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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pneumonia [4,9] and septicemia are still the principle causes of the high mortality in acute renal failure. Moreover, according to the EDTA report, 19% of chronic intermittent dialysis patients die from infection [17]. The resulting conclusion, that cellular and humoral immune responses are suppressed in renal insufficiency, is further supported by experimental evidence.
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PMID:Immune system to uremia. 1 22

Heroin addiction is associated with several severe and occasionally fatal renal complications. Acute renal failure consequent to rhabdomyolysis and myoglobinuria, when treated supportively, carries a good prognosis. Staphylococcal or other bacterial septicemia may in itself prove fatal and is associated with a proliferative immune complex, acute glomerulonephritis, which generally follows the course and prognosis of septicemia. The necrotizing angiitis reported in heroin addicts still is largely undefined. Focal and segmental glomerular sclerosis is the most common pathologic finding in the syndrome of heroin-associated nephropathy (HAN). Typically, HAN presents with massive proteinuria and progresses rapidly to renal failure. Presumptive evidence supports the premise that heroin or its vehicles elicits immunologically mediated renal damage. The antigen still is unidentified. Removing the antigenic challenge by stopping heroin injection apparently interdicts the progression of renal disease. Renal transplantation can be effectively accomplished in patients with HAN without early recurrence if patients discontinue the use of heroin.
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PMID:Renal consequences of narcotic abuse. 2 85

The authors report a statistical analysis of 163 operations of aorto-iliac vascular surgery. A detailed study of their 14 deaths showed the various causes of mortality (immediate post-operative thrombosis, acute renal failure, digestive complications, septic cardiac, pulmonary, hemorrhagic and cerebro-vascular accidents). This analysis, compared with the findings in all the operated patients showed the main factors of risk in this type of surgery (age over 70 years immediate and late reoperations, heart lesions, renal, pulmonary and late lesions, the risk of sepsis). The indicate the means of prevention of such accidents and the therapeutic attitude when they occur. They conclude that the contra-indications are relative, but should be observed in order to lower the risk of this surgery below 5 p. cent mortality rate.
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PMID:[Risk factors in aorto-iliac surgery (author's transl)]. 21 67

Acute intrinsic renal failure occurred in an adult patient with Escherichia coli septicemia. The clinical course did not include any of the circumstances usually present when acute renal failure complicates Gram-negative sepsis. A renal biopsy showed acute proliferative glomerulonephritis. There was no evidence to support other known causes of acute parenchymal renal failure, such as poststreptococcal glomerulonephritis, subacute bacterial endocarditis, or vasculitis. The patient recovered completely with antibiotic therapy, and renal function returned to normal within two weeks. An immunologic mechanism involving E coli was considered responsible for the acute renal failure.
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PMID:Gram-negative sepsis with acute renal failure. Occurrence from acute glomerulonephritis. 33 Aug 92

Clinical characteristics of 46 cases of acute pancreatitis treated with total parenteral nutrition were examined. Hyperalimentation may be used in these severely ill patients with minimal technical or metabolic morbidity. This method of nutritional support can maintain patients with nonfunctional gastrointestinal tracts for several months. Catheter-related sepsis was more common than expected early in the course of acute pancreatitis but caused minimal morbidity. The incidence of catheter-related sepsis late in disease was minor. Hyperalimentation had little if any effect on the pathophysiology of acute pancreatitis as judged by the overall mortality and the incidence and severity of the complications of acute respiratory failure and acute renal failure. It is not clear that parenteral hyperalimentation alters the course of acute pancreatitis but it is a useful adjunct for nutritional support in this illness.
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PMID:Parenteral nutrition in the treatment of acute pancreatitis: effect on complications and mortality. 41 29

In patients with cerebrospinal fluid internal shunts, immune complex glomerulonephritis sometimes develops. Of two new cases the first was classic, while the second was in an adult who had had a ventriculoatril shunt for 8 years; furthermore, the patient had acute renal failure and is the first to have been reported to have Peptococcus septicemia. Shunt glomerulonephritis is characterized by the following: (a) its occurrence following, most often, Staphylococcus albus infection in a patient who usually has a ventriculoatrial shunt; (b) transitory improvement of the symptoms by antibiotherapy only; and (c) full recovery if the prosthesis is removed. Laboratory studies show a low serum concentration of the C3 component of complement, the presence of cryoglobulins and a positive rheumatoid factor test. These abnormalities are reversible with removal of the prosthesis. Optical microscopy of a renal biopsy specimen in the two cases showed cellular proliferation of the glomerular tuft, electron microscopy demonstrated subepithelial deposits and immunofluorescent studies revealed intramembranous and intramesangial immune complexes. These features are similar to those observed in experimental nephritis induced in animals by foreign protein.
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PMID:[Shunt glomerulonephritis: clinical and histopathological manifestations]. 43 34

Eleven cases of renal failure associated with resection of ruptured abdominal aortic aneurysm and requiring hemodialysis are reported. Previously described series have emphasized the extremely high mortality rate in such patients. In our clinical experience, however, 8 of 11 consecutively treated patients with this clinical problem survived and recovered adequate renal function. We believe that these favorable results can be largely explained by the low incidence of pulmonary infection in our patients as opposed to the frequent occurrence of pulmonary sepsis in other reported series. The reduction in the incidence of pulmonary infection can probably be attributed to the early discontinuance of artificial ventilation after prompt removal of pulmonary edema fluid by intensive hemodialysis ultrafiltration. These survival figures demonstrate that, with appropriate intensive management, full recovery is possible in the majority of patients with acute renal failure complicating ruptured aortic abdominal aneurysm. Our experience serves as a stimulus to render full intensive care support to such patients.
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PMID:Acute renal failure after ruptured abdominal aortic aneurysm: an improved clinical prognosis. 45

A retrospective study of 35 newborn with acute renal failure is presented. The main causes of renal failure were neonatal hypoxia by asfixia or hemorrhagic shock (eight), congenital malformations (two) and hypertonic dehydration (25). Mortality rate was 22% including two neonates with severe congenital malformations. Sepsis was considered as the main complicating factor and often as inducer of renal failure. It was present on 55% of cases and on 75% of the deceased newborn. Cerebral injury was frequent but a follow-up study is necessary to establish the rate of neurologic sequelae. Early diagnosis and treatment of renal failure will decrease complications with improvement in prognosis. Etiological analysis of neonatal renal failure shows the need of a better health education of people and also medical control of pregnancy and perinatal period.
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PMID:[Morbidity and mortality of acute renal failure in neonatal period (author's transl)]. 46 2

A male patient was admitted to hospital 12 h after self-poisoning with mercuric chloride. He suffered multiple complications including acute renal failure, ulcerative colitis, anaemia, disseminated intravascular coagulation, chronic sepsis and severe weight loss. Initially he responded well to resuscitative measures and intensive supportive therapy, which included ventilation of the lungs, haemodialysis, dimercaprol, antibiotics, parenteral feeding and gastrointestinal surgery. Unfortunately the sepsis was never satisfactorily eradicated despite satisfactory serum concentrations of the appropriate antibiotics. On day 43 after poisoning he had a grand mal fit; after this there were focal neurological signs and on lumbar puncture he was found to have a raised protein concentration and raised pressure in his cerebrospinal fluid. The condition of the patient rapidly deteriorated and on day 47 he died. Post-mortem examination revealed a large cerebellar abscess. The literature on mercury poisoning is reviewed.
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PMID:A case of poisoning with mercuric chloride. 49 32

This is a retrospective study of 133 episodes of bacteremic infection in 112 hemodialysis patients. The frequency of bacteremic infection was 9.5% in patients with chronic renal failure and 10.9% in patients with acute renal failure. In patients with acute renal failure, pneumonia and intra-abdominal abscess were the most frequent sources of septicemia. Sepsis was usually due to Gram-negative organisms and mortality was high. In patients with chronic renal failure, infection of the shunt or fistula was the most common cause, was frequently due to Staphylococcus organism, and had a more favorable survival rate. Gram-negative septicemia from a nonaccess source in patients with chronic renal failure was associated with a higher mortality. Bacterial endocarditis and septic pulmonary emboli occurred in 3.6% of septic episodes and 0.35% of patients at risk and had very low mortality. A low threshold for obtaining blood cultures and early antibiotic treatment are believed to be important in the treatment of bacteremic infections in patients undergoing long-term hemodialysis.
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PMID:Bacteremic infection in hemodialysis. 50 22


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