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)

Forty-three spinal cord injured patients with endstage renal disease (ESRD) maintained on hemodialysis were studied. The most prevalent renal lesions consisted of chronic pyelonephritis and amyloidosis while the main renal functional features included nephrotic range proteinuria, high urine output and relatively low serum creatinine for the degree of renal insufficiency. Normocytic, normochromic anemia with low reticulocyte response, low serum iron and iron binding capacity and high transfusion requirement and serum ferritin were noted. Various cardiovascular, pulmonary and gastrointestinal abnormalities were found with considerable frequencies. The incidence of amyloidosis was much higher than that reported previously. This is thought to be due to continued progression of amyloidosis occasioned by longer survival in the present series.
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PMID:Clinicopathological characteristics of dialysis patients with spinal cord injury. 688 88

All those clinical, laboratory, radiological and radioisotopic elements of importance in the diagnosis of chronic pyelonephritis in internal medicine have been examined. Anamnestic indications of chronic pyelonephritis include previous infections episodes of the urinary ways, pain in the lumbar and suprapubic region and micturition disturbances. Less significant are objective findings such as pain at percussion of the lumber region, hypertension and possible signs of renal insufficiency. Important diagnostically among laboratory examinations are leucocyturia higher than 1,000.000 in 24 hours, a findings of leucocyte cylinders, bacteriuria higher than 100.000 per cc of urine and the observation of immunoantibodies covering bacteria isolated from the urine. X-ray and radioisotopic examinations are recognised as having considerable diagnostic usefulness. None of the clinical, laboratory, X-ray or radioisotopic findings is, however, strictly specific. Confirmation of a diagnostic suspicion is only possible when scrupulous accumulation of the most typical subjective and objective findings regarding the disease is accompanied by the positivity of diagnostic tests. The results of these tests must in all cases be assessed critically in the context of the clinical picture for, taken singly, they have no decisive value.
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PMID:[The diagnosis of chronic pyelonephritis in internal medicine]. 701 75

When a woman with chronic renal disease wishes to become pregnant, the risk to the mother and the foetus is often inaccurately evaluated or exaggerated. In patients with primary nephropathy the foetal risk is significantly increased by the arterial hypertension frequently associated with renal insufficiency. In systemic lupus erythematosus (SLE) with renal involvement, the risk represented by hypertension is compounded by a high incidence of spontaneous abortion, particularly when the disease is progressive. Pregnancy seems to have little influence on SLE itself, and the classical post-partum problems are controversial. Much more dangerous are acute complications, such as cortical necrosis or haemolytic and uraemic syndromes occurring in apparently healthy women during the last trimester of pregnancy and after delivery. Urinary infections are common during pregnancy. They are heralded by asymptomatic bacteriuria which should be systematically detected, since these infections increase the likelihood of pyelonephritis with in turn increases the severity of perinatal complications.
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PMID:[Kidneys; hypertension and pregnancy. III. The renal risk in pregnancy]. 704 54

One hundred and thirty patients with primary chronic pyelonephritis diagnosed radiologically or by nephrectomy, 84 with unilateral and 46 with bilateral disease, have been followed for six to 240 months. The clinical and radiological features of the disease at presentation, together with its influence on pregnancy, have been analysed. Serial observations of bacteriuria, blood pressure and renal function have been made during follow up and the intravenous urogram (IVU) has been repeated after five years in most patients. Although the disease probably starts in early childhood it often presents to the nephrologist in young adults, mainly women, as symptomatic urinary tract infection, hypertension, renal insufficiency or a combination of these features. Though associated with increased morbidity in pregnancy it does not usually interfere with fertility and in this series it did not cause increased fetal loss. Repeated urinary tract infections and hypertension are common events. Proteinuria is usually minimal and when present is associated with hypertension. The disease in most patients with unilateral disease runs a benign course; a poorer prognosis is associated with bilateral disease, hypertension and proteinuria. Since we found no association between frequent urinary infections and declining renal function we suggest that only symptomatic urinary infection should be treated in adults with chronic pyelonephritis.
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PMID:The natural history of chronic pyelonephritis in the adult. 715 21

The analysis of antibioticograms of patients with a history of chronic pyelonephritis and acute renal insufficiency is presented. It was found that the synergistic effect observed with the use of gentamicin in combination with carbenicillin or ampicillin with cephaloridin provides a decrease in the therapeutic doses of the drugs with a purpose of elimination of their side action.
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PMID:[Microbial flora sensitivity to antibacterial agents in chronic pyelonephritis patients who have had acute kidney failure]. 723 59

The favourable effect of gentamicin and its combination with furosemid was shown in treatment of rats with experimental pyelonephritis. However, alongside the favourable effect, a danger of the gentamicin nephrotoxic effect, especially in combination with furosemid was noted. The nephrotoxic effect was evident from foci of distrophic and necrobiotic changes in the epithelium of the convoluted tubules, impairment of the cortical hemodynamics and development of the cortical hypoxia of the kidneys resulting in severe renal insufficiency. Gentamicin had no direct inhibitory effect on the tissue respiration, did not block the oxygen uptake and oxidative phosphorilation in isolated mitochondria. To prevent the development of the nephrotoxic effect of gentamicin and its combination with furosemid strict and effective control of the antibiotic plasma levels is necessary. Informative tests for the control of the renal function are the concentration parameters of creatinine and urea, especially at the beginning of the pathological state when the level of hyperazotemia is still of a low informative value. The diurnal urine excretion is not an important informative index of renal function.
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PMID:[Use of gentamycin and furosemide in acute pyelonephritis (an experimental morphological study)]. 736 27

This study was carried out to determine the prevalence of hepatitis C virus (HCV) antibodies and the epidemiologic factors associated with HCV infection in patients with chronic renal failure before the onset of ESRD. Sex, age, type of renal disease, level of renal function, and history of blood transfusions and invasive procedures were analyzed in 226 patients with renal disease, compared with a population of 1,244 normal subjects and 124 patients with impaired immunity (patients having autoimmune diseases and receiving chemotherapy treatment). Eighteen seropositive patients with renal disease (prevalence, 7.9%) were found, which was significantly higher than the prevalence in the normal population (1.03% in blood donors, 0.98% in pregnant women; P < 0.001, chi 2). There was no significant association of sex, number of blood transfusions, or history of invasive procedures with the presence of HCV antibodies. The prevalence of HCV antibodies was higher (16.6%) in patients with glomerulonephritis compared with patients diagnosed with interstitial nephritis, pyelonephritis, nephrosclerosis, diabetes mellitus, polycystic kidney, and miscellaneous renal diseases (P < 0.01, chi 2). There was a higher prevalence of HCV antibodies in patients with creatinine clearance lower than 30 mL/min (13%) compared with patients with creatinine clearance higher than 30 mL/min (2.7%) (P < 0.01, chi 2). These data suggest that HCV infection may be associated with the pathogenesis of glomerulonephritis. Alternatively, glomerulonephritis or severe renal insufficiency may increase the likelihood of HCV infection.
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PMID:Epidemiology of hepatitis C virus infection in patients with renal disease. 752 63

In order to estimate the effect of renal disease on the pregnancy, and the effect of pregnancy on the natural course of renal disease, the course and outcome of the 37 pregnancies was analyzed in gravidas with chronic renal disease. The women were cared for between 1978 and 1990 at the Department of Obstetrics, School of Medicine University of Zagreb. Analysis of the results in this article is retrospective. Thirty-six pregnancies finished by vaginal or cesarean delivery or by abortion, while one pregnancy was ectopic and ended by laparotomy during the 20th week. There were 31 live births from 36 fetuses (86.1%), 5 stillbirths (13.19%), of which 2 pregnancies ended in fetal death (abortion). In addition, there were 6 instances of neonatal death (8.3%). Twenty-five percent of pregnancies finished before 37 weeks of gestation. In 6 of 34 (17.6%) deliveries amniotic fluid was meconium stained, and 5 of 31 (16.1%) infants were born hypoxic. There were 29 percent of growth retarded liveborn fetuses. Perinatal mortality was 167/1000. Renal insufficiency was noted in 12 of 37 (32.4%) pregnancies, 54% of pregnant women had hypertension, 8.1% hyperkalemia, 78.4% were anemic, 27% had significant bacteriuria and 21.6% overt pyelonephritis. There was one case of acute deterioration in renal function that required hemodialysis, and one case of preeclampsia. Renal insufficiency or hypertension reduce drastically the chances for a successful outcome of pregnancy in gravidas with kidney disorders. However renal insufficiency in the presence of hypertension, carries even poorer prognosis, with perinatal mortality of 428/1000.
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PMID:[The effect of chronic kidney disease on the course and outcome of pregnancy]. 823 20

Outpatient therapy is currently recommended for women with uncomplicated pyelonephritis, not those with sepsis, renal insufficiency or pathology, or significant underlying disease. Parenteral therapy is usually initiated in the emergency department, followed by oral therapy at home. Pregnant patients are hospitalized, though studies suggest that outpatient therapy may be appropriate.
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PMID:Outpatient parenteral antibiotic therapy. Management of serious infections. Part II: Amenable infections and models for delivery. Pyelonephritis. 832 25

Because of the many newly developed chemotherapeutics it is often hard to choose the most suitable substance for treatment of urinary tract infection (UTI). Substances for first-line oral treatment are the benzylpyrimidine/sulphonamide combinations, amino-penicillins, fluoroquinolones and cephalosporins. In severe infections any of these can be given i.v., as can amino-glycosides or the combination of imipenem and cilastin. It is easier to decide which substance to give before urine culture results are available if the local resistance patterns to the typical pathogens are known. Particular care is mandatory for risk groups such as children, pregnant women, immunocompromised patients and those with renal insufficiency. Before treatment clinical classification of UTI is necessary. In acute uncomplicated cystitis oral antibiotics should be given either as single-shot therapy or over 3 days. In acute uncomplicated pyelonephritis therapy should last for 7 days or until 3 days after fever is gone. If enteral absorption is not guaranteed or in complicated cases of UTI, intravenous drugs should be used for 10-14 days until fever is gone or the complicating factor has been corrected.
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PMID:[Current chemotherapy in urinary tract infection]. 844 43


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