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

The aim of this study was to examine the incidence of different renal lesions in rheumatoid arthritis (RA) and to determine their relationships with the type of previous drug therapy and with the specific features of immune disorders. Ninety four patients, 84 (89.9%) females and 10 (10.6%) males) with RA whose mean age was 45.2 +/- 11.9 years and duration of the disease 7.5 +/- 6.5 years were examined. Most of them had degrees 2 and 3 PA (62.7 and 24.4%, respectively). Systemic manifestations were encountered in 60 (63.8%) patients. Eighty one patients took nonsteroidal antiinflammatory drugs (NSAID) continuously: 18 patients for a year, 32 for 5 years, 14 for 6 to 10 years, and 17 for over 10 years. All the patients underwent clinical, laboratory, and instrumental study of partial functions of the kidney. Immunological study involved solid-phase immunoassay of IgA and IgM rheumatoid factor, von Willebrand factor antigens (WF:Ag), C-reactive protein. The serum concentrations were measured by the Mancini method. Changes in urinalysis and/or signs of decreased glomerular and tubular functions were found in 69 (73.%) patients, 25 (26.6%) had arterial hypertension. Tubular dysfunctions were more common [31 (32.9%) patients]. Signs of early renal failure were detected in 20 (21.2%) patients. There were no cases of acute renal failure. Amyloidosis, glomerulonephritis, pyelonephritis were diagnosed in 5 (5.3%), 16 (17%), and 13 (13.8%) patients, respectively. The above renal lesions were concurrent in some patients. Renal lesion correlated with the progression and severity of RA, the presence of systemic manifestations, and age. There was no relationship of both 5- and 10-year use of NSAID to the symptoms of renal disease. The use of these drugs for over 10 years was concurrent with the signs of chronic renal failure and arterial hypertension. Analyzing immunological disorders showed an association of increased erythrocytic sedimentation rates and WF:Ag with amyloidosis, that of higher IgA concentrations with proteinuria and tubular dysfunctions. It is concluded that renal lesion is common in RA, there is a predominance of tubular interstitial changes. In rare cases nephropathy is characterized by a benign course and fails to result in uremia. The symptoms of renal diseases are largely associated with RA progression and severity and the patients' age. Prolonged continuous use of NSAID may contribute to the development of renal failure. Different immune mechanisms are involved in the pathogenesis of glomerular and tubular nephropathy in RA.
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PMID:[Clinico-immunological aspects of renal lesions in rheumatoid arthritis]. 1152 52

Primary disorders of water balance (central diabetes insipidus [DI], nephrogenic DI, and psychogenic polydipsia) should always be considered in the differential diagnosis of polyuria and polydipsia. In general, animals with these disorders have only one laboratory abnormality: a low urine specific gravity. In most instances, the more common causes of polyuria and polydipsia (e.g., hyperadrenocorticism, chronic renal failure, pyelonephritis, pyometra) have specific and obvious abnormalities associated with the complete blood cell count, the serum chemistry profile, and urinalysis. In some cases, however, a low urine specific gravity may be the only abnormality associated with these more common findings. The workup for polyuria and polydipsia can be tedious, time-consuming, expensive, confusing, and not without significant patient morbidity, especially in those cases with normal or near-normal blood work. This article focuses on the diagnostic approach and problems associated with diagnostic testing in patients with disorders of water balance.
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PMID:Polyuria and polydipsia. Diagnostic approach and problems associated with patient evaluation. 1157 Jan 28

Urinary excretion of N-acetyl-beta-D-glucosaminidase (NAG) was examined in healthy dogs and dogs with urinary diseases, and its clinical usefulness as an indicator of urinary diseases was discussed. Twenty-eight healthy dogs and 20 dogs with urinary diseases were used. Urinary NAG activity was measured using p-nitrophenyl N-acetyl-beta-D-glucosaminide as substrate, and expressed as units per gram of urinary creatinine (NAG index). Urinary NAG index in urine of healthy dogs was 3.2+/-2.4 U/g, and NAG index in the dogs with chronic renal failure or lower urinary tract infection accompanied by pyelonephritis was higher than that in healthy dogs. However, the dogs with lower urinary tract infection without pyelonephritis showed normal values of NAG index. Some dogs with diabetic mellitus showed elevated values of NAG index when control of blood sugar was not successful. Increase of NAG index was observed in some dogs with pyometra before increases of BUN and serum creatinine concentration. Therefore, NAG index in urine seems to be a good indicator for urinary diseases in dogs.
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PMID:Clinical availability of urinary N-acetyl-beta-D-glucosaminidase index in dogs with urinary diseases. 1201 83

The aim of the study was to determine the main clinical and organising difficulties affecting quality and efficacy of medical care in children with acute pyelonephritis (AP). 41 children aged 3 wk--17 yr 4 mo hospitalized for AP at the Department of Nephrology, District Children's Hospital, Szczecin, Poland in 2000 were investigated. Epidemiologic and demographic data, history, clinical presentation, auxiliary investigations, treatment and ambulatory follow-up were analysed. Instead of typical clinical picture neither diagnostic management nor the therapy fulfilled accepted standards. The main problems found were: delay of referral to hospital by primary care doctor, misdiagnosis or inaccurate primary diagnosis followed by insufficient treatment, difficulties with performing simple ambulatory tests (urinalysis, urine culture, ultrasonography) before hospitalisation and lack of co-operation between parents and nephrological outpatient clinic after discharge. For reflux and obstructive nephropathy, often presenting as urinary tract infection, are still the main cause of chronic renal failure in children in Poland the special attention was paid to necessity of thorough education of family doctors in the subject of management of such cases as well as improvement of accessibility to specialistic care.
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PMID:[Acute pyelonephritis--clinical picture and the main diagnostic and therapeutic problems in children]. 1208 83

From November 1998 to March 2000, two hundred patients over the age of 60 years (Elderly) with clinical renal disease were studied. 144 patients were between ages of 60-69 years, 46 between 70-79 years and 10 were above 80 years. The elderly patients (Male 165; Female 35) with renal disease constituted 11% (200/1816) of the total nephrology consultation during the study period. The clinical presentation included chronic renal failure (42.5%); acute renal failure (28%); nephrotic syndrome (14.5%); acute glomerulonephritis (7.5%); renal vascular disease (5%) and renal cystic disease (2.5%). Diabetic nephropathy, obstructive uropathy and hypertensive nephrosclerosis were the major causes of CRF, accounting for 80% of total CRF in the elderly. Chronic glomerulonephritis and chronic pyelonephritis (CPN) were less common and etiology of CRF was uncertain in 5.9% of cases. However, diabetic nephropathy was the commonest (49.4%) cause of chronic renal failure. We did not see a single case of ischemic nephropathy causing CRF in the present study. Prerenal ARF, obstructive uropathy and sepsis were contributing factors for ARF in 82% of the cases. Volume depletion due to gastrointestinal fluid loss and urinary tract obstruction on account of enlarged prostate were the leading causes of ARF in 20 (35.7%) and 8 (14.3%) cases respectively. Sepsis with or without multiorgan failure was the major (46.7%) cause of mortality in patients with ARF and overall mortality was 26.8%. The commonest (31%) cause of nephrotic syndrome was the idiopathic membranous nephropathy. Diabetic nephropathy related to type-2 diabetes mellitus was the second most common (24.1%) cause of nephrotic syndrome. Diffuse endocapillary proliferative GN of post infectious etiology was the commonest (73.3%) type of acute GN in our elderly patients. Renal cystic diseases were noted in 5 (ADPKD 3; Simple cyst-2) patients. Thus, overall spectrum of renal disease in our elderly patients is similar to that of developed nations except in two ways: (i) Endocapillary proliferative GN of post infectious origin was the commonest type of acute GN and (ii) Rarity or absence of ischemic nephropathy and atherosclerotic renal artery occlusive disease.
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PMID:Spectrum of renal diseases in the elderly: single center experience from a developing country. 1209 35

We report the use of a metallic stent in a transplant ureteral stenosis. A 28-year-old man with chronic renal failure due to chronic pyelonephritis, who received a living-donor renal transplant, presented with transplant ureteral stenosis. The stenosis was unresponsive to balloon dilation and was treated by antegrade placement of a self-expanding Memotherm stent. The stented ureter stayed patent for 3 years. It may be reasonable to treat post-transplant ureteral stenosis resistant to balloon dilation with self-expanding metallic stents. However, long-term follow-up is required to evaluate the efficacy of this treatment.
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PMID:Renal transplant ureteral stenosis: treatment by self-expanding metallic stent. 1249 Oct 17

The present paper represents an overview of the imaging methods which could integrate the first ultrasonographic approach to nephrologic diagnosis. It summarizes the clinical indications and the appropriate imaging protocols including conventional radiology, CT, MR and Nuclear Medicine in five different clinical scenarios: reno-vascular hypertension, hematuria, acute pyelonephritis, acute and chronic renal failure, and acute urinary colic.
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PMID:[Nephrologic diagnosis besides ultrasonography: which other imaging methods? Guideline on the use of radiologic methods]. 1250 36

In order to document the incidence, aetiology and outcome of chronic renal failure in Jamaican children, paediatric surgeons and hospital based paediatricians island-wide were contacted, and the nephrology records at the island's paediatric nephrology centres searched for data on children < 12-year-old with chronic renal failure diagnosed for the first time between January 1985 and December 2000. Thirty-four children were identified, 21 were male. The cumulative annual incidence of chronic renal failure was 3.2 per million children aged < 12 years. The incidence is likely underestimated, as some children may have been undiagnosed and/or not referred. Glomerulonephritis was the commonest cause of chronic renal failure (50%) followed by obstructive uropathy, reflux nephropathy, renal dysplasia and chronic pyelonephritis (41.2%). Five children (14.7%) had reflux nephropathy (post obstructive in four). Half the children were already in chronic renal failure at time of presentation. Mortality was 65%. In Jamaica, childhood chronic renal failure is due mainly to potentially treatable diseases. Local physicians should be more aware of potentially progressive renal diseases and their prevention. Earlier referral of difficult cases for nephrological consultation is recommended. A paediatric dialysis/transplant programme is needed.
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PMID:Chronic renal failure in Jamaican children. 1263 36

Renal transplantation in India costs about US$5000 ($1=Rupees 48.25), azathioprine costs $200 a year and cyclosporine costs $2000. Against this the average per capita income is $279 (Rs. 12989) per year; 36% of the population earn less than $105, and only 2.2% earn more than $1000. The country cannot afford to treat end-stage renal disease. Thirty percent of chronic renal failure is due to diabetic nephropathy, and 10% each to hypertensive nephropathy and chronic pyelonephritis. Social and preventive health workers of the Kidney Help Trust administered a questionnaire at the homes of a study population of 25,000, examined the urine of every individual for albumin and reducing substances, and checked the blood pressure of every person aged over 5; 90% of the population cooperated. Six percent were hypertensive and four percent had diabetes. Eight percent of them subsequently took regular treatment. Using only reserpine, hydrallazine and hydrochlorothiazide for hypertension, and glibenclamide and metformin for diabetes (as these are the cheapest agents available), we were able to control the blood pressure to 140/90 or less in 96% of cases, and to reduce HbAIC by 10% or more of the original reading in 77%. An HbA1C of 7% was achieved in 50% of the diabetic subjects. The total cost amounts to 27 US cents for one year per capita of the study population. The Indian Government now spends $7.67 per capita on health each year, but expects patients to attend its Primary Health Centers. The patients do not attend because in doing so they lose a day's wages. We believe that domiciliary treatment is the solution for these diseases, and expect to see a fall in the incidence of chronic renal failure if this is instituted in the future.
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PMID:Prevention of chronic renal failure at the community level. 1286 81

Renal dysplasia and concurrent pyelonephritis were diagnosed in a 15-week-old female Bull Mastiff which presented with clinical signs compatible with chronic renal failure. Ultrasound examination was consistent with renal dysplasia and clinical pathology supported a diagnosis of chronic renal failure and urinary tract infection. Renal histological examination demonstrated inflammation and scarring with concurrent tubular dysplasia and persisting primitive glomeruli, although the presence of chronic inflammation complicated interpretation. It is uncertain whether renal dysplasia was inherited or due to a urinary tract infection acquired in the neonatal period. Renal dysplasia has not previously been reported in the Bull Mastiff breed.
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PMID:Renal dysplasia and urinary tract infection in a Bull Mastiff puppy. 1508 Apr 53


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