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

Laboratory and clinical studies on ceftazidime ( CAZ ), a new cephem antibiotic, were carried out in the field of pediatrics. The results were as follows: Antibacterial activities of CAZ against clinically isolated strains of S. pneumoniae, H. influenzae, E. coli and P. aeruginosa were compared with those of cefotaxime (CTX), ceftizoxime (CZX), latamoxef ( LMOX ), cefoperazone (CPZ) and cefmetazole (CMZ), and also with cefsulodin (CFS) and gentamicin (GM) against P. aeruginosa. Against S. pneumoniae and H. influenzae, CAZ was almost as active as CTX, CZX and CPZ. Against E. coli, it was almost as active as CTX, CZX and LMOX . Against P. aeruginosa, it was almost as active as CFS and GM. Serum concentrations and urinary excretion rates after intravenous bolus injection of CAZ at doses of 20 mg/kg and 10 mg/kg for 5 minutes in each 2 cases (4 cases in total) were determined. The mean serum concentrations of CAZ were 78.9 and 52.0 micrograms/ml at 15 minutes, 38.5 and 27.4 micrograms/ml at 1 hour, and 6.5 and 4.8 micrograms/ml at 4 hours, with serum half-lives (T 1/2) of 1.39 and 1.80 hours respectively. Mean cumulative urinary excretion rate within 6 hours after administration was 84.6%. In a patient with chronic renal failure, serum half-life was 3.22 hours and urinary excretion rate within 6 hours was 22.8% (after intravenous bolus injection of CAZ at a dose of 10 mg/kg). CAZ was administered at a dose of 55.5 mg/kg by intravenous bolus injection to a child with purulent meningitis. The levels of CAZ in the cerebrospinal fluid (CSF) at 1 hour after administration were 2.7-38.9 micrograms/ml with CSF/Serum ratios of 3.2-28.8%. Forty-two pediatric patients with various bacterial infections (pyelonephritis 14, tonsillitis 1, bronchopneumonia 3, pneumonia 17, purulent meningitis 1, bacteremia 2, SSSS 1, enterocolitis 3) were treated with CAZ at a daily dose of 49-222 mg/kg t.i.d. or q.i.d. (as a rule 60 mg/kg t.i.d.). The efficacy rate was 97.6% clinically and 97.8% bacteriologically. No adverse reactions were observed except 1 case with mild diarrhea. Abnormal laboratory findings were also only mild; eosinophilia in 1, slight elevation of GOT in 5 and that of GOT & GPT in 3 cases. These results indicate the usefulness of CAZ in the treatment of bacterial infections in children.
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PMID:[Laboratory and clinical studies on ceftazidime in the field of pediatrics]. 637 56

Bone mineral content (BMC) was measured annually over a three year period in 31 consecutive patients on maintenance hemodialysis (HD). No patient had received treatment with vitamin D derivatives, anticonvulsants or corticosteroids, nephrectomy or a renal transplant. Initial median BMC value in per cent of sex and age matched normal mean was significantly decreased to 91.0% (P less than 0.01), indicating bone mineral loss in chronic renal failure prior to HD. During HD a highly significant fall in mean BMC (in per cent of initial value) continued to 95.1%, 92,7% and 90.8% after 1, 2 and 3 years, respectively, with no influence of age, sex or initial BMC value. The interindividual variation in BMC changes, however, was considerable: the BMC loss over 3 years exceeded 10% in 13 (42%) patients ("rapid losers") while 12 (39%) patients had a BMC loss below 5%, or no loss at all. The "rapid loser" group had significantly higher serum levels of parathyroid hormone and alkaline phosphatases and, moreover, developed a lower serum phosphate and calciumXphosphorus product than the other group of patients ("slow losers"). The mean BMC loss over 3 years of HD was pronounced and significant (P less than 0.02) in patients with chronic pyelonephritis (9.8%) and polycystic kidney disease (14.2%), but much smaller, and not significant, in patients with chronic glomerulonephritis (4.8%). It is concluded that a selection of patients with a high degree of bone mineral loss during HD is not possible by means of sex, age, initial BMC, biochemical parameters, or diagnosis (2 patients with chronic glomerulonephritis appeared to be "rapid losers"). For that purpose a high-precision BMC method is mandatory.
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PMID:Bone mineral content in patients on prolonged maintenance hemodialysis: a three year follow-up study. 664 Oct 32

Patients with chronic renal failure requiring maintenance hemodialysis at the end of pregnancy are not as uncommon as pregnant women previously treated by this therapy. Prophylactic bicarbonate hemodialysis may allow the continuation of pregnancy until delivery of living baby. We report a 22 year old woman with chronic renal failure due to pyelonephritis secondary to bilateral reflux. Hypertension, metabolic acidosis and hydramnios happened at the 13th week (creatinine clearance 16 ml/min). Thirteen bicarbonate hemodialysis periods were necessary up to the 34th week when delivery by cesarean section was achieved giving birth to a 1500 g hypotrophic boy.
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PMID:[Preventive hemodialysis using a bath rich in bicarbonates in a pregnant woman with chronic kidney failure]. 666 29

343 patients with disease of solitary kidney were analysed. Urolithiasis was found in 230 of them. Incidence of chronic pyelonephritis was 91, renal hypertension 50 and chronic renal failure 63 per cent. Urinary obstruction took place in 140 (61%) patients. 312 operations were performed on 175 patients. 149 anuric patients were operated, 92 underwent ureteric catheterisation and 16 hemodialysis. Primary operative lethality was 5 and recurrence rate 36 per cent.
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PMID:[Characteristics of the clinical course and treatment of patients with urinary calculi of a solitary kidney]. 671 Nov 54

Vesicoureteral reflux is an anatomic abnormality, mostly affecting a pediatric population, which may be the second leading cause of end-stage renal failure. Most cases of reflux are due to abnormalities in the insertion of the ureters into the bladder, either congenital or acquired. Most commonly, VUR is discovered during routine evaluation of urinary tract infections, but may also be present in patients with severe hypertension or chronic renal failure. The diagnosis is confirmed radiologically, utilizing either voiding cinecystography or radioisotopic methods. VUR can result in renal failure through scarring secondary to 'chronic pyelonephritis' or through a glomerulopathy, possibly immune in origin. In most series, the glomerulopathy is felt to be the cause of the end-stage renal failure. Treatment of VUR includes conservative (medical) management with the hope that maturation of the ureterovesical junction will cure reflux. Surgical therapy is reserved for those patients in whom this maturation is not expected to occur or in those whose urinary infections cannot be controlled. In those patients who have developed the glomerulopathy secondary to VUR, surgery may not halt the progression of the renal disease. VUR in a transplanted kidney may result in a higher risk of loss of the graft due to glomerulopathy or chronic rejection.
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PMID:Vesicoureteral reflux and reflux nephropathy. 676 61

Three adult patients with unilateral renal agenesis/total dysplasia (= aplasia) and with an early chronic renal failure are presented. One patient had renal agenesis without ureter bud and ureteric ostium on one side, and reflux pyelonephritis on the other; one had small compact total renal dysplasia (= aplasia) on one side, while chronic uric acid nephropathy (chronic renal disease as a cause of gout) was diagnosed on the other; the third patient had a total large multicystic dysplasia on one side, and on the other a segmental large multicystic dysplasia. Radiological steps and radiodiagnostic criteria are discussed and the combination of urogenital and extraurogenital anomalies is referred to.
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PMID:Chronic renal failure due to unilateral renal agenesis and total renal dysplasia (= aplasia). Report of three cases. 687 81

High pressure reflux may be a major cause of chronic renal failure both with and without associated urinary tract infection. The concept of reflux nephropathy includes not only the entity previously known as "chronic atrophic pyelonephritis," but other forms of renal disease such as the Ask-Upmark kidney, renal segmental hypoplasia, and the generalized changes that resemble those of obstructive nephropathy but which are secondary to reflux. Lobar and papillary anatomic variations play an important role in predisposing certain kidneys or parts of a kidney to damage from high pressure reflux, with or without infection. Prolonged high pressure sterile reflux can not only cause focal scarring in papillae susceptible to intrarenal reflux, but can cause the conversion of nonsusceptible papillae, so that scarring may then become generalized. The mechanisms of scar production induced by intrarenal reflux remain unclear, but mechanical immunologic, bacterial, and vascular factors are current subjects of investigation. There is mounting evidence that it is in infancy that a train of events starts which culminates in this renal damage and that much of this may be well under way quite early in childhood and remain clinically undetected until later in life, when the end results (i.e., hypertension and/or renal failure) become manifest.
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PMID:Neuhauser lecture. Reflux nephropathy: a personal historical review. 702 97

A 55-year-old woman in an advanced stage of chronic renal failure due to pyelonephritis developed severe hyponatraemia after receiving 400 mg/day of ibuprofen for 3 days. The typical symptoms and the hyponatraemia disappeared when the drug was withdrawn. The likely mechanism involved and the clinical implications are discussed.
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PMID:Ibuprofen induced hyponatraemia. 720 92

Eight cases of acquired cystic disease of the kidney (ACDK) associated with chronic renal failure and hemodialysis are described. No patient had a family history or clinical evidence of congenital adult polycystic kidney disease (CAPKD). Glomerulonephritis was the cause of renal failure in 6, and pyelonephritis in 2. Massive renal and perirenal hemorrhage necessitated 3 nephrectomies in 2 patients. Single kidney weights did not exceed 280 Gm., a major feature in the distinction of ACDK from CAPKD. Morphologically, in addition to the usual stigmata of end-stage kidneys, 40 to 80 per cent of the renal parenchyma was replaced by small cysts. Continuity of cysts with tubules was established by nephron dissection.
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PMID:Acquired cystic disease of kidney in chronic dialysis patients. 721 Mar 78

Gross vesico-ureteric reflux is the essential pathogenetic factor in the etiology of the small, scarred kidney of non-obstructive, chronic pyelonephritis (reflux nephropathy). 18 (12.5%) of 144 patients entering a dialysis-transplant programme had end-stage reflux nephropathy. The majority of patients initially presented with severely impaired renal function, hypertension and significant proteinuria. Documented urinary tract infections had only occurred in one-third of the patients. 8 of the 12 women presented during a pregnancy, usually with a presentation resembling toxaemia of pregnancy. Reflux nephropathy is a significant cause of end-stage chronic renal failure.
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PMID:End-stage reflux nephropathy. 726 18


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