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)

Trehalose synthesis (RpoS-dependent) and betaine uptake mediated by transporters ProP and ProU contribute to the osmotolerance of Escherichia coli K-12. Pyelonephritis isolates CFT073 and HU734 were similar and diminished in osmotolerance, respectively, compared to E. coli K-12. The roles of RpoS, ProP and ProU in osmoregulation and urovirulence were assessed for these isolates. Strain HU734 expressed an RpoS variant which had low activity and a C-terminal extension. This bacterium accumulated very little trehalose and had poor stationary-phase thermotolerance. For E. coli CFT073, introduction of an rpoS deletion impaired trehalose accumulation, osmotolerance and stationary-phase thermotolerance. The rpoS defects accounted for the difference in osmotolerance between these strains in minimal medium of very high osmolality (1.4 mol kg(-1)) but not in medium of lower osmolality (0.4 mol kg(-1)). The slow growth of both pyelonephritis isolates in high-osmolality medium was stimulated by glycine betaine (GB) and deletion of proP and/or proU impaired GB uptake. An HU734 derivative lacking both proP and proU retained osmoprotective GB uptake activity that could be attributed to system BetU, which is not present in strain K-12 or CFT073. BetU transported GB (K(m), 22 microM) and proline betaine. High-osmolality human urine (0.92 mol kg(-1)) included membrane-permeant osmolyte urea (0.44 M) plus other constituents which contributed an osmolality of only approximately 0.4 mol kg(-1). Strains HU734 and CFT073 showed correspondingly low GB uptake activities after cultivation in this urine. Deletion of proP and proU slowed the growth of E. coli HU734 in this high-osmolality human urine (which contains betaines) but had little impact on its colonization of the murine urinary tract after transurethral inoculation. By contrast, deletion of rpoS, proP and proU had no effect on the very rapid growth of CFT073 in high-osmolality urine or on its experimental colonization of the murine urinary tract. RpoS-dependent gene expression is not essential for growth in human urine or colonization of the murine urinary tract. Additional osmoregulatory systems, some not present in E. coli K-12 (e.g. BetU), may facilitate growth of pyelonephritis isolates in human urine and colonization of mammalian urinary tracts. The contributions of systems ProP and ProU to urinary tract colonization cannot be definitively assessed until all such systems are identified.
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PMID:The osmotic stress response and virulence in pyelonephritis isolates of Escherichia coli: contributions of RpoS, ProP, ProU and other systems. 1139 Jun 97

From November 1998 to March 2000, two hundred patients over the age of 60 years (Elderly) with clinical renal disease were studied. 144 patients were between ages of 60-69 years, 46 between 70-79 years and 10 were above 80 years. The elderly patients (Male 165; Female 35) with renal disease constituted 11% (200/1816) of the total nephrology consultation during the study period. The clinical presentation included chronic renal failure (42.5%); acute renal failure (28%); nephrotic syndrome (14.5%); acute glomerulonephritis (7.5%); renal vascular disease (5%) and renal cystic disease (2.5%). Diabetic nephropathy, obstructive uropathy and hypertensive nephrosclerosis were the major causes of CRF, accounting for 80% of total CRF in the elderly. Chronic glomerulonephritis and chronic pyelonephritis (CPN) were less common and etiology of CRF was uncertain in 5.9% of cases. However, diabetic nephropathy was the commonest (49.4%) cause of chronic renal failure. We did not see a single case of ischemic nephropathy causing CRF in the present study. Prerenal ARF, obstructive uropathy and sepsis were contributing factors for ARF in 82% of the cases. Volume depletion due to gastrointestinal fluid loss and urinary tract obstruction on account of enlarged prostate were the leading causes of ARF in 20 (35.7%) and 8 (14.3%) cases respectively. Sepsis with or without multiorgan failure was the major (46.7%) cause of mortality in patients with ARF and overall mortality was 26.8%. The commonest (31%) cause of nephrotic syndrome was the idiopathic membranous nephropathy. Diabetic nephropathy related to type-2 diabetes mellitus was the second most common (24.1%) cause of nephrotic syndrome. Diffuse endocapillary proliferative GN of post infectious etiology was the commonest (73.3%) type of acute GN in our elderly patients. Renal cystic diseases were noted in 5 (ADPKD 3; Simple cyst-2) patients. Thus, overall spectrum of renal disease in our elderly patients is similar to that of developed nations except in two ways: (i) Endocapillary proliferative GN of post infectious origin was the commonest type of acute GN and (ii) Rarity or absence of ischemic nephropathy and atherosclerotic renal artery occlusive disease.
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PMID:Spectrum of renal diseases in the elderly: single center experience from a developing country. 1209 35

32 patients with chronic lymphoid leukemia (CLL) were examined to specify reasons of renal damage. Measurements were made of blood urea, creatinine, total protein, electrolytes, uric acid. Also, urinary sediment, diurnal loss of protein and creatinine with urine, glomerular filtration rate, concentration ability of the kidneys were studied. Urinary system was assessed by ultrasound. Most CLL patients studied had renal affection characteristic for chronic pyelonephritis with chronic renal insufficiency. The ultrasonic investigation stated reduced size of the kidneys, thinning of the cortex, extension of the renal pelvis and calyces, concrements. The kidneys and ureters were pressed and displaced by enlarged spleen, liver, lymph nodes. The plan of CLL patients' examination must include ultrasonic investigation of the abdominal organs for early detection of renal lesions.
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PMID:[Renal lesions in patients with chronic lymphocytic leukemia]. 1243 39

This study among elderly renal Egyptian patients (n=220) with only 20 of them were subjected to renal biopsy. Results showed: diabetic nephropathy in 28.2%, hypertensive nephrosclerosis 25.5%, UTI, cystitis and pyelonephritis in 6.8%, renal stones in 5.9%, obstructive uropathy in 7.6%, simple cysts in 4.5%, CRF of unknown origin in 13.1%, and others in 26.4%. DM and HTN were S related to kidney function tests and increase in elderly. Other cardiovascular risk factors and smoking are reported by previous workers to be HS related to renal diseases. Age was significantly related to GFR, BUN and Cr. but sex difference was not significantly related to renal diseases. Multiple myeloma, lupus nephritis, vasculitis and hepatitis B were all recorded in few numbers of elderly Egyptians. HCV was more common and more likely to cause renal diseases. Abdomino-pelvic ultrasound was confirmatory to clinical renal diseases diagnosis. Among patients (n=20) biopsies showed focal necrotizing GN in 20%, membranous nephropathy in 50% and renal amyloidosis in 30%. CTIN was associated in some cases due to NSAID intake. Analgesic nephropathy was a common problem that might lead to ARF in some cases especially in the elderly. Ultrasound results among the biopsy group were confirmatory to clinical diagnosis.
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PMID:Pattern of renal diseases among elderly Egyptians patients with acute or chronic renal diseases in Ain Shams University and Nasser Institute Hospitals, Cairo, Egypt. 1633 99

Urinary tract infections (UTIs) are among the most common infections caused by microorganisms, and pyelonephritis is the most severe infection of the urogenital tract. The risk of developing chronic renal insufficiency due to a UTI without other risk factors is low. The pathogenicity and virulence of the infective microorganisms as well as the efficiency of local or systemic defence mechanisms determine the course and severity of the disease. Virulence properties (adhesins, toxins, capsule, iron uptake) are encoded by genomic structures and the determination of virulence is influenced by the host situation. In renal insufficiency, a variety of quite different substances (uraemic toxins, betaine, amino acids, creatinine, urea, glucose) influence the microbial environment. Defence factors (Tamm-Horsfall protein, defensin, phagocytic activity of granulocytes) and underlying anatomical lesions as well as pre-existing renal disease determine the severity of UTI and the prognosis of renal insufficiency.
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PMID:The interaction of urinary tract infection and renal insufficiency. 1684 55

Clinical and microbiological efficacy of Cifran OD (Ranbaxy, India), a formulation with prolonged action and extended release of ciprofloxacin was studied in 22 patients with bacteriuria and lingering diabetes mellitus. Ciprofloxacin was used in doses of 500 or 1000 mg orally once a day depending on the severity of the disease singns for 2-3 weeks as etiotropic therapy and only in 2 cases with severe pyelonephritis it was used intravenously drop-wise and orally simultaneously. Twenty eight microbial strains isolated from urea of the patients were tested. The main species of the isolates belonged to the family Enterobacteriaceae. Twenty five isolates (89.3%) were susceptible to ciprofloxacin and 3 isolates (10.7%) were resistant. The clinical efficacy of ciprofloxacin was 90.9%.
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PMID:[Therapy of urinary tract infections in patients with diabetes mellitus]. 1701 12

Urinary tract infections may induce severe inflammation, transient impairment in renal function and scar formation, ranging in severity from acute symptomatic pyelonephritis to chronic pyelonephritis, which have a potential to lead to renal failure and death. The present study aimed to investigate the possible protective effect of montelukast, a selective antagonist of cysteinyl leukotriene receptor 1 (leukotriene CysLT1), against Escherichia coli-induced oxidative injury and scarring in renal tissue. Wistar rats were injected 0.1 ml of E. coli (ATCC 25922 10(10) cfu/ml) or saline into left renal medullae. Six rats were assigned as the sham group and were given 0.1 ml 0.9% NaCl. Pyelonephritic rats were treated with either saline or montelukast immediately after surgery and at daily intervals. Twenty-four hours or one week after E. coli injection, rats were decapitated and the kidney samples were taken for histological examination or determination of renal malondialdehyde, glutathione (GSH) levels, myeloperoxidase (MPO) activity, and collagen contents. Formation of reactive oxygen species in renal tissue samples was monitored by using chemiluminescence technique with luminol and lucigenin probes. Creatinine, blood urea nitrogen and lactate dehydrogenase (LDH) activity were measured in the serum samples. E. coli inoculation caused significant increases in malondialdehyde level, MPO activity, chemiluminescence levels and collagen content, while GSH level was decreased in the renal tissues (p<0.05-0.001). On the other hand, serum TNF-alpha, LDH, blood urea nitrogen and serum creatinine levels were elevated in the pyelonephritic rats as compared to control group. Leukotriene CysLT1 receptor antagonist montelukast reversed all these biochemical indices, as well as histopathological alterations, that were induced by acute pyelonephritis. It seems likely that montelukast protects kidney tissue by inhibiting neutrophil infiltration, balancing oxidant-antioxidant status, and regulating the generation of inflammatory mediators suggesting a future role for leukotriene CysLT1 receptor antagonists in the treatment of pyelonephritis.
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PMID:Oxidative renal damage in pyelonephritic rats is ameliorated by montelukast, a selective leukotriene CysLT1 receptor antagonist. 1717 92

The goal of the present study was to describe the clinical, haematological and ultrasonographic findings and treatment of 17 cattle with pyelonephritis. Fifteen cattle had an abnormal general condition, which varied in severity; five animals had signs of colic. The urine was brownish-red in 11 animals and cloudy in 13. Clumps of purulent material were seen in the urine of nine animals and clots of blood in two. The specific gravity was lower than normal in 13 animals and ranged from 1.005 to 1.020. A urine test strip revealed protein in 16 animals, blood in 16 and leukocytes in 12. Bacteriological examination of urine yielded Corynebacterium renale in 11 animals, Arcanobacter pyogenes in two and Escherichia coli in one. Rectal examination revealed abnormalities of the urinary tract in 11 animals; there was dilatation of the left ureter and/or enlargement of the left kidney in eight cases, and dilatation of the right ureter and/or enlargement of the right kidney in three others. The most frequent abnormal haematological finding was an increase in the serum concentrations of total protein, fibrinogen, urea and creatinine, a decreased haematocrit and a positive glutaraldehyde test. In 13 animals, ultrasonography via the rectum and right flank using a 5.0MHz transducer revealed dilatation of the right or left ureter, cystic lesions in one or both kidneys and dilatation of the renal sinus. Eight animals were euthanased or slaughtered at the owners' request or because of a poor prognosis. Nine (53%) animals were successfully treated; five received antibiotics and four underwent unilateral nephrectomy and antibiotic therapy. The treated animals were clinically healthy when discharged from the clinic 10-21 days after admission. A follow-up via telephone 8-24 months later revealed that none had experienced complications and all were in full production. In cattle with severe unilateral pyelonephritis, unilateral nephrectomy is the treatment of choice.
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PMID:Clinical and ultrasonographic findings, diagnosis and treatment of pyelonephritis in 17 cows. 1736 3

A 30-year-old seventh gravida presented with acute renal failure at 28 weeks of gestation. All her previous pregnancies were normal. With a differentional diagnosis of acute pyelonephritis, acute interstitial nephritis (cefuroxime induced) or rapidly progressive glomerulonephritis, treatment with antibiotics, intensive hemodialysis (HD) and pulse methylprednisolone followed by oral prednisolone was initiated. She was maintained on HD 5-6 times per week aiming at serum urea level of less than 15 mmol/L. After six weeks on HD, she underwent a cesarean section at 34 weeks of gestation with delivery of a baby weighing 1.6 kg. Percutaneous left renal biopsy performed one week post-delivery showed anti-glomerular basement membrane (GBM) antibody-mediated crescentic glomerulonephritis. The anti-GBM antibody, which was negative during pregnancy, was found to be positive at this juncture and remained so until ten months post-delivery while on HD. The patient continues to be on regular maintenance HD.
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PMID:Anti-glomerular Basement Membrane Antibody Disease Presenting as Acute Renal Failure During Pregnancy. 1765 25

The objective of this study was to evaluate the role of urolithiasis, infection, and bladder dysfunction in the pathogenesis of renal failure in rats subjected to supratrigonal cystectomy. One group of Sprague-Dawley rats was submitted to supratrigonal cystectomy, a second to cystectomy during which a suspension of Proteus mirabilis was injected into the bladder stump, and a third to sham surgery (controls). The animals were sacrificed two months after surgery. Blood pressure and serum urea and creatinine were measured before surgery and at sacrifice when a careful inspection of the urinary tract was performed to determine the presence of hydronephrosis and calculi. Microbiological analyses were performed on urine aspirated from the bladder and on the kidneys. Significant differences were found between values of systolic blood pressure and serum urea and creatinine recorded prior to the surgical procedure and those recorded at sacrifice in each group except the control group. Renal failure was present in all animals subjected to cystectomy. Urinary calculi were documented in 5/10 animals subjected to cystectomy only and in all rats inoculated with P. mirabilis. Hypertension was documented in 43.75% of animals subjected to cystectomy. Pyelonephritis was diagnosed only in animals with urinary calculi, in each of which urine culture was also positive. No cases of renal failure, hypertension, calculi, and/or pyelonephritis were detected in the sham group. The findings of this study indicate that kidney failure in rats subjected to supratrigonal cystectomy is related to the severe bladder dysfunction induced by the surgical procedure.
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PMID:Experimental supratrigonal cystectomy: II--Evaluation of urinary calculi, infection, and bladder dysfunction in the pathogenesis of renal failure. 1808 27


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