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)

Hamster to rat renal xenotransplantation was performed with recipient nephrectomies. Recipients were treated beginning on day 0 with continuous FK 506 monotherapy, a 7-day or open-ended monotherapeutic course of cyclophosphamide (CP), and the two drug regimens combined. CP alone (10 mg/kg/day) prevented a xenospecific antibody response and tripled median survival of the kidney (defined as recipient death) from 6 (control) to 18.5 days whereas FK 506 alone had no effect. The drugs in combination were no better than CP alone (15 days) unless the 5-day course of CP was given at a higher dose (15 mg/kg) and started 3 days preoperatively (79 days). In further experiments, adjuvant measures were added to the minimally effective FK 506/7-day CP regimen which gave a median survival of only 15 days. In the most successful modification, intraoperative antibody depletion by the temporary transplantation of third party hamster liver or en bloc kidneys increased median survival from 15 to 34 and 48 days, respectively. An intraoperative i.v. dose administration of the anticomplement drug K76 instead of antibody depletion increased survival to 26 days. Although the events of kidney rejection were similar to those of heart xenografts and partially forestalled by the antibody inhibiting CP treatment, or by antibody depletion, survival for > 100 days was accomplished in only 5 of 86 treated animals. The poorer survival previously reported with cardiac xenotransplantation is largely explained by the life support requirement of the kidneys. Renal failure was responsible for almost all deaths before 60 days, and subnormal renal failure was a pervasive adverse factor thereafter, frequently caused by pyelonephritis which is suspected to have had an immunologic etiology.
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PMID:Hamster to rat kidney xenotransplantation. Effects of FK 506, cyclophosphamide, organ perfusion, and complement inhibition. 753 96

This prospective study investigated hypertension and renal vasoconstriction developing during the 1st year after renal transplantation in patients randomly allocated to treatment with FK 506 (n = 28) or CyA (n = 13). Starting doses were 0.2-0.3 mg/kg per day for FK 506 and 5-8 mg/kg per day for CyA: doses were subsequently adjusted to trough levels (5-15 ng/ml for FK 506 and 100-150 ng/ml for CyA). We compared 24-h ambulatory blood pressure measurement, antihypertensive treatment, serum creatinine, and resistance index (RI), measured by Doppler ultrasound at the level of the interlobar artery. Until month 2 of treatment, FK 506-treated patients had a significantly lower RI (8%) and better renal graft function, as evidenced by significantly lower serum creatinine values. Some 13% of FK 506-treated patients, compared to 70% of CyA-treated patients (P < 0.01), needed additional antihypertensive drugs after transplantation to keep blood pressure stable. FK 506 treatment, at the above-mentioned dosages, was associated with a significantly higher number of infections (urinary tract infection, pyelonephritis, and pneumonia). We conclude that CyA produces greater renal vasoconstriction and systemic hypertension than FK 506, as reflected in higher renal interlobar artery RI values and a greater need for antihypertensive treatment. After 2 months of treatment and a reduction in CyA trough levels, the renal effects (i.e., lower RI and lower creatinine values), but not the systemic hypertensive effects, disappear.
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PMID:Pronounced renal vasoconstriction and systemic hypertension in renal transplant patients treated with cyclosporin A versus FK 506. 950 47

Renal transplantation (RTx) is widely accepted as the preferred method of treatment for children with end-stage renal disease (ESRD). This is a retrospective analysis of the results of RTx in children performed at the Surgical Kidney Hospital, Damascus, Syria. Between November 2002 and November 2004, a total of 176 RTx procedures have been performed in our center. Of them, 11 recipients (6%) were younger than 14 years of age. The mean age was 11 years with range of 5 to 14 years. There were six males (55%) and five females (45%). All patients received kidneys from living donors. Seven donors were related (64 %) while four (36%) were unrelated .The cause of ESRD in these patients were reflux nephropathy in three, nephronophthisis and hypoplastic kidneys in two cases each and polycystic kidney disease, rapidly progressive crescentic glomerulonephritis, Alport's syndrome and chronic pyelonephritis in one patient each. All grafts were placed extra-peritoneally. Immunosuppression was based on triple therapy with cyclosporine (CsA) mycophenolate mofetil (MMF), and prednisolone. Tacrolimus (TAC), MMF, and prednisolone, and sirolimus (SRL), MMF, and prednisolone were used in one patient each. Induction immunosuppression in immunologically high-risk patients was, with anti-thymocyte globulin (ATG) in one patient and basiliximab in two patients. The mean duration of follow-up was 12 months {3 to 24 months}. All 11 (100 %) patients were alive at last follow-up with functioning graft. Ten patients (88%) had normal graft function and one (12%) had mild graft dysfunction. Complications encountered were infections in four patients, early steroid-responsive acute rejection in one patient, and mild biopsy-proven chronic rejection in another patient; the latter probably due to poor compliance. No urological complications were encountered. Our study, despite involving a small number of patients with a relatively short duration of follow-up, suggests that the results of pediatric renal transplant at our center are encouraging.
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PMID:Pediatric renal transplantation in syria: a single center experience. 1764 4

Calcineurin inhibitor Tacrolimus, is a potent immunosuppressive drug widely used in order to prevent acute graft rejection. Urinary tract infection (UTI) is the most frequent infectious complication in renal transplant patients and long-term use of Tacrolimus might be involved in higher susceptibility to bacterial infections. It remains largely unknown how Tacrolimus affects the host innate immune response against lower and upper UTI. To address this issue, we used experimental UTI model by intravesical inoculation of uropathogenic E.coli in female wild-type mice pre-treated with Tacrolimus or solvent (CTR). We found that Tacrolimus pre-treated mice displayed higher bacterial loads (cystitis, pyelonephritis and bacteremia) than CTR mice. Granulocytes from Tacrolimus pre-treated mice phagocytized less E. coli, released less MPO and expressed decreased levels of CXCR2 receptor upon infection. Moreover, Tacrolimus reduced TLR5 expression in bladder macrophages during UTI. This immunosuppressive state can be explained by the upregulation of TLR-signaling negative regulators (A20, ATF3, IRAK-M and SOCS1) and parallel downregulation of TLR5 as observed in Tacrolimus treated granulocytes and macrophages. We conclude that Tacrolimus impairs host innate immune responses against UTI.
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PMID:Calcineurin inhibitor Tacrolimus impairs host immune response against urinary tract infection. 3064 71