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

Between 1962 and 1970, 36 children with acute biopsy-proven poststreptococcal glomerulonephritis (PSGN) entered a prospective long-term follow-up study. The initial biopsies were scored into four histological grades using criteria based on endocapillary proliferation, leucocyte infiltration, epithelial "hump" and crescent formation; 5 patients had grade-1 (least severe), 14 grade-2, 15 grade-3 and 2 grade-4 biopsies. Two children died from rapidly progressive glomerulonephritis; both had grade-4 biopsies. Early repeat biopsy in 12 patients showed improvement in all but one patient who progressed from grade 2 to type 2 mesangiocapillary glomerulonephritis (MCGN). The initial biopsy grade correlated significantly with heavy proteinuria (chi2 = 9.73, P less than 0.01) but not with hypertension, haematuria or renal functional impairment. Follow-up observations were made after mean periods of 9.5 years (range 5.4-12.4 years; 32 subjects) and 19.0 years (range 14.6-22 years; 30 subjects). None of the survivors had an abnormal plasma creatinine. Only one patient (grade-3 biopsy), a female with a subsequent history of recurrent pyelonephritis, was hypertensive. Isolated microscopic haematuria persisted in 1 grade-2 and 2 grade-3 subjects. One grade-2 subject had proteinuria secondary to MCGN and one grade-3 subject had mild proteinuria and borderline hypertension. Although 20% of subjects had urinary abnormalities, we conclude that the long-term outcome of PSGN in children is excellent.
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PMID:Poststreptococcal glomerulonephritis in children: clinicopathological correlations and long-term prognosis. 315 45

The pharmacokinetics of disopyramide was studied in 15 patients with renal dysfunction (4 with pyelonephritis, 7 with glomerular nephritis and 4 with interstitial nephritis). The elimination rate constant of unbound disopyramide was 0.094 h-1 and CLu/f (unbound clearance divided by bioavailability) was 245 ml/min. Both the unbound renal clearance (CLR) and CLu/f were highly correlated with the creatinine clearance (CLCR). The apparent unbound metabolic clearance in the patients was approximately two-fold lower than that previously reported in normal subjects. The estimated unbound metabolic clearance in the renal dysfunction patients showed a significant negative correlation with the alpha 1-acid glycoprotein (AAG) concentration and only a weak, non-significant correlation with CLCR. As AAG in the renal dysfunction subjects was increased in comparison with normal values, it is possible that AAG is a factor in the decrease in the apparent unbound metabolic clearance.
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PMID:Does alpha 1-acid glycoprotein reduce the unbound metabolic clearance of disopyramide in patients with renal impairment? 318 Dec 85

The progression of renal failure was analyzed in 108 patients with mild to moderate renal impairment, none of whom had received any form of dietary protein, phosphate restriction or immunosuppressive treatment. The reciprocal of plasma creatinine was plotted against time using a minimum of six plasma creatinine values taken over at least six months (mean 13 values over 41 months). Plots indicated there was linear deterioration in 70 patients, non-linear deterioration in 15 and stable renal function in 24. Progressive renal failure was common in patients with glomerulonephritis, diabetic nephropathy, chronic pyelonephritis and polycystic kidney disease. Most patients with hypertensive nephrosclerosis, analgesic nephropathy and renal impairment following acute renal failure were stable. Among those with progressive impairment the mean rates of deterioration were significantly faster for patients with glomerulonephritis and diabetic nephropathy compared to those with chronic pyelonephritis, polycystic kidney disease and undiagnosed renal disease (p less than 0.01). Hence the underlying renal pathological changes appear to be important in determining progression of renal failure and also the subsequent rate of deterioration. For those with linear progression of renal failure there was a significant correlation between 24-h urinary protein excretion and the rate of deterioration. This relationship held for glomerulonephritis and chronic pyelonephritis as separate diagnostic groups only. Proteinuria, therefore, may be a useful prognostic index for the rate of progression of established renal failure. Calcium phosphate product correlated poorly with the rate of deterioration. We were unable to demonstrate a relationship between spontaneous protein intake and deterioration of renal function. However, patients prescribed high protein diets were not included in dietary analysis and we cannot, therefore, exclude the possibility that a high dietary protein intake may accelerate renal failure. Similarly we were unable to show a significant relationship between blood pressure and progression of renal failure although there were weak correlations between mean arterial pressure and rate of deterioration for chronic pyelonephritis and glomerulonephritis.
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PMID:Renal pathology and proteinuria determine progression in untreated mild/moderate chronic renal failure. 320 6

The authors analyzed the frequency of chronic renal insufficiency (CRI) and the level of serum creatinine (200 mumol/l and more) in 10,350 outpatients aged over 60 (I group), 2400 persons of the same age in need of episodic hospitalization (II group), and in 1840 patients who died in hospital (III group). In the 1st group CRI frequency was 0.98%, in the 2nd group--6.9%, in the 3rd group--14.6%. Pyelonephritis (76.1%) and myelonephropathy (7.5%) were among CRI main causes. The authors underlined the multitude of factors causing CRI in middle-aged patients and the prospects of adequate therapy even in terminal states; CRI syndromes were considered for persons of this age group.
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PMID:[Chronic renal failure in middle-aged and elderly persons]. 320 58

Ureterocolonic anastomosis (UCA) was performed in 10 dogs with transitional cell carcinoma of the urinary bladder trigone or the urethra, or both. All grossly visible tumor was excised. All of the dogs recovered from anesthesia and surgery and had anal continence with no urine leakage. One dog died of undetermined causes 7 days after surgery. Nine dogs survived 1 to 5 months. The owners of eight of the dogs considered their dog's quality of life to be acceptable. Four dogs were euthanatized because of neurologic disease, three of which also had nausea and vomiting. The neurologic and gastrointestinal signs may have been caused by hyperammonemia, metabolic acidosis, and uremia. Blood ammonia levels were elevated in two dogs with neurologic signs. Hyperchloremic metabolic acidosis that was reversible with bicarbonate therapy was diagnosed in five dogs. All of the dogs were azotemic because of intestinal recycling of urea. Serum creatinine concentrations increased in four dogs after surgery. Drug-induced renal disease may have developed in two dogs. Pyelonephritis developed in five kidneys, two of which had outflow obstruction and two had bilateral hydroureteronephrosis before the UCA. In this small number of dogs, surgical excision of transitional cell carcinoma was not curative with six dogs having confirmed metastatic lesions at the time of death.
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PMID:Ureterocolonic anastomosis in ten dogs with transitional cell carcinoma. 323 87

In the pathogenesis of infectious diseases, great importance is attached to the problem of adhesion of bacteria to cells. In 100 urine specimens from normal test persons, patients with infections of the lower urinary tract, with chronic pyelonephritis and glomerulonephritis were studied. The adhesion of strains of Escherichia coli to human uroepithelial cells depended on the concentration of single urinary factors. While increased concentrations of urea and creatinine favored the adhesion process, a statistically significant negative influence was found with regard to potassium, immunoglobulins and pH value. Considering the multifactorial effects of the urinary constituents, we found in a multivariate comparison that none of the studied physiological features alone exerts a fundamental influence upon adhesion, but in their entirety they determine the environmental conditions for the adhesion of bacteria to cells in the urine.
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PMID:The influence of selected urinary constituents on the adhesion process of Escherichia coli to human uroepithelial cells. 332 20

The association between pyelonephritis and vesicoureteral reflux (VUR) following pediatric renal transplantation is unclear. To understand the relationship of vesicoureteral reflux with urinary tract infection (UTI) and pyelonephritis, 67 patients were evaluated for reflux and pyelonephritis. Sixty-seven pediatric patients, aged 2 to 18 (39 males and 28 females) underwent renal transplantation. Beginning in 1982, all patients underwent voiding cystourethrography or radionuclide voiding studies 1 to 3 months postoperatively to assess the incidence of VUR. Techniques of ureteroneocystostomy (UNC) included the Leadbetter-Politano (L-p) in 39 cases, and two different modifications of the LICH (herein called LICH-1 and LICH-2) in 30 cases. Urinary cultures were performed routinely. Pyelonephritis was considered present in any patient with UTI and increased serum creatinine or fever greater than 38.5. VUR occurred in 36% of patients; highest in LICH-1 (79%), intermediate in L-P (22%), and lowest in LICH-2 (9%). VUR was not statistically significantly higher in females (43%) v males (31%). UTI occurred in 37% of patients. The difference in incidence between females (54%) and males (26%) was significant (P less than .05). The frequency of UTI in patients with VUR was 46% v 33% in patients without reflux (NS). However, pyelonephritis that occurred in 16% of cases overall was present in 82% of UTIs in patients with reflux v 14% of UTIs in patient without reflux (P less than .01). Pyelonephritis is significantly increased in pediatric renal transplant patients with UTI was have VUR. A nonrefluxing UNC is advocated in all patients. All renal transplant patients should have routine monitoring of urinary cultures and should be evaluated of VUR posttransplant.
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PMID:Pyelonephritis following pediatric renal transplant: increased incidence with vesicoureteral reflux. 332 24

Ureterocolonic anastomosis was evaluated in 13 clinically normal dogs. Urinary continence was maintained after surgery, and the procedure was completed without technique errors in all but 2 dogs. Three dogs died within 5 weeks (2 of undetermined causes and 1 of aspiration pneumonia and neurologic disease), and 1 dog was euthanatized 4 months after surgery because of neurologic signs. Two healthy dogs were euthanatized 3 months after surgery for light microscopic evaluation of their kidneys. Five dogs were euthanatized 6 months after surgery for light microscopic evaluation of their kidneys. Gastrointestinal and neurologic disturbances developed in 4 dogs at various postoperative intervals. Plasma ammonia concentration measured in 2 dogs with neurologic signs was increased. Plasma ammonia concentration measured in 5 dogs without neurologic signs was within normal limits. All 5 dogs, in which metabolic acidosis was diagnosed, had high normal or above normal serum chloride concentration. Serum urea nitrogen values were increased after surgery because of colonic absorption of urea. Serum creatinine concentration was increased in 1 dog 6 months after surgery. Individual kidney glomerular filtration rate was reduced in 38% (3/8) of the kidneys from 4 other dogs at 6 months after surgery. Of 5 dogs euthanatized at 3 to 4 months after surgery, 4 had bilateral pyelitis, and 1 had unilateral pyelonephritis. Six months after surgery, pyelonephritis was diagnosed in 40% (4/10) of the kidneys from 5 dogs. The ureterocolonic anastomosis procedure is a salvage procedure that should allow complete cystectomy. However, variable degrees of metabolic acidosis, hyperammonemia, and neurologic disease may result.
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PMID:Ureterocolonic anastomosis in clinically normal dogs. 342 37

Although various complications such as electrolyte imbalance and urinary infection are known to be induced by ureterosigmoidostomy, it is still a surgical technique difficult to ignore since it allows patients to lead an almost normal life without the encumbrance of external urinary devices. At our hospital, we performed eighteen ureterosigmoidostomy operations between 1976 and 1985. Herein, we review the postoperative conditions of electrolyte, renal function and other complications. The patients (16 male, 2 female) were between 53 and 72 years old, the mean age being 61.5 years. The primary diseases were bladder tumor (14 patients), prostatic cancer (2), carcinoma of the female urethral diverticulum (1) and urethral stricture (1). As to the electrolytes, both serum Na and serum K values fluctuated within the normal range. Hyperchloremia was detected in 4 cases (22.2%), but it was only slightly above the normal range and the conditions were more or less stabilized a year after the operation. Although blood urea nitrogen had a tendency to elevate one or two years after the operation, serum creatinine fluctuated within the normal range. During the observation period, only 7 of the 18 cases (38.9%) showed complications, the major complication being pyelonephritis (3 cases). Postoperative excretory urogram revealed slight to medium hydronephrosis two months after the operation in 9 of the 18 cases (50%), but most of these conditions were normalized within a year. Four patients died after leaving hospital; 3 due to the recurrence of cancer and one due to pneumonia. The 14 other outpatients are enjoying a normal life without the use of any external urinary device.
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PMID:[Ureterosigmoidostomy--clinical review of 18 cases]. 344 31

The effect of captopril, an angiotensin-converting enzyme inhibitor, was studied in rats subjected to Escherichia coli pyelonephritis. Eight weeks after pyelonephritis was induced in male Sprague-Dawley rats, the rats were randomly assigned to treatment groups based on urinary protein excretion. In experiment 1, rats were given captopril, 50 mg/kg of body weight, or saline solution via daily intraperitoneal injection. To eliminate complications with captopril-induced peritonitis, experiment 2 was performed in which rats were given the same treatment by daily gavage. In both experiments, 24-hour urinary protein excretion in the saline-treated rats was significantly greater than that of the captopril-treated rats after 12 weeks of treatment (P less than 0.05). Plasma urea nitrogen, plasma creatinine, and endogenous creatinine clearance did not differ between treatment groups during the course of therapy in experiment 1. There were no differences in these values in experiment 2, except at week 8 of treatment when the captopril-treated rats had significantly lower plasma creatinine and higher endogenous creatinine clearance than did the saline-treated rats (P less than 0.05). There was also no difference between treatment groups in the degree of morphologic renal damage based on light microscopic evaluation of kidneys at the end of treatment.
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PMID:Effect of captopril on the progression of induced pyelonephritis in the rat. 352 5


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