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

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

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

The etiology of persistent hypokalemia and renal potassium loss was investigated in three children. Each had normal blood pressure but low plasma aldosterone values in relation to elevated plasma renin activity. None had a history of licorice abuse, laxative or diuretic use, persistent vomiting or diarrhea, pyelonephritis, or diabetes insipidus. Additional studies in one patient showed low prostaglandin E excretion and a normal platelet aggregation response to epinephrine and ADP. Although certain aspects of this condition resemble Bartter syndrome, the low concentrations of aldosterone and the absence of evidence for mineralocorticoid excess suggest a previously undescribed syndrome.
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PMID:Hypokalemia, normal blood pressure, and hyperreninemia with hypoaldosteronism. 702 99

Obstructive uropathy causes tubular resistance to aldosterone and severe metabolic imbalance may be precipitated by an episode of pyelonephritis. In the last 3 years we investigated 52 episodes of pyelonephritis (positive urine culture, elevated C reactive protein, fever, elevated neutrophil count) in 50 children between 15 days and 15 months of age. Ultrasonography voiding cystography and renal scintiscan were performed in all cases and i.v. urography in some. A salt-losing syndrome with hyponatremia and hyperkalemia (Na < 125 meq/liter; K > 6.3 meq/liter) was observed in 17 infants < 3 months, accompanied by plasma aldosterone concentration of 5000 to 23,000 pg/ml (normal value, < 1000 pg/ml). All these children had a severe urinary tract (UT) malformation (ureteropelvic junction stenosis in 7 cases, vesicoureteral reflux in 7, posterior urethral valves in 2, double system in 1). Thirteen infants < 3 months, 7 with no urinary tract malformations, did not have electrolyte imbalance. Pyelonephritis was diagnosed in 20 other patients ages 4 to 15 months, including 16 with severe UT malformations; 4 had normal UTs. We conclude that a salt-losing syndrome with tubular resistance to aldosterone can occur during pyelonephritis in young infants with congenital UT malformation, that the risk diminishes considerably or disappears after 3 months of age and that in the absence of UT malformation pyelonephritis does not cause acute sodium loss of clinical relevance.
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PMID:Acute pyelonephritis as a cause of hyponatremia/hyperkalemia in young infants with urinary tract malformations. 771 92

The authors examined 150 patients with pronounced arterial hypertension: 73 with essential hypertension, 42 with chronic glomerulonephritis, 26 with chronic pyelonephritis and 10 with diabetic glomerulosclerosis. In addition to conventional tests, measurements were made of renin activity, levels of plasma aldosterone and hydrocortisone, IgA, IgG, IgM, CIC. A significant rise in concentrations of aldosterone, hydrocortisone against a significant fall in those of plasma renin were registered in all the patients irrespective of the disease. Significant differences between the groups by the renin profile, aldosterone and hydrocortisone levels were absent. It is suggested that changes in the hormonal spectrum and immunological indices are independent of renal affections in hypertension, while involvement of renin-angiotensin-aldosterone system in hypertension stabilization has no nosological specificity. The pattern of the immunity shifts evidences for their important pathogenetic role in maintenance and progression of arterial hypertension.
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PMID:[Changes of the renin-angiotensin-aldosterone system and immunologic parameters in essential and symptomatic arterial hypertension]. 814 96

Although adrenal tumors detected during pregnancy are extraordinarily rare, the pathophysiologic repercussions of untreated adrenal neoplasms are enormous to both mother and fetus. From our computer-based registry of pregnant patients from 1975 through 1996 (n = 30,246), four cases of adrenal neoplasms associated with pregnancy were identified (0.013%), analyzed, and compared with the current medical literature. Four women ages 36, 29, 22, and 21 years had adrenal neoplasms diagnosed with pregnancy. Patient 1 had an unsuspected pheochromocytoma identified at autopsy. At 27 weeks into her pregnancy the patient suffered a myocardial infarction, and both she and the fetus died. Patient 2 was incidentally found to have adrenal and pancreatic neoplasms on screening abdominal computed tomography for von Hippel-Lindau disease. The study identified a pregnancy. She elected to terminate the pregnancy and underwent resection of both tumors. She died 3 years later of metastatic islet cell cancer. Both of these patients had previously delivered healthy babies, but both pregnancies were complicated by hypertension. Patient 3 had a functional adrenal tumor identified initially by urinary aldosterone studies because of symptoms of severe hypertension, and patient 4 had an adrenal mass diagnosed via ultrasonography at 30 weeks' gestation because of concerns for right-sided pyelonephritis. These two women underwent careful monitoring throughout the remainder of their pregnancies with eventual delivery of healthy babies. Both women later underwent successful operative resection of benign adrenal adenomas. Adrenal neoplasms discovered during pregnancy are rare. The onus, however, is on physicians to consider this diagnosis in pregnant women with hypertension, headaches, or other manifestations of adrenal disorders. Surgical management of identified adrenal lesions is thereafter straightforward. Missing the diagnosis has grave implications for these young women and their fetuses.
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PMID:Adrenal tumors and pregnancy. 988 Apr 29

We report a 5-week-old boy who developed severe hyponatremia and hyperkalemia secondary to acute pyelonephritis. The patient presented with non-specific signs, including poor appetite, failure to thrive, and dehydration. An endocrinological evaluation led to a diagnosis of pseudohypoaldosteronism. The patient had phimosis, but no congenital urinary tract malformations. Outflow obstruction secondary to the phimosis appears to have caused pyelonephritis, and renal inflammation decreased responsiveness to aldosterone transiently.
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PMID:Reversible secondary pseudohypoaldosteronism due to pyelonephritis. 1273 13

Hyponatremia is the most common electrolyte abnormality in children and underlying causes are many. It is most often caused by excessive salt loss from the gut but is also associated with severe systemic disorders in which there is actual or apparent aldosterone deficiency, such as congenital adrenal hyperplasia (CAH), which is the most common inherited disorder of aldosterone synthesis, and pseudohypoaldosteronism (PHA). Abscent aldosterone activity also leads to hyperkalemia which is characteristic for PHA and can result in life threatening arrythmias. This is a case report about a boy presenting with life threatening electrolyte disturbances in conjunction with PHA resulting from pyelonephritis and vesicoureteral reflux.
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PMID:[A case report - Severe electrolyte disturbances in an eight week old boy]. 2044 21


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