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)

The renal acidosis may appear by a decrease of the number of nephrons able to function (decrease of the filtrate of the glomerulum) as well as by a selective alteration of the tubular acidification mechanism. In 66 patients with chronic renal insufficiency of different degrees of severity (32 patients with diabetic glomerulosclerosis, 18 patients with chronic glomerulonephritis and 16 patients with chronic pyelonephritis) studies of the parameters of the acid-base-state and the renal insufficiency were carried out. 53 of these patients had a pathologically changed acid-base-state which was most expressed in patients with chronic pyelonephritis. A characteristic relation between the renal function (creatinine clearance) and the change of the pH-values was observed. The regression curve of the pH-values was descending so that in clearance values below 25 ml/min in nearly all patients a pronounced acidosis was present. This could be proved in the patients with pyelonephritis already when higher clearance values were present. The forms of the development of the metabolic acidosis in chronic renal insufficiency are discussed.
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PMID:[Metabolic acidosis in chronic renal insufficiency of various etiology]. 2 13

Since 1973 30 patients with urinary tract infections (UTI) or pyelonephritis have been treated with sisomicin, a new aminoglycoside, in a daily dose of 2 mg/kg for a period of seven to nine days. From a clinical point of view the result of treatment was good. Complete resolution was achieved in 17 patients, improvement in nine, and there was no effect in four patients. Thirty-five causative organisms (Escherichia coli = 23, Proteus sp. = 7, Klebsiella sp. = 3, Pseudomonas aeruginosa = 1, Citrobacter = 1) were isolated before treatment. Thirty of the organisms were eliminated during treatment, but seven reappeared during the follow-up period; five strains persisted. Side effects observed consisted of reversible increase of serum creatinine in four patients, excretion of granular casts in 14 patients, and a transient rise of alkaline phosphatase, SGOT and/or SGPT in five patients. No signs of ototoxicity or any other adverse reactions were found and local tolerance was good. In 20 patients blood samples for assay were obtained daily one hour after i. m. injection of 1.0 mg/kg. No evidence of drug accumulation in the serum was found: the mean serum concentrations one hour after injection remained between 3.4 and 3,9 microgram/ml during the entire treatment period. Sisomicin is a highly effective antibiotic for the treatment of UTI caused by gramnegative pathogens. On account of its potential toxicity however, it should be used, like other aminoglycosides, only in selected cases.
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PMID:[Efficacy, tolerance, and pharmacokinetics of sisomicin in urinary tract infections (author's transl)]. 10 44

From July 1967 to September 1974, 26 kidney transplantations were carried out in 16 children aged 6 to 17 years, in Gotherburg. The average age at the primary transplantation was 12 years and average body weight 29.7 kg. Five patients had familial juvenile nephronophthisis, 5 chronic glomerulonephritis, 5 chronic pyelonephritis, and one bilateral Wilms's tumour. Four patients were predialytic. Fourteen grafts came from living related donors. The surgical technique was standard as was the immunosuppression with azathioprine and cortisone; exceptionally antilymphocyte globulin was used. Thirteen patients were alive in September 1974, observed 2-65 months, 8 with a normal serum creatinine, 3 with moderately elevated serum creatinine, and 2 on hemodialysis. The 6- and 12-month survivals of patients are 100% and 93% respectively. Normal growth and full rehabilitation in recipients of functioning grafts make renal transplantation justified as a therapeutic procedure in terminally uremic children.
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PMID:Renal transplantation in children. 17 8

Urinary cyclic AMP excretion per 24 h or per g creatinine in primary hyperparathyroidism (1 degrees HPT) has been evaluated by several authors with conflicting results. In 50 patients with 1 degrees HPT, 25 patients with secondary (2 degrees) HPT and 35 healthy control persons we determined urinary cyclic AMP per 24 h or per g creatinine. These parameters did not satisfactorily discriminate patients from controls, especially when glomerular filtration rate (GFR) as determined by creatinine clearance was reduced. Since urinary cyclic AMP is derived from plasma by glomerular filtration and from kidney by tubular production-the amount of tubules is reflected by GFR-the cyclic nucleotide was related to GFR. In controls urinary cyclic AMP correlated better with GFR than with creatinine excretion. Additionally, in 45 of 50 patients with 1 degrees HPT and in all with 2 degrees HPT, urinary cyclic AMP/GFR was raised. In 1 degrees HPT serum levels of parathyroid hormone correlated closer with urinary cyclic AMP/GFR than with urinary cyclic AMP/g creatinine. The ratio cyclic AMP/GFR decreased to normal or subnormal values after removal of adenomatous or hyperplastic glands in 1 degrees HPT and during infusion of calcium in 2 degrees HPT. In 50 patients with renal lithiasis caused by diseases other than 1 degrees HPT (anatomical variations, pyelonephritis, immobilization after tetraplegia) the ratio cyclic AMP/GFR was not raised. Urinary cyclic AMP/GFR, therefore, reflects parathyroid hormone excess more reliably than cyclic AMP/g creatinine.
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PMID:Hyperparathyoidism: influence of glomerular filtration rate on urinary excretion of cyclic AMP. 19 82

Renal function was investigated in a group of ten patients aged two months to eleven years, with chronic or recurrent urinary tract infection caused by different malformations of the urinary tract. The following tests were performed: endogenous creatinine clearance, maximal urinary concentrating ability, urinary acidification, maximal urinary diluting ability, free water clearance, index of fractional distal sodium delivery and index of distal tubular reabsorption of sodium. It is concluded that the follow-up of glomerular function by means of creatinine clearance and of tubular function by means of maximal concentrating ability consitute the most sensible way to detect renal functional impairment in children with chronic or recurrent pyelonephritis.
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PMID:[Alterations of renal function in pyelonephritis (author's transl)]. 23 18

The behaviour of serum and urinary lysozyme was investigated before and after renal transplantation in 20 patients. The mean postoperative observation time was 67.8 (10 to 212) days. In 11 patients with reversible olig-anuria due to prolonged preoperative ischaemia, lysozymuria lasted for a period of 17 days after surgery, whereas in 8 patients with immediate transplant function lysozymuria disappeared 7 days after transplantation. Serum lysozyme concentrations were markedly elevated before transplantation in all patients. In patients with transplant failure due to ischaemia, normalization of serum lysozyme levels was achieved 28 days after surgery; patients with immediate function showed normal serum lysozyme levels already 7 days after transplantation. Prolonged lysozymuria was also noticed in 2 cases with irreversible ischaemic transplant failure, in 1 case with recurrence of glomerulonephritis and in 1 further case with acute pyelonephritis in the transplant. In 7 cases with an acute renal rejection crisis, lysozymuria was evident 0.7 days before clinical diagnosis of rejection. Serum lysozyme levels showed a strong correlation with serum correlation with serum creatinine concentrations. Therefore, lysozymuria in renal transplant patients indicates tubular transplant damage of varied aetiology. Elevated serum lysozyme levels, on the other hand, seem to reflect a reduced glomerular filtration rate.
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PMID:[Behaviour of serum and urinary lysozyme after renal transplantation (author's transl)]. 32 38

Isotope renography was carried out in 64 kidney transplant patients attending a follow-up clinic. Graft survival in these patients ranged from two months to ten years. Forty-one patients had normal renograms and 98% of these had satisfactory function (creatinine clearance greater than 50 ml/min). Eighteen patients showed a major renogram abnormality and 50% of these had impaired function. Five of these 18 have been explored and found to have graft complications (obstructive disease in four, chronic pyelonephritis in one). Exploration has not been undertaken in the remaining 13 but nine show evidence suggestive of graft pathology (proteinuria, impaired creatinine clearance, elevated urinary enzymes, calyceal distortion on IVP). A successful kidney transplant should result in a normal isotope renogram, and a major abnormality of the renogram suggests the presence of a graft complication, even when the creatinine clearance is unimpaired. We feel renography is useful for identification of renal transplant patients who require further investigation or closer follow-up.
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PMID:Isotope renography and long term follow-up of renal transplant patients. 36 Nov 40

Tobramycin, an aminoglycoside antibiotic, was used to treat 52 infections due to gram-negative organisms in 51 patients. Complicated urinary tract infections, bacteremia and pyelonephritis accounted for 80% of the infections. The rate of immediate satisfactory response was 79%. During therapy with tobramycin, resistant organisms emerged in four patients--two Pseudomonas aeruginosa and two Escherichia coli strains. There were four superinfections with tobramycin-resistant Providencia sp. In four seriously ill patients the serum creatinine concentration increased 1 mg/dL or more; in three the increase was transient. No auditory toxicity was noted in the 19 patients in whom serial audiograms were made. In vitro testing of isolates from these patients showed that tobramycin and gentamicin had equal activity against Enterobacteriaceae. Tobramycin was two to four times more active against susceptible P. aeruginosa.
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PMID:Clinical and laboratory study of tobramycin in the treatment of infections due to gram-negative organisms. 40 32

To define better the natural history of bacteriuria in females, we followed 60 schoolgirls with bacteriuria and 38 matched controls for periods ranging from nine to 18 years. Among the schoolgirls with bacteriuria (greater than or equal to 10(5) organisms per milliliter in two or more consecutive cultures), reflux was repaired in five, nephrectomy was performed in two, and reduced inulin clearance was noted in one subject with atrophic pyelonephritis. Serum creatinine was slightly higher in cases than in controls. Renal scars or caliectasis occurred in 16 cases but in none of the controls. Blood pressure was similar in both groups. Episodes of bacteriuria in cases and controls were, respectively: five or more episodes, 21.7 and 2.6 per cent; and episodes during pregnancy, 63.8 and 26.7 per cent. Seven children of the cases but none of the children of controls showed urinary-tract infections. Bacteriuria among schoolgirls defines a group at great risk of recurrent symptomatic infections and renal scars and at low risk of reduced renal function.
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PMID:Natural history of bacteriuria in schoolgirls. A long-term case-control study. 46 Mar 40

Cellular immune reactivity was studied in 78 patients with various forms of renal disease by skin testing with four recall antigens and a lymphocyte transformation test with tuberculin PPD and leucoagglutinin. Patients with S-creatine greater than or equal to 230 micromol/l as well as those with chronic pyelonephritis who had S-creatinine values below 230 micromol/l had significantly lower skin reactions than the controls to streptokinase-streptodornase, parotitis and PPD. Glomerulonephritic patients with S-creatinine values below 230 micromol/l had normal skin reactivity. Lymphocyte transformation tests showed decreased reactivity only in patients with S-creatinine level greater than or equal to 230 micromol/l. The results suggest an association of chronic pyelonephritis with a defective efferent, nonspecific arm of cellular immunity.
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PMID:Cellular immunity in renal diseases. 47 86


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