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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.
Nephron 1976
PMID:Immune system to uremia. 1 22

Plasma kallikrein releases bradykinin when activated by gram-negative septicemia or irreversible hemorrhagic shock. Pancreatitis releases glandular kallikrein causing hypotension and increased vascular permeability. Bradykinin in the brain produces hypertension. Renal kallikrein is released by high arterial pressure, vasodilators, low doses of noradrenaline, angiotensin II, mineralocorticoids and rapid volume expansion. It has a biphasic relation to sodium excretion. In essential hypertension, kallikrein release into the blood and urine is low and facilitates hypertension. High renin in Bartter's syndrome is balanced by high PGE and kallikrein without hypertension.
Nephron 1979
PMID:Kallikrein, kininogen and kinins in control of blood pressure. 37 13

A single center experience of 514 ciclosporin-treated renal allografts which survived longer than 1 year was reviewed in order to analyze the causes of renal allograft loss beyond the 1st year post-transplantation and the contribution of selected parameters to long-term survival. 83 grafts were lost between 1 and 5 years with the most common causes of graft loss being chronic rejection (54%), death (14%), noncompliance (13%) and sepsis (11%). Actuarial 5-year graft survival rates, decaying from 100% at 1 year, of living related and cadaveric grafts were 88.6 and 79.5%, respectively. Parameters with a substantial influence on long-term survival included the quality of early graft function and incidence of acute rejection in the 1st year post-transplantation. A marker for long-term survival (> 5 years) was a significantly lower serum creatinine (177 mumol/l; < or = 2 mg/dl) at 1 year. We conclude that chronic rejection is responsible for the majority of late graft losses in the ciclosporin era as in the earlier azathioprine period.
Nephron 1992
PMID:Causes of late renal allograft failure in the ciclosporin era. 143 37

In our previous studies, we found increased levels of urinary trypsin inhibitory activity in gentamicin-induced nephrotoxicity in rats. Following administration of the Bowman-Birk trypsin and chymotrypsin inhibitor (BBI), no proteinuria was detected in gentamicin-treated rats, and a decrease in creatinine clearance was noted in only 50% of the injected rats. In the present study, we examined the antimicrobial activity of gentamicin against Escherichia coli in the presence of BBI in gentamicin-induced nephrotoxicity in rats. We found that 50% of rats with E. coli-positive blood cultures died of septicemia. All the rats injected with E. coli plus gentamicin or E. coli plus gentamicin plus BBI survived, the latter showing no proteinuria or deterioration in creatinine clearance. In conclusion, BBI, which is an effective inhibitor of gentamicin-induced nephrotoxicity, does not affect the antimicrobial activity of gentamicin sulfate.
Nephron 1992
PMID:Antimicrobial gentamicin activity in the presence of exogenous protease inhibitor (Bowman-Birk inhibitor) in gentamicin-induced nephrotoxicity in rats. 152 44

The factors predisposing to and complicating acute renal failure (ARF) in the medical intensive care unit (ICU), and their relative influence on outcome during ARF are unclear. We retrospectively evaluated the relative importance of age, prior chronic disease (including chronic renal failure), sepsis and organ system failure, for development and outcome of ARF in the medical ICU. Of 487 consecutively admitted patients, 78 (16%) had ARF, in 63% treated with renal replacement therapy. Mortality was 63%. Independently from each other, advancing age, prior chronic disease, and cardiovascular and pulmonary failure directly related to the development of ARF, while neurological failure related inversely. Sepsis only contributed to ARF prediction from these variables if cardiopulmonary failure was excluded. Advancing age, cardiovascular failure before and after onset of ARF, pulmonary failure before ARF and use of renal replacement therapy were the major independent factors directly related to ARF mortality, while prior chronic renal failure related inversely and sepsis did not contribute. Hence, the outcome of ARF in a medical ICU is largely dependent on factors predisposing to ARF, even though the severity and complications of ARF may partly contribute. Our results may help in deciding on the prevention and therapy of ARF in a medical ICU.
Nephron 1991
PMID:Acute renal failure in the medical intensive care unit: predisposing, complicating factors and outcome. 176

Infection of the sternoclavicular joint due to Staphylococcus aureus occurred in 2 hemodialysis patients. Good results were achieved in both cases by applying appropriate antibiotic therapy. Sternoclavicular joint sepsis is rare. However, it is often associated with underlying conditions, and hemodialysis must be recalled as one of the possible predisposing factors.
Nephron 1990
PMID:Sternoclavicular joint infection in hemodialysis patients. 224 79

During the last 4 years, the Permcath Quinton double-lumen silicone catheter was inserted into the internal jugular vein of 57 uraemic patients with difficulty for creating conventional vascular access for haemodialysis. In 4 patients, with definitive contraindication of conventional vascular access, this catheter still permits haemodialysis after a duration of 8-25 months. In 25 further patients with terminal uraemia, but poor vein system, it allowed the maturation of an arteriovenous fistula after 2-14 months of use. In 17 patients already on chronic haemodialysis, but who lost abruptly their vascular access (15 grafts and 2 arteriovenous fistulae), it allowed a new arteriovenous fistula to mature in 16 cases after a mean duration of 7.3 +/- months. In 5 patients with short life expectancy because of neoplasia, it allowed to dialyse them until their death which occurred after 6.5 +/- 2.2 months. In 6 patients with acute renal failure and haemostasis problems, it allowed to perform not only dialysis, but also plasmapheresis in 3 and parenteral nutrition in 3 other cases. The complications were the following: sepsis (n = 3); episodes of hypocoagulability due to inadvertent injection of heparin stored in the lumen (n = 2), thrombosis of the lumen (n = 3), and insufficient flow (n = 6). In no case these complications prevented continuation of haemodialysis. The catheter had to be removed in 2 cases because of septis and in 1 case because of insufficient flow. In 3 cases the catheter had to be replaced because of thrombosis and in 1 case because of laceration. These complication rates are, however, fewer than those reported in the literature for arteriovenous shunts or rigid subclavian and femoral catheters. The Permcath catheter seems, therefore to be the method of choice for immediated vascular access in patients in whom the creation of conventional vascular access is difficult.
Nephron 1989
PMID:Use of Permcath (Quinton) catheter in uraemic patients in whom the creation of conventional vascular access for haemodialysis is difficult. 260 97

A long-term hemodialysis male patient was known to have systemic iron overload due to regular blood transfusions. As he was suspected to have aluminum overload, he received a single intravenous administration of desferrioxamine (that supported the hypothesis). Four days later, he became highly febrile with no focus of infection on physical examination. All blood cultures yielded Yersinia enterocolitica. The aim of this case report is to recall the potential risk of Yersinia sepsis in iron overload patients treated with desferrioxamine, even for a short time. The diagnosis should be suspected even in the absence of digestive symptoms, leading to immediate desferrioxamine withdrawal and antibiotic therapy.
Nephron 1988
PMID:Septicemia due to Yersinia enterocolitica in a long-term hemodialysis patient after a single desferrioxamine administration. 323 80

The morbidity and mortality of hemodialysis by internal central venous catheterization in the subclavian and internal jugular positions are reviewed. A follow-up study was performed in our unit over 10 years (786 catheterizations). The most frequent complications were inadequate flow (7.6%) inadvertent withdrawal (5.6%) and bacteremia (5.1%). The overall complication rate was 27.2%. Kinking (p less than 0.001), bleeding (p less than 0.01) and bacteremia (p less than 0.05) occurred more frequently in patients with chronic renal failure, compared to patients with acute renal failure. Inadvertent withdrawal was the only complication observed more frequently in the internal jugular than in the subclavian position (10.8 vs. 4.3%; p less than 0.01). Bacteremia occurred more frequently after prolonged periods of catheterization (greater than 10 days). No fatal complications were observed. To obtain a more accurate idea about mortality, two supplementary large groups were studied: a review of 11 published series (1,542 catheterizations) and a questionnaire-based survey of 16 dialysis centers (approximately 4,000 catheterizations). Six fatalities were registered: 1 due to septicemia (in the literature review) and 3 due to traumatic perforation of the cardiac or the vessel wall, 1 to septicemia and 1 to air embolism (in the questionnaire-based survey). Based on the three different groups studied, the mortality of catheter dialysis could be estimated to be between 0 and 1.25/1,000 catheterizations.
Nephron 1987
PMID:Morbidity and mortality of central venous catheter hemodialysis: a review of 10 years' experience. 369 29

We have evaluated the incidence, prevalence, predisposing factors and evolution of urinary tract infection (UTI) developing late after transplantation in 63 patients whose graft had lasted at least 3 months and whose follow-up averaged 7 years. Beyond 3 months after transplantation incidence of UTI decreases progressively, from 25 to 0%, 50% of the patients remaining free of infection throughout the period of observation. Neither the original kidney disease except perhaps diabetic nephropathy nor the presence of vesicoureteral reflux were predisposing factors. Incidence and prevalence in females were twice that in male. Late UTI did not affect graft or patient survival, or graft function at 5 years. Most UTI were asymptomatic and had a benign course. However, in 3 patients septicemia or graft dysfunction ensued demonstrating the need for continuous monitoring of urine cultures.
Nephron 1985
PMID:Late urinary tract infection after transplantation: prevalence, predisposition and morbidity. 388 73


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