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

The symptoms and clinical course of chronic hypokalemic nephropathy are described in 21 patients with longstanding potassium deficiency. In 14 patients (group A) the potassium depletion was caused by malnutrition and/or abuse of laxatives and/or diuretics. 7 patients (group B) suffered from primary (6 cases) or secondary (1 case) aldosteronism. The average duration of potassium depletion was 8.8 years in group A and 3.4 years in group B. Depending on the duration of potassium depletion, chronic renal disease develops which may end in terminal renal failure. Urinalysis is non-specific or negative. The clearance of creatinine slowly decreases. Metabolic alkalosis is a constant finding and in group A occurs with a tendency to hyponatremia and hypochloremia, with the development of metabolic acidosis only in advanced renal insufficiency. In contrast to patients of group B, patients of group A have normal or low blood pressures converting to hypertension, if at all only in the late phase. The cases of group A had secondary aldosteronism (and, correspondingly, a hyperplastic juxtaglomerular apparatus). Although urinary tract infection is a regular finding in advanced stages, the clinical, radiological and histological evidence suggests that bacterial pyelonephritis, if occurring at all, is rather a complication than the cause of the disease. In 5 patients 7 instances of acute renal failure of unknown origin were observed which was lethal in one case. Another patient died from terminal renal failure, a third from an intercurrent pneumonia. Renal histology obtained from 13 patients showed the picture of diffuse chronic abacterial interstitial nephritis.
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PMID:Symptoms and course of chronic hypokalemic nephropathy in man. 87 Feb 67

Renal papillary and cortical necrosis (RPCN) in newborn infants has been generally fatal. This report describes three survivors of neonatal RPCN who have been followed up from 23 to 57 months. The cause of RPCN was hemorrhage and asphyxia neonatorum in two patients and hemorrhage and shock in one. The diagnosis was confirmed in one patient by an excretory urogram at 3 weeks of age and in another by renal biopsy at 5 weeks of age. In the third, diagnosis was made retrospectively. Findings from subsequent examination showed that creatinine clearance was normal in one patient, slightly reduced in another, and moderately reduced in the third. Maximum ability to concentrate urine was decreased in all. Follow-up excretory urograms in all three patients showed dilated bizarre-appearing calices and renal cortical atrophy. These radiologic findings are similar to those found in segmental hypoplasia or chronic (atrophic) pyelonephritis.
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PMID:Neonatal renal papillary and cortical necrosis. 87 13

In 38 patients with glomerulo- (20 patients) and pyelonephritis the renal blood flow was measured with radioxenon. Despite normal creatinine clearance in chronic diseases the blood flow is already reduced. The correlation to the creatinine clearance is loose. In glomerulonephritis above all a reduction of the blood flow of the cortex appears, in pyelonephritis the participation of the cortex is reduced. Correlations of blood circulation and blood pressure are to be found in no stage of the disease. Concerning the renal insufficienzy there does not exist a disease-specific pattern of blood flow. In renal insufficiency the diuresis is independent of blood flow.
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PMID:[Kidney circulation in chronic parenchyma diseases and in kidney insufficiency]. 89 9

Twenty-six patients with radiological unilateral chronic pyelonephritis, 36 patients with bilateral chronic pyelonephritis, 14 patients with papillary necrosis and nine patients with obstructive atrophy have been followed from five to 135 months for a total of 374 patient years. Serial changes in renal function and pyelographic appearances have been correlated with bacteriuria, analgesic ingestion, blood pressure and reflux. The calculated survival rate at five years was 95 per cent for patients with bilateral pyelonephritis and 92 per cent for patients with papillary necrosis. The ten-year survival rate was 86 per cent and 56 per cent respectively. The survival rate for patients with unilateral pyelonephritis and obstructive atrophy was 100 per cent at five and ten years. Bacteriuria was not associated with deteriorating renal function determined by serial plasma creatinine estimations. Although all patients in whom there was some radiographic change had bacteriuria on later review, other factors, including excess analgesic intake, reflux and stones were recognized in most. There was a high incidence of analgesic ingestion among patients whose renal function declined and in whom there was some change in serial radiographs. The prevalence of hypertension among patients with normal renal function was 12 and 28 per cent for patients with unilateral pyelonephritis and bilateral pyelonephritis respectively. There was a significant increase in both blood urea and plasma creatinine in all patients with hypertension (diastolic pressure greater than 90 mm Hg) and a much higher prevalence of hypertension in patients whose plasma creatinine exceeded 1.3 mg/100 ml. Thrity per cent of patients with unilateral pyelonephritis and 50 per cent with bilateral pyelonephritis had vesicoureteric reflux of varying degrees. There was no evidence to suggest that major degrees of reflux (grade 3) was associated with further renal damage. These observations indicate the benign course of the majority of patients with radiological pyelonephritis. Control of blood pressure, and analgesic intake will help to preserve renal function whilst prevention of symptomatic urinary infection by long term low dose therapy will reduce morbidity.
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PMID:A prospective study of patients with radiological pyelonephritis, papillary necrosis and obstructive atrophy. 94 Sep 21

Endogenous creatinine clearance was measured in 220 pregnant women with acute pyelonephritis and the results compared to data obtained from 167 pregnant control patients without acute pyelonephritis. These data showed that an appreciable number of patients with pyelonephritis occurring during pregnancy demonstrated a transient but definite diminution in renal function during the acute attack. Causes of this temporary renal dysfunction are discussed.
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PMID:Transient renal dysfunction associated with acute pyelonephritis of pregnancy. 109 76

It is now apparent that the standard total cystectomy and Bricker procedure, by eliminating the ureterovesical junction with its reliable antireflux mechanism, markedly reduces the protection of the upper urinary tracts. In an attempt to restore this protective principle, the subserosal ileoureteral antireflux procedure was devised and subsequently performed in 6 patients with infiltrating bladder carcinoma. The operation is technically easy to perform, it is not time consuming and has consistently prevented ileoureteral relux without causing obstruction. There have been no serious complications, no episodes of pyelonephritis or urinary leakage and no evidence of renal functional deterioration as measured by serum creatinine and IVP. Although it is still to early to predict the eventual long-term results our experience with the first 6 patients with the antireflux ileoureteral anastomosis suggests that this modification of the original Bricker procedure offers superior protection to the upper urinary tracts.
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PMID:Antireflux ureteroileal anastomoses in humans. 111 11

Survival after serum creatinine exceeded 10.0 mg/100 ml was increased if one peritoneal dialysis was performed. After one peritoneal dialysis 'survival' of 62 patients to the present time, death or the next dialysis averaged 119 days; median survival was 28 days. Characteristics of prolonged survivors were persistent reduction of serum creatinine below the predialysis concentration, tubulointerstitial diseases, i.e. polycystic kidneys, pyelonephritis or obstructive nephropathy, potentially reversibel complications such as urinary tract infection or extracellular volume depletion, and high urine volume, and low blood pressure. Occasional pateints with survival exceeding 2 years suggest the possibility of prolonged benefit after a single dialysis at least in those wiht characteristics favoring longer survival.
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PMID:Prognosis of chronic renal failure. III. Survival after one peritoneal dialysis. 112 60

A long-term study of 17 patients with paroxysmal nocturnal hemoglobinuria revealed an unexpectedly high incidence of functional and anatomic renal abormalities. All patients demonstrated varying degrees of hematuria and proteinuria distinct from hemoglobinuria. All patients also had granular casts in multiple urinalyses. Evaluation of renal function revealed hyposthenuria, abnormal tubular function and declining creatinine clearance. Radiologically, one or more of these demonstrated enlarged kidneys, renal cortical infarcts and thinning, papillary necrosis, acute renal atrophy, retroperitoneal hematoma and ureteral infarction, which were confirmed by autopsy studies. Hypertension developed in 7 patients. Urinary tract infection was uncommon and no patient had a clinical history compatible with chronic or acute pyelonephritis. Contrary to usual opinion our compatible clearly showed evidence of frequent and widespread renal pathology in paroxysmal nocturnal hemoglobinuria most likely due to repeated microvascular thromboses similar to the venous trombosis involving other organs in this disorder. Since most of these patients present initially to urologists knowledge of this entity is mandatory.
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PMID:Urologic manifestations of paroxysmal nocturnal hemoglobinuria. 114 29

After serum creatinine levels exceeded 10mg/100ml, median survival was 55 days (to death or dialysis) in a group of 112 patients with chronic renal disease. Renal failure was partially reversible in 29 patients, partially accounting for prolonged survival. Those with polycystic kidneys, pyelonephritis, or obstructive nephropathy survived longer,partially because of more frequent reversibility and a slower increase in serum creatinine concentration. Kiabetic nephropathy, myelomatous kidneys, and amyloidosis were associated with shorter survival, less frequent reversibility, and more rapid progression. Urinary infection and extracellular volume depletion often accounted for partially reversible renal failure and prolonged survival. Blood pressure and age were not prognostic variables, while coexistent heart failure shortened survival. Survival correlated significantly with sodium excretion.
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PMID:Prognosis of chronic renal failure. II. Factors affecting survival. 114 31

Insulin antagonism characterizes infection, but the mechanism is unknown. Previous studies have been performed during the acute catabolic stage of infection, and the resultant metabolic changes reflect this decreased food intake and weight loss. To delineate metabolic alterations due to infection itself, rats with pyelonephritis induced by tail-vein injection of 1 ml. of Streptococcus faecalis (10(9) bacteria per milliliter) were studied two weeks later during a period of near-normal weight gain and food intake. Fasting growth hormone concentrations (nanograms per milliliter) in the pyelonephritic rats were nearly five times normal (45.8 vs. 9.9). Intra-arterial glucose and insulin tolerance tests were impaired. Early glucose-induced insulin release was depressed. Fat pads from infected rats manifested higher basal lipolysis per cell. Glycerol-mediated gluconeogenesis by liver slices was decreased. This pathway was unaffected by insulin in infected rats but readily inhibited in control rats. The following metabolic parameters were similar in control and infected animals: (in vivo) fasting concentrations of plasma glucose, free fatty acids, triglycerides, total corticoids, creatinine, insulin, glucagon, molar ratios of insulin and glucagon, glucose and insulin responses to tolbutamide, and glucagon and free fatty acid suppression after glucose; (in vitro) glucose metabolism by muscle and fat, epinephrine- and theophylline-stimulated lipolysis and re-esterification by epididymal fat pads, fasting hepatic glycogen content, glucose production by liver slices with and without alanine. No plasma insulin antagonist was found in the infected rats. Metabolic alterations in infected rats can be demonstrated independently of the associated catabolism. Increased growth hormone secretion cannot explain all of these changes.
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PMID:Metabolic studies in the pyelonephritic rat. 117 60


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