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)

Urinary tract infection is a common paediatric disease. Pyelonephritis may lead to severe renal damage (renal scarring), with possible arterial hypertension and renal insufficiency. Treatment and prognosis are closely related to a number of risk factors such as clinical, biological, radiological and scintigraphic data. The aim of the management is to give the most appropriate treatment and follow-up to avoid renal scarring.
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PMID:[Urinary infection in the child: diagnosis, treatment, and prognosis]. 1049 85

A 51-year-old female patient was hospitalized in our department with high fever and left flank pain. Laboratory examination showed leukocytosis, increase of C-reactive protein (CRP), hyperglycemia and renal insufficiency. Enterobacter aerogenes grew out of the cultured urine. The radiograph and computerized tomographic (CT) scan revealed streaky gas in the destroyed left renal parenchyma with perirenal gas. She was diagnosed with left emphysematous pyelonephritis. Antibiotics therapy, treatment for sepsis and disseminated intravesicular coagulation was initiated resulting in mitigation of inflammation. High blood glucose initially required insulin therapy, but finally returned to normal levels through administration of oral antidiabetics. Although leukocytosis and low grade fever continued, the patient was discharged on day 53 with a negative CRP. CT scan indicated that the emphysematous change was localized after three months and almost resolved after four months. Renal scintigram indicated the residual function of the affected kidney. Because of the possibility of residual renal function and the cure by conservative therapy alone, the conservative therapy is preferred when the initial treatment is effective.
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PMID:[A case of emphysematous pyelonephritis improved with conservative therapy--indication for conservative therapy]. 1087 58

Acute renal insufficiency (ARI) complicated the course of the underlying process, including primary and secondary glomerulonephritis, interstitial nephritis, pyelonephritis, dysmetabolic nephropathies, urolithiasis, tubulopathies, renal congenitae defects and injuries in 136 of 1695 children with nephrological diseases hospitalized at Republican Pediatric Renal Center during the last decade. In 69.1% cases ARI developed by the renal type, in 23.5% cases was caused by prerenal factors, and rarely (in 7.4% cases) by postrenal factors. Renal ARI in children was caused by 5 causes, including glomerulonephritis (47%), acute tubular necrosis (19%), interstitial nephritis (14%), vascular disorders (11%) resultant from vasculitis, renal vein thrombosis, and acute crystalluria (9%) which developed in the presence of grave dysmetabolic nephropathy. Among three clinical variants of ARI the most severe was observed in renal ARI leading to grave endogenous intoxication and pronounced decompensation of renal function. More benign course of renal ARI caused by acute tubular necrosis or acute crystalluria differed significantly from prerenal ARI by a more pronounced endogenous intoxication, increased fractionated sodium excretion, and renal insufficiency index higher than 1.
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PMID:[Diagnosis of acute renal failure in pediatric nephrology]. 1133 30

The case of lingual cancer in the 25-years old man treated in 2nd ENT Department Silesian Medical Academy in Zabrze was presented in this paper. The patient has been treated from 1989 due to chronic pyelonephritis finished with the renal insufficiency. In 1991 the renal graft was performed and in 1993 graftectomy due to its rejection. In 1991-1993 the long-term immunosuppression was taking including medicines like Cyclosporin, Imuran, Azatioprin and Encorton. The aim of this study was to consider the influence of immunosuppression therapy on lingual cancer appearance in our patient.
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PMID:[A case of tongue neoplasm in a 15-year old patient treated with immunosuppressants for renal insufficiency]. 1135 87

Diuretic and aciduretic reactions were compared in healthy children and children with various renal diseases using furosemide loading test. Diuresis, urinary pH, urinary excretion of titered acids and ammonium, and ammonium coefficient were evaluated in healthy controls, patients with chronic and acute renal insufficiency, convalescents after acute renal insufficiency and acute postinfection glomerulonephritis, patients with chronic pyelonephritis, interstitial nephritis, lipoid nephrosis, hematuric chronic glomerulonephritis, and patients with a solitary kidney. Diuresis, urinary pH, ammonium excretion, and ammonium coefficient are proposed as the main test parameters. Patients with the distal tubular acidosis syndrome formed a special group by the results of urinary pH measurements during the third hour of furosemide action. The test helps evaluate the severity of disease and predict its course.
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PMID:[Functional furosemide loading test. Practical use in children with kidney diseases]. 1201 72

Pyelonephritis, in which renal tubular epithelial cells are directly exposed to bacterial component, is a major predisposing cause of renal insufficiency. Although previous studies have suggested C-C chemokines are involved in the pathogenesis, the exact source and mechanisms of the chemokine secretion remain ambiguous. In this study, we evaluated the involvement of Toll-like receptors (TLRs) in C-C chemokine production by mouse primary renal tubular epithelial cells (MTECs). MTECs constitutively expressed mRNA for TLR1, 2, 3, 4, and 6, but not for TLR5 or 9. MTECs also expressed MD-2, CD14, myeloid differentiation factor 88, and Toll receptor-IL-1R domain-containing adapter protein/myeloid differentiation factor 88-adapter-like. Synthetic lipid A and lipoprotein induced monocyte chemoattractant protein 1 (MCP-1) and RANTES production in MTECs, which strictly depend on TLR4 and TLR2, respectively. In contrast, MTECs were refractory to CpG-oligodeoxynucleotide in chemokine production, consistently with the absence of TLR9. LPS-mediated MCP-1 and RANTES production in MTECs was abolished by NF-kappaB inhibition, but unaffected by extracellular signal-regulated kinase inhibition. In LPS-stimulated MTECs, inhibition of c-Jun N-terminal kinase and p38 mitogen-activated protein kinase significantly decreased RANTES, but did not affect MCP-1 mRNA induction. Thus, MTECs have a distinct expression pattern of TLR and secrete C-C chemokines in response to direct stimulation with a set of bacterial components.
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PMID:Roles of toll-like receptors in C-C chemokine production by renal tubular epithelial cells. 1216 29

The primary causes of renal insufficiency in Albanian children are reflux nephropathy and obstructive uropathies. The poor availability and technical quality of conventional radiological imaging in detecting vesicoureteral reflux (VUR) and lower urinary tract obstruction stimulated this pilot study, with the aim of evaluating the diagnostic efficacy of voiding cystourethrosonography (CUS). The study included 34 patients (aged 0.1-14 years) with acute pyelonephritis, 7 of whom already had renal insufficiency. In 22 patients voiding cystourethrography (VCUG) was also performed and a diagnostic concordance of 66.6% between the two techniques was found. Overall CUS showed a sensitivity superior to VCUG in detecting VUR, partly due to technical problems in performing the fluoroscopic examination. For the same reasons, VCUG missed 1 diagnosis of posterior urethral valves, while CUS correctly identified all 4 patients with this diagnosis. In 34 patients, CUS diagnosed 55 cases of grade II-V VUR and 11 urinary tract malformations; 12 patients underwent surgical intervention, some of them on the basis of CUS only. The follow-up of 31-81 (mean 53) months after CUS was completed by 94% of patients, excluding complications due to missed diagnoses. CUS was demonstrated to be a safe, reliable, and reproducible imaging modality without X-ray hazards that could be useful in developing countries. The potential limiting factors of the technique include the operator's training and experience and the costs of the contrast medium.
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PMID:Voiding cystourethrosonography for the diagnosis of vesicoureteral reflux in a developing country. 1509 75

The aim of this study was to assess bone status in 220 subjects with end-stage renal failure (ESRF) (146 men, mean age 53.0 +/- 13.9 years and 74 women, mean age 48.1 +/- 14.3 years). The duration of hemodialysis (durHD) and duration of renal insufficiency (durRI) were, in men, 2.6 +/- 3.8 years and 7.7 +/- 8.0 years, and, in women, 2.8 +/- 3.4 years and 9.1 +/- 7.6 years, respectively. ESRF was caused by the following reasons: chronic glomerulonephritis in 92 patients, diabetes in 52, chronic pyelonephritis in 37, polycystic kidney disease in 19, amyloidosis in 5, hypertension in 4 and unknown cause in 11. The control group consisted of 1615 normal healthy subjects (1216 women, mean age 48.1 +/- 12.1 years and 399 men, mean age 52.9 +/- 14.8 years). Mean age did not differ between patients and controls. Skeletal status was evaluated by quantitative ultrasound (US) measurements at the hand phalanges using DBM 1200 (IGEA, Italy) which measures amplitude-dependent speed of sound (Ad-SoS, m/s). The mean value of Ad-SoS in male patients was 1981 +/- 88 m/s, T-score -l2.03 +/- 1.26, Z-score -0.53 +/- 1.7 and, in female patients, 1967 +/- 96 m/s, -2.23 +/- 1.37, -1.41 +/- 1.56, respectively. Respective values in male controls were 2008 +/- 81 m/s, -1.66 +/- 1.16, -0.01 +/- 0.98 and, in female controls, 2026 +/- 81 m/s, -1.4 +/- 1.15, -0.74 +/- 0.86, and were significantly higher than in male (p < 0.001) and female (p < 0.0000001) patients. A correlation analysis of Ad-SoS with durHD and durRI showed that only in males did both factors significantly influence parameters measured (r = -0.26, p < 0.01). Multiple stepwise regression analysis of Ad-SoS on age, durHD, durRI, weight and height was possible to perform only in males and the following equation was established: Ad-SoS = 2545 m/s - 3.09 x age (years) - 5.68 x durHD (years) - 2.15 x height (cm) - 0.99 x durRI (years), p < 0.000001, r = 0.55, SEE = 69.6. Concluding, in subjects with ESRF treated with hemodialysis, skeletal status assessed with the use of quantitative US was affected.
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PMID:Quantitative ultrasound at hand phalanges in adults with end-stage renal failure. 1512 Dec 47

Urinary tract infection (UTI) is a frequent cause of morbidity during the first years of life and may lead to renal insufficiency. Transforming growth factor-beta1 (TGF-beta) is both immunoregulatory and an important mediator of interstitial fibrosis. TGF-beta was detected in the urine of 52% of 48 children aged 1-24 months with a first episode of UTI (94% due to Escherichia coli) and no obstructive nephropathy compared with 0 of 20 healthy young children (P<0.001). TGF-beta was detected in the urine only during the early stage (<1 day) after initiation of treatment. It was detected more frequently (P=0.06) and in significantly higher concentrations (P=0.046) in children with a normal (99m )Tc-dimercaptosuccinic acid scan compared with those with abnormal scans performed 3-14 days after the diagnosis of UTI, suggesting a regulatory role in fibrogenesis and outcome of pyelonephritis in childhood.
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PMID:Transforming growth factor-beta1 in the urine of young children with urinary tract infection. 1559 71

Tamm-Horsfall protein (THP) is exclusively produced by renal tubular cells of the distal loop of Henle and is the most abundant urinary protein in mammals. The physiological function of THP has remained elusive for over half a century; however, new lines of research position it as a central antimicrobial molecule combating urinary tract infection (UTI). Furthermore, the genetic basis of familial juvenile hyperuricemic nephropathy (FJHN), glomerulocystic kidney disease (GCKD) and autosomal dominant medullary cystic kidney disease 2 (MCKD2) has been recently attributed to mutations within the THP gene. In these clinical conditions misfolded THP accumulates in the tubular cells, ultimately leading to overt renal insufficiency. UTI is the most common nonepidemic bacterial infection in humans, where both innate and adaptive components of the immune system as well as the bladder epithelium are involved in its prevention and clearance. Since the urogenital tract is devoid of typical physical barriers such as mucus or a ciliated epithelium, soluble mediators with potent anti-bacterial capabilities might exist. Recently, genetic ablation of the THP gene was shown to lead to severe infection and lethal pyelonephritis in experimental models of UTI. In addition, mounting evidence indicates that, beyond simply a direct antimicrobial activity, THP is a potent immunoregulatory molecule that induces specific THP-directed cell-mediated immunity. In light of these novel findings the particular role of THP as a specialized defense molecule in the urinary tract is discussed.
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PMID:The multiple functions of Tamm-Horsfall protein in human health and disease: a mystery clears up. 1598 9


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