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

1. The renal dysfunction in the chronic compensated pyelonephritis means a selective decrease of the maximum osmotic concentration power, the ammonia secretion and the total secretion of hydrogen ions in the glomerular filtration rate, proximal reabsorption of the fluid of the tubule, excretion of osmotically free water and acidity of the urine which can be titrated. 2. The functional distrubances observed in chronic pyelonephritis do not as a whole differ from those disturbances in chronic compensated glomerulonephritis, but in the disease first mentioned there is in every case no decrease of the endogenic creatinine clearance and the maximum water diuresis. 3. The latent chronic pyelonephritis differs from the latent chronic glomerulonephritis by a normal endogenic creatinine clearance and maximum water diuresis and by a decrease of the ammonia and hydrogen ion secretion. These disturbances to a certain extent may be regarded as specific for the chronic pyelonephritis. In comparison with the chronic hypertonic pyelonephritis in the chronic hypertonic pyelonephritis the maximum water diuresis is normal and the titratable acidity is slightly increased. 4. The kind of renal dysfunctions can be of importance for the differential diagnosis between chronic glomerulonephritis and chronic pyelonephritis particularly in the latent forms of the two diseases.
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PMID:[Tubular kidney dysfunction and its etiology in chronic pyelonephritis]. 84 42

Emphysematous pyelonephritis is a severe necrotizing infection that usually occurs in patients with diabetes mellitus or obstructive uropathy. Although glucose fermentation has been considered as the main cause of gas production the actual mechanism remains controversial. Compositions of gas samples from 2 patients with emphysematous pyelonephritis recently encountered were analyzed, and showed 15% hydrogen, 4.8% carbon dioxide, 60% nitrogen, 6.7% oxygen and some unknown gases in case 1, and 3.4% hydrogen, 22% carbon dioxide, 66% nitrogen and 9.8% oxygen in case 2. These results tend to implicate mixed acid fermentation of glucose as the pathway by which emphysematous urinary tract infections develop.
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PMID:Mixed acid fermentation of glucose as a mechanism of emphysematous urinary tract infection. 205 76

Alpha-hemolysin (AH) is a 110,000-dalton protein secreted extracellularly by certain Escherichia coli. This protein is an acknowledged virulence factor for E coli and recently has been implicated as an important determinant in the pathogenesis of E coli pyelonephritis. Recombinant engineered strains of E coli were used that varied only in their ability to secrete AH extracellularly. The effect of AH on vital dye exclusion, oxygen consumption rate (QO2) adenosine triphosphate (ATP) levels, superoxide (O2-) and hydrogen peroxide (H2O2) production in preparations of isolated rat cortical renal tubular cells (RTCs) was assessed. Approximately 5-10 pg of AH dramatically stimulated QO2 by nearly 150%. This was associated with a marked increase in production of O2- and H2O2, to 13.9 +/- 1.7 and 13.2 +/- 2.1 nM/mg cell protein, respectively (P less than 0.05), as well as a 38% decrease in cellular ATP. These biochemical effects were all seen after a 30-minute exposure to AH and by 120 minutes were associated with 15.7% +/- 1.1% of RTCs that were unable to exclude vital dye. The effect of AH on QO2 and O2- formation was prevented by pretreatment of RTCs with ouabain, which indicates that the effect of AH on oxygen metabolism is linked to Na-K ATPase activity. However, when ouabain-treated RTCs were exposed to AH, ATP remained depressed despite the inhibition of QO2 and O2- production. In contrast, in ouabain-pretreated RTCs, cell membrane integrity was dramatically protected, because only 2.4% +/- 0.4% of RTCs were not unable to exclude vital dye. Thus, the data demonstrate that E coli AH provokes at least two biochemical events that may be injurious to RTC: increased oxygen intermediates (O2- and H2O2 and ATP depletion. These findings with ouabain suggest that the first mechanism of injury may be a more proximate cause of cell death. Moreover, the data suggest that endogenous production of reactive oxygen molecules may be critical modulators of RTC membrane injury.
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PMID:Mechanism of Escherichia coli alpha-hemolysin-induced injury to isolated renal tubular cells. 303 Jan 15

Although emphysematous pyelonephritis has been recognized for more than a hundred years, the actual etiology is still unknown. Glucose fermentation has been implicated as a mechanism of gas formation. We report a case of emphysematous pyelonephritis in which real-time ultrasonography demonstrated intravascular gas bubbles originating in the involved kidney, and passing into the inferior vena cava and hepatic veins. Gas from the affected kidney was analyzed by chromatography; the result showed hydrogen 10.5%, carbon dioxide 39%, nitrogen 49.6% and oxygen 0.8%. The clinical presentation and the results of gas analysis implicate a critical condition that bacteria proliferated rapidly by mixed acid fermentation of glucose. Additionally, the finding of gas production and transportation could explain the previous hypothesis of gas transport. In this critical situation immediate drainage with medical intervention is indicated to treat this life threatening condition.
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PMID:Gas in hepatic veins: a rare and critical presentation of emphysematous pyelonephritis. 825 88

In the pathogenesis of glomerulonephritis, acute renal failure, pyelonephritis and other diseases of the kidneys oxygen radicals are involved. Some types of glomerulonephritis are characterized by infiltration of the glomeruli by neutrophils and monocytes which can form oxygen radicals (superoxide, hydrogen peroxide). The increased amount of cAMP in glomeruli can be due to oxygen radicals. Cyclic nucleotides modulate the inflammatory or immune response in glomerular disease and play a part in the action of local mediators of the inflammation. Oxygen radicals act as second messenger for the activation of cytokines via NF-kappaB transcription factor, they stimulate the formation of TNF-alpha, IL-1, IL-6 and influence the expression of monocyte-specific cytokines (CSF-1 and MCP-1). Radicals formed by the system myeloperoxidase--hydrogen peroxide--halogen derivatives activate proteolytic enzymes (proteinases) which break down collagen and other components of the extracellular matrix present in the basal membrane of glomeruli and in the mesangium. Oxygen radicals and proteinases can cause and amplify glomerular damage. Glucocorticoid administration leads to an increased activity of endogenous antioxidant enzymes in the glomerulus and reduced the of lipid peroxidation.
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PMID:[The role of oxygen radicals in the pathogenesis of glomerulonephritis]. 859 8

A 60-year-old-man without a history of diabetes mellitus, or invasive manipulation or obstruction of the urinary tract was admitted for septic shock. Type I emphysematous pyelonephritis was clear in this case: gas within the renal parenchyma extending into the subcapsular region and the perirenal space was present on spiral computerised tomography (CT). Surgical nephrectomy was performed because biochemistry, urography and CT identified a damaged non-functioning left kidney. The outcome was favourable. All urine, blood and nephrectomy specimen cultures were positive for a specific Escherichia coli which produced a high level of gas compared to a reference E. coli strain in the same standard medium, despite the absence of diabetes mellitus. Certain strains of bacteria are able to produce high levels of nitrogen, carbon dioxide and hydrogen and such fermentation in the absence of a high glucose serum level might explain the acute gas-producing bacterial renal infection.
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PMID:Emphysematous pyelonephritis related to specific gas-forming Escherichia coli without diabetes mellitus. 1041 18