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)

Patients with pyelonephritic renal scarring are at risk of developing renal failure and hypertension. We studied glomerular filtration rate (GFR), renal plasma flow (RPF), filtration fraction (FF), systolic (SBP) and diastolic (DBP) blood pressure, fractional sodium, potassium and phosphate excretion, peripheral renin activity (PRA), plasma aldosterone (p-Aldo), urinary albumin excretion (U-Alb) and urinary beta 2-microglobulin excretion (beta 2-M) in hydropenia and during transition to 3% volume expansion with isotonic saline infusion in 22 female patients with renal scarring due to pyelonephritis and 9 healthy controls. The patients had significantly lower GFR, higher SBP and higher PRA in hydropenia, but there was no significant difference in RPF, FF, DBP or p-Aldo. After volume expansion, SBP, DBP, PRA and p-Aldo were significantly higher in patients than in controls. Transition to 3% volume expansion was associated with a similar increase in SBP in both patients and controls, whereas DBP increased significantly more in the patients (p less than 0.01). Volume expansion resulted in a significant suppression of PRA and p-Aldo in both patients and controls. The patients with renal scarring had the same capacity to excrete sodium and water during transition to volume expansion as the healthy controls. The renin-aldosterone system seems abnormally activated and is probably more important than hypervolemia in the development of hypertension in this group of patients.
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PMID:Role of hypervolemia and renin in the blood pressure control of patients with pyelonephritis renal scarring. 304 33

Thirty cases of multicystic dysplastic kidney (MCDK) were diagnosed over 11 years. Nine patients underwent nephrectomy: three for increasing kidney size (classic MCDK) and six because of an inconclusive diagnosis (hydronephrotic MCDK). Of the remaining 21 patients, 19 were followed up for a mean of 33.5 months (range, 2-101 months). Follow-up ultrasound examinations revealed that 16 kidneys did not change in size, one decreased in size after cyst puncture, and two disappeared (one after cyst puncture). This series included one case of non-renin-producing hypertension that was controlled medically, one case of nephroblastomatosis found in the removed dysplastic kidney, and one case of pyelonephritis in the contralateral kidney. When the diagnosis of classic MCDK is made with imaging modalities, the lesion may not have to be removed unless there is growth of the mass during the 1st year of life. Nine percent of these lesions will disappear within the first 3 years of follow-up, and the authors recommend an even longer period of follow-up.
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PMID:Follow-up studies of multicystic dysplastic kidneys. 328 52

Conflicting opinions exist concerning the use of various birth control methods for women suffering from kidney diseases. Some researchers think kidney diseases are a contraindication for the use of IUD; since IUDs may cause inflammatory processes; others think that preventive therapy of extragenital diseases may make the use of IUD possible. The article studies the functional condition of the urinary system and various hormone levels (renin, aldosterone, vasopressin, cortisol) in women using an IUD. The selections of hormones was based on their role in regulating the water-salt exchange before disturbed in pathologic kidney patients. 43 women aged 19-30 were monitored before insertion and 6 months after insertion of an IUD. 20 women suffered from chronic pyelonephritis, 13 from a latent form of chronic glomerulonephritis; the control group consisted of 10 healthy women. All had previously borne children or had an induced abortion. Besides radioisotopic and radio-immunologic testing, such clinical indicators as bilirubin concentration, cholesterol, and urea in the blood, were determined. Some dependencies were found: for chronic pyelonephritis a positive correlation between the concentration of vasopressin and aldosterone, vasopressin and cortisol, and cortisol and the amount of leukocytes; for chronic glomerulonephritis, a positive correlation between aldosterone concentration and arterial pressure, cortisone level and amount of protein in the urine and concentration of vasopressin and amount of erythrocytes in the urine. The reaction of the kidneys to IUD-induced aseptic inflammatory processes in the uterus is more pronounced for healthy women and women suffering form chronic pyelonephritis, than for women with latent chronic glomerulonephritis, as demonstrated in the test by a reduction in cortisol concentration. The minor changes of the renal functions noticed in healthy and, to a somewhat larger degree, in women from chronic pyelonephritis do not constitute a contraindication for IUD usage and, for latent forms of chronic glomerulonephritis, the IUD is preferred. The functional condition of the kidneys of women suffering from chronic pyelonephritis who use an IUD should be tested by using dynamic scintigraphy.
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PMID:[Function of the kidneys and the renin-aldosterone system in women before and after use of intrauterine contraceptive devices]. 332 76

The long-term results of surgical and specific drug therapy were compared in a group of 57 patients with primary aldosteronism (PA) (46 with aldosterone-producing adenoma (APA), 11 with idiopathic hyperaldosteronism (IHA) and bilateral adrenal hyperplasia). Unilateral adrenalectomy completely normalized blood pressure (BP) in 77.1% of surgically treated APA, evidently improving hypertension in remaining 22.9%. No recurrence of the adenoma in the remaining adrenal was seen in any of the surgical APA cases. In 19 of the non-surgical patients (11 with APA, 8 with IHA) monotherapy with spironolactone reduced blood pressure in 73%, though total BP normalization was an exception. The treatment normalized hypokalemia, low total exchangeable potassium, tendency to hypernatremia, and high total exchangeable sodium. Surgical as well as conservative therapy increased to normal or above-normal levels plasma renin activity suppressed prior to treatment. Pre-operatively high urine and plasma aldosterone levels normalized in all adrenalectomized patients, but remained above the normal range during spironolactone therapy in spite of a small decline in its absolute values. The disturbances of maximum renal concentrating capacity due to impaired nephron responsiveness to sufficiently high endogenous vasopressin concentrations were completely eliminated after kaliopenic nephropathy had been repaired. The other renal functions remained within normal values. Echocardiographically diagnosed left ventricular hypertrophy was seen less often than in the other types of arterial hypertension, tending to regress after APA management. Our longitudinal study (2-16 years) showed primary aldosteronism as a well curable, albeit rare, cause of hypertension. As regards BP and laboratory tests normalization, better results were achieved in surgical APA cases than in patients treated with spironolactone. Older age, longer history of hypertension and more frequent incidence of obesity, nephrosclerosis and pyelonephritis may be responsible for hypertension persisting after surgical treatment.
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PMID:Long-term results of surgical and conservative treatment of patients with primary aldosteronism. 345 May 33

Renin-angiotensin-aldosterone (RAA) function was studied in children with secondary hypertension of 2 varieties: vasorenal hypertension (VRH) and arterial hypertension (AH) associated with chronic pyelonephritis. Children with VRH showed RAA activation that depended on the duration of the disease for its markedness. A direct correlation found between ABP, on the one hand, and plasma renin activity and blood aldosterone level, on the other, is evidence of the latter's involvement in VRH pathogenesis. In AH that is due to chronic pyelonephritis, RAA activation was also demonstrated, however, its pathogenetic involvement was only documented in children with urinary passage disorders (vesico-renal reflux), whereas in the rest RAA activation was not a primary cause of BP elevation.
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PMID:[The renin-angiotensin-aldosterone system in children and adolescents with nephrogenic hypertension]. 352 87

Except for infections (pyelonephritis, abscess of the kidney), which cause symptoms such as pyuria, pain and fever, most diseases of the renal parenchyma were unknown in Greek and Roman antiquity. Even in the Renaissance they were not yet properly identified. Edema was generally thought to be related to liver disease. Proteinuria was discovered at the end of the 18th century. In 1827 Bright provided the first, almost complete clinical description of the various forms of acute and chronic glomerulonephritis and showed that they were accompanied by macroscopic changes in the kidneys. Between 1850 and 1885, Frerichs, Klebs and Langhans described the primary glomerular lesions. The amount of new knowledge acquired during the 20th century has been tremendous, and covers the mechanism of urine formation, the role of sodium retention in edematous states, the physiology and physiopathology of the renin-angiotensin-aldosterone system, the glomerular origin of the nephrotic syndrome, new methods of investigation, progress in histology and immunology, the discovery of many tubular syndromes, the introduction of antibiotics and antihypertensive drugs, and the development of dialysis and transplantation.
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PMID:[On the history of kidney disease]. 355 Oct 58

A retrospective study of the prevalence of arterial hypertension in patients with radiological signs of chronic pyelonephritis was done. During six years i.v. urography has been performed in 936 patients, 297 (31.7%) of whom had hypertension, and 123 (13.1%) had radiological signs of chronic pyelonephritis. Out of the patients with chronic pyelonephritis 87 (70.7%) subjects (57 men, 30 women) had arterial hypertension. Bilateral chronic pyelonephritis was radiologically confirmed in 61 (70.1%) and unilateral parenchymal renal disease in 26 (29.9%) of the patients with hypertension. When the diagnosis has been postulated on the basis of radiologically evident changes of kidney parenchym (renal scarring) or the combined calyx-parenchymatous lesions, it could be shown that the frequency of hypertension in these patients was statistically higher (p less than 0.001) than in the group of patients that displayed only isolated calyx lesions. Moderate and pronounced hypertension were more common (52.5%) in patients with bilateral pyelonephritis scarring compared with hypertonic patients having the same, but unilateral changes. Patients with radiological signs of chronic pyelonephritis and hypertension had proteinuria and various degrees of renal failure significantly more often than these with normal blood pressure. On the basis of the presented results the authors concluded that the prevalence of arterial hypertension in patients with chronic pyelonephritis is much higher (70.1%) than in the average population (31.7%). Hypertension is more common and its complications are severe in the patients with chronic fibrose pyelonephritis. In these patients is also frequent chronic renal failure. The observed facts can be explained on the basis of recent knowledge about pathophysiological mechanisms in chronic pyelonephritis (the renin-angiotensin-aldosterone system, renal prostaglandins system and glomerulo-tubular balance).
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PMID:[Prevalence of arterial hypertension in patients with radiologic signs of chronic pyelonephritis]. 377 67

Unilateral parenchymatous kidney disease associated with high blood pressure represents a potentially curable form of hypertension. Surgery may normalize blood pressure in a substantial number of these patients. Curable renal parenchymatous hypertension includes unilateral tubulointerstitial kidney diseases such as chronic pyelonephritis, reflux nephropathy, segmental hypoplasia and radiation nephritis, hydronephrosis, simple renal cysts, traumatic kidney lesions and renal tumors associated with high blood pressure. Renal ischemia and in turn activation of the renin angiotensin system is involved in the pathogenesis of hypertension in most of these patients. In patients with unilateral kidney disease and hypertension, both an operative and a medical therapeutic approach have a high success rate. Good candidates for nephrectomy are young patients with severe hypertension, strict unilateral disease, normal plasma creatinine levels and minimal function of the involved kidney. In unilateral hydronephrosis reconstructive surgery or nephrectomy may cure or improve hypertension in the vast majority of the patients. Surgically correctable hypertension has also been reported in some patients with large renal cysts and renal tumors (hemangiopericytoma, Wilm's tumor, hypernephroma, renal pelvic tumor).
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PMID:Curable renal parenchymatous hypertension: current diagnosis and management. 390 29

Radioimmunoassays of plasma hormones were carried out, and correlation coefficients between the blood somatotrophin level and blood thyrotrophic hormone, thyroxine, renin, and aldosterone, as well as between blood somatotrophin and diastolic BP, cardiac index, total peripheral resistance, the tension and ejection time, cardiac cycle duration and electrocardiographic SV1 + RV5, were calculated in 95 patients with essential hypertension and symptomatic arterial hypertensions. Blood somatotrophin levels were shown to be basically increased in second- and third-stage essential hypertension and in chronic pyelonephritis with arterial hypertension. However, the hormone is not likely to be directly involved in the BP control.
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PMID:[Concentration of somatotropic hormone in the blood in arterial hypertension of different origin]. 391 80

We investigated 112 patients with end stage renal disease. Clinical evaluations included cystoscopy, cystometry, voiding cystography, bilateral retrograde pyelograms, history and physical examination, and appropriate serum and urinary studies. Of the 112 patients 28 (25 per cent) had significant abnormalities of the urinary tracts. Of the 28 patients 17 had lower tract abnormalities, such as detrusor hyporeflexia, obstructing prostatic hyperplasia and urethral stricture, and 11 had upper tract disease, 9 of whom required a pre-transplant surgical procedure. Included in the group of 9 patients were those with polycystic kidneys, staghorn calculi, renin-related renal hypertension, chronic pyelonephritis and persistent vesicoureteral reflux. None of the azotemic patients had significant morbidity with the timing of the surgical procedures. We believe that eradication of such conditions in the pre-transplant period resulted in a more suitable candidate for renal transplantation. Furthermore, we believe that our finding of 25 per cent abnormalities underscores the need for early urologic evaluation of these patients to ensure their functional capabilities as a recipient.
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PMID:Pre-transplant urologic investigation and treatment of end stage renal disease. 633 46


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