostomy. In the subgroup of patients operated upon after 6 years of age, successful surgery had no effect on the further decline of renal function when this was already severely compromised. We conclude that early antireflux surgery or, in selected cases, temporary vesicostomy followed by ureteral reimplantation was effective in significantly improving GFR and sharply decreasing febrile UTIs in patients with massive bilateral PVRR and renal damage at presentation.
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PMID:Postoperative medium-term follow-up of patients with bilateral, massive primary vesicorenal reflux and reduced renal function at presentation. 2405 9


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