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

Three patients with well documented unilateral chronic pyelonephritis (UCP) of bacterial origin, one hypertensive and two normo-tensive, were presented. Removal of the contracted kidney in the hypertensive patient did not eradicate the hypertension. An attempt was made to define UCP as closely as possible. The clinical, roentgenologic, bacteriologic, functional and pathologic criteria of UCP was described. But, as other conditions may mimic the roentgenologic, functional and pathologic picture of UCP, a history of recurrent urinary tract infection accompanied by a documented unilateral renal bacteriuria is the basic requirement for a sustained diagnosis of UCP. In view of these more exacting criteria in the diagnosis of UCP, and its water and salt-losing functional pattern, UCP is a rare cause of hypertension, in the majority of cases the association of UCP with hypertension is merely coincidental.
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PMID:Unilateral chronic pyelonephritis and hypertension: coincidental or causal relationship? 71 16

Plasma aldosterone, plasma renin activity, sodium and potassium in the plasma and the urine were determinated under acute stimulation with saline-depletion (furosemide) and under acute suppression with saline infusion in 40 patients with primary hypertension stage I, 19 patients with primary hypertension stages II and III, and 11 patients with renal hypertension (chronic glomerulonephritis and chronic pyelonephritis). The majority of the patients with primary hypertension stage I showed a good stimulation of the plasma aldosterone and the plasma renin activity under acute salt depletion. Three out of the 40 patients with primary hypertension stage I, and 13 of the 19 patients with primary hypertension stages II and III did not show any stimulation of the renin secretion ("low renin hypertension"). In all these patients the plasma aldosterone stimulation remained intact. With infusion of saline all the groups showed suppression of the plasma aldosterone and the plasma renin activity. A good stimulation of the plasma renin activity, demonstrates that in our experiments the renin-angiotensin system cannot be responsible for the increase in aldosterone secretion under salt depletion. Most likely the increase of the plasma aldosterone, in spite of the fixed renin activity, is stimulated by the sodium depletion due to diuretics. In all patients with primary hypertension we did not find an inadequate reaction of the aldosterone secretion under saline infusion. The patients with renal hypertension showed a minimal stimulation and suppression of the plasma renin activity. The plasma aldosterone secretion increased only slightly under sodium depletion and the decrease under saline infusion was statistically not significant. Thus we conclude that these patients show an inadequate reaction of the plasma aldosterone and renin secretion under salt infusion and depletion.
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PMID:[Plasma aldosterone and plasma renin activity in patients with essential and renal hypertension under acute stimulation with saline depletion and acute suppression with saline infusion]. 115 49

It is apparent that the split function study and renal vein renin determination are complementary and afford valuable information for selecting patients with potentially curable renovascular hypertension. The split function study, when interpreted with the recently defined split function ratio, offers the clinician a highly accurate means of diagnosing significant renal ischemia. Because the split function ratio shows the disparity between the ischemic and contralateral kidney to a greater degree, the chance of misdiagnosis due to laboratory or physician error is minimized. The split function study, however, is of limited value in patients with pyelonephritis since the water- and salt-losing characteristics of the pyelonephritic kidney may mask significant renal ischemia. In these patients, as well as those with a nonfunctioning kidney or hydronephrosis, the renal vein renin determination is the test of choice. In addition, the added morbidity of the split function study is not warranted in a patient with an elevated peripheral renin which, for interpretation, requires an accurate 24 hour urine for sodium, a renal vein renin ratio outside the range of patients with essential hypertension (renal vein renin ratio greater than 1.7) and evidence of suppression of renin secretion from the contralateral kidney. If, however, the renin determination does not afford convincing evidence of significant renal ischemia in a patient with radiographic evidence of renal arterial stenosis, a split function ratio definitely should be determined to more completely define the pathology. The attendant morbidity of a carefully performed split renal function study does not approach the morbidity and mortality associated with unnecessary surgery or inadequately treated hypertension.
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PMID:Ureteral catheterization studies. 115 55

Renal transportation of sodium and potassium was studied in 85 patients who sustained hemorrhagic fever complicated with renal syndrome (HFRS). The examinees were given routine diet No. 7 recommended by Pevzner. The conclusions were made on the analysis of circadian excretion and clearance of electrolytes studied and the levels of their water-load-induced tubular transportation: distal and proximal reabsorption and distal excretion of sodium, the correlation between potassium secretion and reabsorption in the distal part of the nephron. It was revealed that within the first year after the disease onset, 37.5 per cent of patients had increased levels of sodium excretion as part of the salt-loss syndrome developed due to decreased sodium reabsorption in the distal part of the nephron. Later the status was featured by moderately pronounced disorders of distal sodium reabsorption in 6.25 per cent of the patients only, mostly in those with HFRS-induced pyelonephritis. Increased excretion of potassium noted in the first months after HFRS only was the result of an increase in sodium excretion. The aforementioned disorders could be easily compensated by a routine diet and therefore a decrease in the levels of sodium or potassium avoided.
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PMID:[Electrolyte excretion in patients with a history of hemorrhagic fever with renal syndrome]. 197 Sep 13

Bacteriological, pharmacokinetic and clinical studies on cefpodoxime proxetil (CPDX-PR, CS-807), a new oral cephem antibiotic, were carried out in the field of pediatrics. The results obtained are summarized as follows. 1. Antibacterial activities of R-3746 (Na-salt of cefpodoxime (CPDX] against clinically isolated strains of Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, Enterococcus faecalis, Branhamella catarrhalis, Escherichia coli, Proteus mirabilis and Haemophilus influenzae were compared with those of cefaclor, cephalexin and cefadroxil. R-3746 is superior to other antibiotics against S. pneumoniae, S. pyogenes, B. catarrhalis and Gram-negative rods. 2. Serum concentrations of CPDX after administration of CPDX-PR at doses of 3 mg/kg (fasting), 6 mg/kg (non-fasting) and 6 mg/kg (fasting) were determined. Mean AUC (area under curve)'s of CPDX obtained were 9.60, 31.35 and 17.89 micrograms.hr/ml, respectively for the 3 dosages. The mean half-lives of CPDX were 3.35, 1.88 and 1.76 hours, respectively. The mean urinary recovery rate within 8 hours after administration of CPDX-PR at a dose of 3 mg/kg (fasting) was 39.2%. 3. CPDX-PR was administered to 37 pediatric patients with various bacterial infections (pyelonephritis 9, cystitis 4, pneumonia 7, acute bronchitis 3, otitis media 2, tonsillitis 10, subcutaneous abscess 1 and purulent lymphadenitis 1). The overall clinical efficacy rate was 91.9% and the overall bacteriological eradication rate was also 91.9%. 4. No adverse reactions were observed. Abnormal laboratory findings were moderate, eosinophilia in 2 and slight elevation of GOT and GPT in 1. The taste and the odor of the CPDX-PR preparation was sufficiently tolerable. From the above results we have concluded that CPDX-PR is a useful oral antibiotic in the treatment of bacterial infections in children.
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PMID:[Bacteriological, pharmacokinetic and clinical studies on cefpodoxime proxetil in the pediatric field]. 256 89

Cell surface hydrophobic properties and expression of P-fimbriae were examined in 130 strains of Escherichia coli derived from women (n = 66) and children (n = 64) with acute non-obstructive pyelonephritis and in 170 faecal strains of E. coli from healthy adults (n = 103) and children (n = 67) by use of the salt aggregation test and the P-fimbriae-specific particle agglutination test. The strains of E. coli isolated were aggregated in salt solutions of varying molarity (0.001-1.6 M final concentration). Patients with predisposing medical or urological conditions in the urinary tract were excluded. Pyelonephritic strains of E. coli from the women and children had a higher degree of cell surface hydrophobicity (80 and 98% respectively) than faecal strains from healthy adults and children (57 and 82% respectively, P less than 0.01 and P less than 0.01). Both pyelonephritic and faecal strains of E. coli from the children were more often salt aggregation positive (hydrophobic) than faecal strains of E. coli from healthy adults (P less than 0.01 and P less than 0.001, respectively). Pyelonephritic strains of E. coli from women and children were more often P-fimbriated (79 and 84% respectively) than faecal control strains from women and children (15 and 33%, P less than 0.001 and P less than 0.001, respectively) but there was no significant correlation between expression of P-fimbriae and cell surface hydrophobicity.
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PMID:Hydrophobic properties of Escherichia coli causing acute pyelonephritis. 257 Aug 5

Severe hypertension was diagnosed in a dog that initially was referred for evaluation of visual deficits and retinal hemorrhage and eventually was donated for medical treatment of hypertension. Initial blood pressure measured by direct methods was markedly high (systolic, 275 mm of Hg; diastolic, 170 mm of Hg). Measures of renal function were within normal limits, with the exception of hypotonic urine. A test protocol was designed to exclude possible secondary causes of hypertension; negative results of such tests allowed the diagnosis of essential hypertension. The consistency of the hypertension and its response to medical control were studied for 5 years. Blood pressure while the dog was untreated during those years was 240 +/- 24 mm of Hg (systolic) and 146 +/- 14 mm of Hg (diastolic). Plasma renin activity was within normal limits, and the response of the renin-angiotensin system to varied salt intake was normal. The most effective medications used to lower blood pressure were propranolol and captopril, both of which were more effective than salt restriction alone. Five years after the diagnosis of hypertension, the dog was euthanatized because of chronic renal failure secondary to pyelonephritis. Hypertension was less severe as the condition progressed into chronic renal failure. Complete necropsy did not reveal an obvious cause of the hypertension, and histopathologic changes were limited to the cardiovascular system, eyes, and kidneys.
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PMID:Essential hypertension in a dog. 275

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

A-61827 (A-60969 is the hydrochloric salt of A-61827) is a new aryl-fluoronaphthyridine which is active against aerobic and anaerobic bacteria. The MICs of A-61827 for 90% of strains (MIC90) of staphylococci and streptococci were less than or equal to 1 microgram/ml and were generally 1 to 4 twofold dilutions less than those of ciprofloxacin for these bacteria. The MIC90S of A-61827 for members of the family Enterobacteriaceae and Pseudomonas aeruginosa were also less than or equal to 1 microgram/ml. Ciprofloxacin was 1 to 3 twofold dilutions more active than A-61827 against these gram-negative bacteria. Neisseria gonorrhoeae, Campylobacter jejuni, and Haemophilus influenzae were susceptible to less than 0.06 microgram of A-61827 per ml. The MIC90 of A-61827 for Legionella pneumophila was 0.25 microgram/ml. A-61827 was as potent or 1 to 2 twofold dilutions more potent than ciprofloxacin against these organisms. The MIC90 of A-61827 for all anaerobic bacteria was less than or equal to 4 micrograms/ml compared with less than or equal to 32 micrograms/ml for ciprofloxacin. In mouse protection tests, A-61827 was as active as ciprofloxacin against Escherichia coli, P. aeruginosa, and Salmonella typhimurium and 5 to 10 times more active than ciprofloxacin against Staphylococcus aureus and Streptococcus pyogenes. A-61827 was as active as ciprofloxacin against P. aeruginosa in a mouse pyelonephritis model and more active than ciprofloxacin and metronidazole in a mouse Bacteroides fragilis abscess model. After oral administration of 100 mg/kg to mice, the peak concentrations of A-61827 and ciprofloxacin in serum were 2.3 and 2.4 micrograms/ml and the half-lives in serum were 3.9 and 1.2 h, respectively.
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PMID:A-61827 (A-60969), a new fluoronaphthyridine with activity against both aerobic and anaerobic bacteria. 334 9

In a series of 400 transplantations, 8 children presented a severe lesion of the lower urinary tract requiring an intestinal graft to divert the urine or to replace the useless bladder: 4 cases of posterior urethral valves and 4 cases of neurogenic bladder. Four permanent urinary diversions and 4 bladder enlargements, including 3 temporary diversions, were performed. The sigmoid colon was used in 5 cases and the ileum was used in 3 cases. The preparation of the intestinal graft was always performed prior to the transplantation. The uretero-intestinal anastomosis included an antireflux device in 3 of the 8 cases. There were no deaths in this series. Three occlusions and 2 lymphoceles occurred in the immediate post-transplantation period, but were corrected by re-operation. Two cases of calculi occurred in the long term, one of which required operation. Moderate stenosis of the renal artery in one case resulted in systemic hypertension which was well controlled by medical treatment. An episode of acute pyelonephritis resolved rapidly with antibiotic treatment. Two cases of acidosis were corrected by salt supplementation. There was one case of early graft rejection on the 15th day and a delayed rejection after 18 months, leading to removal of the transplant. At the present time, 6 renal grafts function normally (75%) with a follow-up of 1 to 8 years.
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PMID:[Urinary diversions and intestinal grafts in renal transplantation in children. Report of 8 cases]. 355 89


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