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

We have determined glomerular filtration rate (GFR), renal plasma flow (RPF), urinary excretion of albumin and beta 2-microglobulin, urinary osmolality and total renal area in 22 female patients with renal scarring and a history of febrile urinary tract infections (UTI) and in nine healthy age-matched controls with normal i.v. urography. The aim of the study was to compare different methods of determining glomerular function in patients with renal scarring due to previous pyelonephritis and to determine the urinary excretion of beta 2-microglobulin in these patients. All individuals were investigated in hydropenia. The patients with renal scarring had significantly lower GFR, smaller kidneys and lower urinary osmolality than the controls. A significant positive correlation between GFR and total renal area (r = 0.70, p less than 0.001) and between GFR and urinary albumin excretion (r = -0.69, p less than 0.001) was demonstrated. This indicates that determinations of total renal area from an i.v. urography and the urinary albumin excretion can be used for estimating GFR. Increased urinary excretion of beta 2-microglobulin does not occur in patients with renal scarring until the glomerular function is severely deteriorated.
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PMID:Renal size, glomerular function and urinary excretion of albumin and beta 2-microglobulin in patients with renal scarring due to pyelonephritis. 332 22

Pyelonephritic renal scarring is a common cause of renal failure and hypertension. We studied glomerular filtration rate (GFR), renal plasma flow (RPF), filtration fraction (FF), total renal area (TRA), systolic (SBP) and diastolic (DBP) blood pressure in 22 female patients with verified renal scarring and a history of febrile urinary tract infection (UTI) and in 9 healthy age-matched women with normal urograms and no history of symptomatic UTI. The patients with renal scarring had significantly lower GFR, smaller TRA and higher SBP than the healthy controls, but not significantly different RPF or FF. A decrease in GFR and RPF was associated with higher SBP and DBP in the patients with renal scarring. RPF/TRA, representing an approximation of the perfusion of renal tissue and GFR/TRA, were similar in patients with renal scarring and healthy controls. A reduction of renal parenchyma was accompanied by a proportional decrease in GFR and RPF, resulting in unchanged FF. These findings do not support the concept of hyperfiltration as a main cause of renal insufficiency in patients with pyelonephritis renal scarring. An increase in FF and a decrease in GFR/TRA and RPF/TRA was associated with higher DBP and a decrease in GFR/TRA and RPF/TRA with an increase in the urinary albumin excretion. We conclude that renal hemodynamics play an important part in the blood pressure control of patients with renal scarring and that in these patients with various degrees of renal failure there was no evidence of hyperfiltration or hyperperfusion by remnant glomeruli.
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PMID:Renal hemodynamics and blood pressure control in patients with pyelonephritic renal scarring. 341 7

Three experimental models of vesico-sigmoidostomy are studied (model-1, end to side V-S plus urethral ligation, model-2, end to end V-S, in "Y of Rous" plus urethral ligation and model-3, vesico-sigmoidoplasty), with aim of reproducing chemical imbalance observed in human subjects with ureterosigmoidostomy. Authors have evaluated clinical biochemical (serum acido-base balance, Cl, Na+, K+, BUN, creatinine, ammonia and albumin), and histologic variables in the first, third and fifth month after operation in 225 rats. Animal of model-1 presented more frequently than model-2 and model-3, alterations (hyperchloraemic acidosis, uraemia, hyperammonemia and hypoalbumin) as well as affectation of upper urinary system for acute or chronic pyelonephritis.
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PMID:[Biochemical complications of experimental vesico-sigmoidostomy]. 357 61

1-N[(S)-4-amino-2-hydroxybutyryl]-kanamycin B (habekacin), a new aminoglycoside antibiotic found in 1973 was tested for its nephrotoxicity, pharmacokinetics and prophylactic efficacy in 351 female rats. Increased urinary elimination of tubule cells and malate dehydrogenase (MDH) demonstrated tubulotoxicity even at the minimal dosage of 2.5 mg/kg/d. At high dosages (100 or 50 mg/kg/d) habekacin produced more tubule damage than dibekacin. At lower dosages (20, 10 or 5 mg/kg/d) both aminoglycosides showed similar effects. Additionally, possible glomerular lesions were found at high dosages (100 mg/kg/d) as indicated by proteinuria, CAF (cellulose acetate foil)-electrophoresis of the urinary protein and raised albumin/globulin ratio. - Pharmacological studies revealed serum concentrations similar to dibekacin, in renal tissue, however, the concentrations of habekacin were much higher than those of dibekacin. - In experimental E. coli pyelonephritis, 9 single doses of habekacin or dibekacin (5 mg/kg) given prophylactically reduced the bacterial counts significantly; a single dose of the antibiotics (5 mg/kg) was slightly effective.
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PMID:Habekacin: nephrotoxicity, pharmacokinetics and prophylactic efficacy in rats. 391 52

Plasma concentrations of middle molecule (MM) fractions were quantitatively assessed by use of combined gel filtration and ion exchange chromatography in 82 non-dialyzed azotemic patients. "Sick" patients exhibiting uremic symptoms were compared with symptom-free azotemic patients with regard to plasma levels of individual MM fractions. The patients with edema, pericarditis and intercurrent infections had significantly higher plasma concentration of MM fraction 7c than symptom-free controls. The results confirm our earlier anecdotic observations that high plasma concentration of fraction 7c often associated with uremic symptoms. In the symptom-free group, the patients with polycystic kidney disease showed a significantly lower concentration of fraction 7b in plasma than those with pyelonephritis; the patients on protein restricted diet had higher plasma concentrations of fractions 7b and 7c than those on diets with daily protein intake of 60 g or more. Slight correlations between some biochemical parameters and MM fractions in plasma were found in the total patient material; the highest correlation between albumin and fractions 7c (r = -0.36), and 7d (r = 0.36), respectively. Statistical analysis of this survey has shown that the accumulation of MM fractions, especially fraction 7c, is associated with uremic "sickness", i.e. edema, pericarditis and intercurrent infection.
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PMID:Uremic middle molecules in non-dialyzed azotemic patients: relation to symptoms and clinical biochemistries. 706 71

The diagnostic value of 99mtechnetium-dimercaptosuccinic acid (DMSA) scintigraphy, ultrasonography and renal functional parameters [urine N-acetyl-beta-D-glucosaminidase (NAG)/creatinine and urine albumin/creatinine quotients] in acute pyelonephritis (APN) were studied in 39 children (28 girls, 11 boys, median age 9 months, range 2 weeks to 9.4 years, 28 patients < 1 year, 11 patients > 1 year) with first-time urinary tract infection. Ultrasonography of the urinary tract was performed on admission and together with DMSA scintigraphy (< 10 days from admission). Urine NAG/creatinine and urine albumin/creatinine quotients were measured daily and after 6-8 weeks. Ultrasonography revealed abnormalities in 12 of 39 (31%) patients [11/32 patients (34%) with positive DMSA scintigraphy], while DMSA uptake defects were present in 32 of 39 (82%) patients [21/28 < 1 year (75%), 11/11 > 1 year (100%), P = 0.08]. Urine NAG/creatinine and urine albumin/creatinine quotients were significantly higher in children < 1 year with APN, as well as in non-renal fever controls, than in older children. However, in both age groups the urine NAG/creatinine and urine albumin/creatinine quotients were significantly higher in APN than in non-renal fever. The urine NAG and albumin excretion decreased rapidly after the initiation of antimicrobial therapy and had normalized at 6-8 weeks. The size and grade of the DMSA uptake defect (DMSA score) did not correlate with duration of disease at admission, maximum C-reactive protein or maximum fever. The urine NAG/creatinine quotient in the children < 1 year showed, however, a significant correlation with the DMSA score (r = 0.58, P < 0.05), while no correlation was found in the older children. We conclude that DMSA scintigraphy is a sensitive method to confirm the clinical diagnosis of APN, although a substantial number of infants appear to have normal scans. Early determination of the urine NAG/creatinine and albumin/ creatinine quotients may further improve the diagnostics in the infant.
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PMID:Functional parameters and 99mtechnetium-dimercaptosuccinic acid scan in acute pyelonephritis. 769 7

The relationship between urine interleukin-6 (IL-6) and interleukin-8 (IL-8)/creatinine quotients and 99mTc-dimercaptosuccinic acid (DMSA) scintigraphy, performed within 10 days of acute first-time pyelonephritis and after 1 year, was studied in 41 children. The urine IL-6 and IL-8/creatinine quotients were also related to the urine N-acetyl-beta-D-glucosaminidase (NAG) and albumin/creatinine quotients. Presence of DMSA uptake defects, reflecting local inflammation, in children in the acute phase of pyelonephritis, were associated with elevated urine IL-6/creatinine quotients (median 27 pg/mumol); in children without DMSA changes there was no increase in quotients (median non-detectable) (P < 0.05). Persistent DMSA changes at the 1-year follow-up, probably reflecting renal scarring, were only seen in children with increased urine IL-6/creatinine quotients in the acute phase (P < 0.01). No correlation was found between urine IL-8 and DMSA uptake defects. Vesicoureteral reflux (VUR) at 6-8 weeks did not correlate with the urine cytokine levels in the acute phase. The urine excretion of NAG and albumin, reflecting renal dysfunction, was associated with values of both urine IL-6 and IL-8/creatinine quotients, but not with DMSA defects or VUR. Thus, the initial urine IL-6/creatinine quotients might be used as an indicator of risk for persistent renal damage in acute pyelonephritis.
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PMID:Urine interleukin-6 and interleukin-8 in children with acute pyelonephritis, in relation to DMSA scintigraphy in the acute phase and at 1-year follow-up. 788 89

Studies of the pathophysiology of renal disease in non-insulin-dependent diabetes mellitus (NIDDM) have been hindered by the lack of an appropriate experimental model. We examined the natural history of metabolic and renal changes in the partially inbred Zucker Diabetic Fatty Rat (ZDF/Drt-fa), a model that closely mimics the metabolic abnormalities of NIDDM. Lean nondiabetic littermates served as controls. Body weights in the obese rats were higher initially, but thereafter stabilized at values similar to those in lean controls. Blood glucose levels rose to overtly hyperglycemic levels in the obese group, stabilizing in the 300 to 400 mg/dL range. Serum insulin, cholesterol, and triglyceride levels were all elevated in the obese group, though insulin levels declined later in life. Values for systolic blood pressure rose slightly with age in both groups, but remained within the normal range, and did not differ between groups. Urinary albumin excretion values were higher in the obese group at all time points, and rose progressively throughout the study. Morphologic examination revealed the presence of severe hydronephrosis in almost all animals, affecting lean as well as obese rats. In some cases, complications were found, including tubular dilation, necrotizing granulomas, inflammatory changes, and pyelonephritis, some of which were fungal. Accordingly, the ZDF/Drt-fa rat appears to be an excellent model of the metabolic changes that characterize NIDDM. Unfortunately, the utility of this model for study of diabetic renal disease is compromised by the ubiquitous presence of other, nondiabetic renal lesions.
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PMID:Evolution of metabolic and renal changes in the ZDF/Drt-fa rat model of type II diabetes. 880 17

In 180 children (87 children belonging to a control group, 68 with fever of non-renal origin, and 25 with pyelonephritis) albumin and immunoglobulin G (markers for glomerular dysfunction), alpha-1-microglobulin and beta-NAG (markers for proximal tubular dysfunction) and apolipoprotein A1 (marker of "postrenal' dysfunction) were measured in second-voided morning urine. In children with fever of non-renal origin, glomerular dysfunction was encountered in 8.8%, tubular dysfunction in 17.6% and mixed glomerular-tubular dysfunction in 14.7% of cases. Among children with pyelonephritis, 28% revealed glomerular dysfunction and 44% mixed glomerular-tubular dysfunction. No case of solitary proximal tubular dysfunction was observed in children with pyelonephritis. There were highly significant differences in presence and expression of glomerular dysfunction between children with fever of non-renal origin and children with pyelonephritis (P < 0.0001), whereas with regard to proximal tubular dysfunction, the differences were only moderately significant (beta-NAG: P < 0.01) or of low significance (alpha-1-microglobulin: P < 0.05). This may indicate that morphologic changes occur during interstitial pyelonephritis due to inflammation of glomeruli, resulting in glomerular dysfunction, while proximal tubular dysfunction may additionally be due to fever-associated function processes.
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PMID:[Microproteinuria and enzymuria in fever and pyelonephritis in childhood. A prospective study of 180 children]. 912 85

Prostatilen (5 mg/day i.m. for 5 days) was given to 46 patients with chronic pyelonephritis in the latent inflammation phase. The treatment resulted in relief of clinical symptoms, positive trend in laboratory indices characterizing activity of renal inflammation, albumin-globulin ratio. There was a decrease in leukocyturia, bacteriuria, ESR, blood fibrinogen and ceruloplasmin levels. Prostatilen reduced hypercoagulation and enhanced fibrinolytic activity of blood. The immunograms showed prostatilen-induced correction of immunity: T-lymphocyte count and functional activity increased, proportion of T-cell subpopulations returned to normal, metabolic activity of phagocyte oxygen-dependent substances became more intensive. The ability of prostatilen to initiate normalization of hemocoagulation and immunity is thought to be an essential factor of its therapeutic efficacy in chronic pyelonephritis.
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PMID:[The bioregulatory therapy of patients with chronic pyelonephritis]. 938 26


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