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Results for “Pyelonephritis”

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PubMed1986

[Xanthogranulomatous pyelonephritis with cancer of the kidney pelvis--a rare coincidence].

Xanthogranulomatous pyelonephritis is a specific form of a chronically destructive inflammation of the kidney. In addition to our own case of the extremely rare coincidence of xanthogranulomatous pyelonephritis and a transitional cell carcinoma of the renal pelvis our report also refers to seven further cases of xanthogranulomatous pyelonephritis. Any preoperative diagnosis usually is inaccurate. The symptoms are: general poor health, renal pain, fever, marked reduction or complete loss of the renal function, and frequently radiological evidence of a renal tumor. Surgery of xanthogranulomatous pyelonephritis often results in nephrectomy.

Adult↗

PubMed1979

[Significance of the ability of E. coli to alter capillary permeability for the reproduction of pyelonephritis in mice].

Experiments in a number of biological models showed that the cultures of E. coli isolated from the urine of children with pyelonephritis had a varied spectrum of pathogenic properties. Histologically confirmed pyelonephritis induced by intravenous infection in CBA mice, treated with 5% glucose by the method of Montgomerie et al., correlated with the bacterial adhesiveness to the epithelium and the interference with capillary permeability, registered in experiments on the pulmonary model with Evans blue used for control. The criterion for the development of pyelonephritis in mice, which was based, in the opinion of Mintogemerie et al., on the positive results, indicating the presence of the infecting agent in the culture obtained by inoculation with the samples of urine and kidney tissue, was found to be insufficient, as only 28 out of 45 cultures of E. coli isolated from the kidneys coincided with histologically confirmed cases of pyelonephritis.

Animals↗

PubMed1981

[Effectiveness of antibiotic therapy in pyelonephritis after kidney transplantation].

Determination of bacteriuria, leucocyturia, active leucocytes and Sternheimer-Malbin's cells in patients with transplanted kidneys during the postoperative period provided identification of pyelonephritis in the transplanted kidney. E. coli, Proteus, Staphylococcus, P. aeruginosa and microbial associations were the main causative agents of pyelonephritis in such patients. The majority of the causative agents were polyresistant to antibiotics. Investigation of the microbial sensitivity to antibiotics and determination of their levels in the patients promote development of rational schemes for the treatment of pyelonephritis. Early identification of pyelonephritis of the transplanted kidney and its timely treatment with antibiotics allow avoiding destruction of the transplanted organ and promote its normal functioning.

Adult↗

PubMed1982

Free water reabsorption during saline diuresis in experimental enterococcal pyelonephritis in rats.

Inability to attain Umax after overnight dehydration is the earliest functional abnormality in human and experimental pyelonephritis caused by diverse microorganisms. In order to characterize the defect in Umax in experimental enterococcal pyelonephritis, another index of renal concentrating ability. TcH2O, was determined during saline loading. Normal TcH2O depends on adequate sodium chloride delivery and reabsorption in the ascending limb of Henle's loop and water reabsorption from the collecting duct. Rats with early pyelonephritis, 3 days after intravenous injection of enterococci, were compared with normal rats in studies of Umax during hydropenia and TcH2O during 1.2% saline infusion. Mean Umax in infected rats was significantly lower than in uninfected rats (1120 vs. 2767 mOsm/kg H2O) (p less than 0.01), but CIn in infected rats was not significantly different from that in uninfected rats (0.96 vs. 0.89 ml/min per 100 gm) (p less than 0.05). During saline diuresis, maximal Cosm/CIn was more than 35% in both the normal and infected rats. The relationship between TcH2O/CIn and Cosm/CIn was linear in both groups, and the r, slope, any y intercept of the regression equation of TcH2O/CIn vs. Cosm/CIn in infected rats were not significantly different from those in normal rats. During saline diuresis the regression of sodium excretion UNaV/CIn) vs. Cosm in infected rats was not significantly different from that in control rats. The finding of normal TcH2O during saline loading suggests that reabsorption of increasing amounts of sodium chloride from the ascending limb of Henle's loop and reabsorption of water in the collecting duct are normal in early pyelonephritis.

Animals↗

PubMed1981

Acute pyelonephritis in pregnancy: an anterospective study.

During a 4.5-year period, over 2% of 24,000 obstetric patients at Parkland Memorial Hospital were admitted for acute pyelonephritis. Chills accompanying back pain was the most common presenting complaint in the se 656 women; lower urinary tract symptoms and nausea and vomiting were also common. All women had fever and, with few exceptions, costovertebral angle tenderness. In most cases, the clinical impression was confirmed by bacteriuria. Significant transient renal dysfunction was demonstrated in 60 (21%) of 282 women tested. Of 501 of the 656 women with antepartum pyelonephritis who delivered at Parkland Hospital, 23% developed recurrent pyelonephritis; in half of these patients, this recurrence was antepartum. Of 393 and of the 501 women tested, 20% had asymptomatic bacteriuria at delivery. An 8- to 13-year follow-up study was done on 208 of the 501 women following the index pregnancy; 42% were treated for 1 or more episodes of symptomatic urinary infection when not pregnant. In 140 of the 501 women, a subsequent pregnancy was cared for at Parkland Hospital. Thirty-eight percent of these patients had at least 1 urinary infection during 1 of these pregnancies: 29% had pyelonephritis, and 9% had either asymptomatic bacteriuria or cystitis.

Acute Disease↗

PubMed1980

Effect of pyelonephritis during pregnancy on mother and fetus.

Pyelonephritis during pregnancy was found to have a higher incidence when the patient's history contained some indication of an earlier renal disease. Pregnancy associated with chronic nephritis has to be interrupted in the first trimester as the particular conditions of pregnancy predispose to pyelonephritis. Provided pregnancy pyelonephritis is diagnosed and treated early enough the incidence of intrauterine fetal death, premature, birth and perinatal fetal loss will not be higher than the average, but developmental retardation has a slightly higher incidence. The degree of renal disturbance not only increase the probability of pyelonephritis but also the damage suffered by the mother and fetus. The prevention of inflammatory renal and appropriate treatment of inflammatory renal diseases and the constant control of the patient is the task of prenatal and nephrological care, so as to avoid early and late complications.

Abortion, Induced↗

PubMed1980

[Pyelonephritis in various types of obstructive uropathies in children].

Kidney biopsies were examined in 73 children with some forms of obstructive uropathies: vesico-renal reflux and obstructive megaurether. In 59 patients (80%), chronic pyelonephritis was detected. The predominant morphological form of chronic pyelonephritis in patients with obstructive uropathies is a mixed form with a combination of tubulo-stromal-vascular changes. In most patients chronic pyelonephritis was extensive up to the development of nephrosclerosis, in 22% it developed against the background of renal dysplasia. The nature and intensity of pyelonephritis was shown to depend on the severity of congenital pathology of the urinary tracts and the age of the patients.

Adolescent↗

PubMed1995

Xanthogranulomatous pyelonephritis in pediatric patients.

We observed xanthogranulomatous pyelonephritis in 5 of 27 nephrectomies (18.5%) performed for end stage pyelonephritis. Two patients were 5 months old or younger, of normal birth weight and the products of uncomplicated full-term pregnancies. In all cases clinical histories and findings were consistent with xanthogranulomatous pyelonephritis yet this diagnosis was suspected prospectively in only 1 case. Our observations, supported by recent literature, suggest that xanthogranulomatous pyelonephritis may occur more commonly than previously reported. In addition, the clinical and pathological expression of this process in the pediatric population appears to be no different from that in adults. The true incidence and presumed chronicity of this process need to be reevaluated in light of recent data.

Adolescent↗

PubMed1995

[Organ-preserving surgeries and nephrectomy in pregnant women with severe forms of acute suppurative destructive pyelonephritis].

The results of surgical treatment of pyodestructive pyelonephritis in 105 (4.2%) pregnant women and puerperae out of 2506 ones treated in the urology department from 1986 to 1994 are analyzed. Uni- and bilateral apostematous nephritis, carbuncle and abscess of the kidney were diagnosed in 89 and 16 patients, respectively. Nephrostomy was the principal method of treatment of focal suppurative forms of acute pyelonephritis. Bilateral nephrostomy was carried out in 12 pregnant patients, in 3 of them secondary nephrectomy was performed. Nephrectomy is indicated in total destruction of the kidneys, it was made in 37 (35.2%) pregnant women and puerperae. Introduction of radical surgery into practical treatment of neglected forms of pyodestructive pyelonephritis led to almost total liquidation of postoperative mortality in pregnant women. The efficacy of treatment of pregnant women is provided by varying in extension surgical interventions on the kidneys. Organ-sparing and radical operations in grave purulent pyelonephritis were effective in 97.2% of pregnant patients.

Acute Disease↗

PubMed1994

Erythropoietin in pregnancies complicated by pyelonephritis.

OBJECTIVE: To determine whether antepartum pyelonephritis causes an acute or delayed alteration in erythropoietin production. METHODS: Serum erythropoietin concentrations were determined prospectively using an enzyme-linked immunosorbent technique in 36 pregnant women admitted to Parkland Hospital with pyelonephritis. Healthy nonanemic pregnant women served as controls. RESULTS: Serum erythropoietin levels in women with antepartum pyelonephritis were not different from those measured in normal pregnant women. Specifically, there were no differences in erythropoietin levels in women who had anemia at admission (n = 6; 13.8 mU/mL), hemolysis (15.4 versus 12.9 mU/mL), or renal insufficiency (14.5 versus 12.9 mU/mL) secondary to renal infection as compared to controls. CONCLUSION: We conclude that antepartum pyelonephritis does not alter erythropoietin production either acutely or within several days of infection. Because erythropoietin production was not decreased, we suggest that hemolysis is the major factor contributing to anemia associated with renal infection.

Adult↗

PubMedDate not supplied

[The suppression of the Ca ATpase activity of rat kidney microsomes under the action of blood plasma as an index of the severity of the status of pyelonephritis patients].

Whether blood plasma from 63 pyelonephritis patients can inhibit Ca-ATPase activity when compared to known toxicity marker (middle-sized molecule number) was studied. This was done to assess diagnostic potentialities of the test based on the ability of plasma from pyelonephritis patients to inhibit the test enzymatic system, i. e. Ca-ATPase activity of the microsome fraction from renal cortex in intact rats. The inhibition of Ca-ATPase activity by the plasma is shown to correlate with inflammation activity and the patients condition. In pyodestructive acute pyelonephritis this inhibition reached 60.6 +/- 3.86%, in acute serous pyelonephritis 36.02 +/- 1.54%. It follows, that the above parameter is more informative than the number of middle-sized molecules and can be introduced as one of the criteria of the patients' condition and for choice of treatment.

Acute Disease↗

PubMed1993

[The role of echo scanning of the kidneys in the diagnosis of acute pyelonephritis].

The role of echo scanning in the diagnosis of acute pyelonephritis was evaluated in 123 patients. It was established that ultrasonography in acute pyelonephritis is a highly informative diagnostic method. The importance is high in acute obstructive pyelonephritis and less informative in acute non-obstructive pyelonephritis. The method has no equal counterparts in the most difficult cases for diagnosis. Association of renal echo scanning with traditional method significantly increases the diagnosis quality.

Acute Disease↗

PubMed1993

Comparison of excretory urography and ultrasonography for detection of experimentally induced pyelonephritis in dogs.

Pyelonephritis was experimentally induced in 10 clinically normal dogs by nephropyelocentesis and introduction of Proteus mirabilis into the randomly chosen right or left renal pelvis. Dogs were examined by nephrosonography and excretory urography before and 2 weeks after infection. The major nephrosonographic findings of pyelonephritis were renal pelvic dilatation, usually with proximal ureteral dilatation, and a hyperechoic mucosal margin line within the renal pelvis, proximal portion of the ureter, or both. In addition, at least one or more of the following were observed: generalized hyperechoic renal cortex, focal hyperechoic areas within the medulla, and focal hyperechoic or hypoechoic cortical lesions. Interpretation of excretory urograms resulted in 3 false-negative and 1 false-positive conclusions, compared with the histologic findings. Interpretation of nephrosonograms resulted in 2 false-negative and no false-positive conclusions. Of the kidneys with histologic evidence of pyelonephritis, 73% were detected by excretory urography, whereas 82% were detected by nephrosonography. Nephrosonography appeared to be useful for detection of mild to moderate cases of acute pyelonephritis that may be be interpreted as such by excretory urography.

Animals↗

PubMed1993

[Contribution of experimental pathology to the understanding of human pyelonephritis].

The close similarities between the urinary tract of primates make it possible to use the monkey as a model for understanding the pathophysiology of pyelonephritis in the human. Basically, experimental protocols consist in introducing uropathogenic strains of E. coli into the bladder and/or the ureter in the monkey and to determine early and late consequences of the subsequent renal tissue infection. Lesions appear within the first minutes of bacterial invasion. They result from the virulence of the parasite, which pertains to multiple factors, with a prominent role of fimbrial adhesion. However, the defense mechanisms of the host better explain the renal tissue insult. They comprise early ischoemia due to granulocyte aggregation within the renal capillaries, followed by damage due to oxygen free radicals which are generated during reperfusion. The primate model of pyelonephritis is extremely useful to understand most clinical, functional and radiological events observed in the course of human pyelonephritis. This model also serves to test pharmacological manoeuvres aimed at preventing the renal tissue injury of pyelonephritis.

Animals↗

PubMedDate not supplied

[Xanthogranulomatous pyelonephritis in childhood: considerations on 2 new cases].

The Authors report their experience about two cases of xanthogranulomatous pyelonephritis in childhood. The clinical history, diagnostic procedures and surgical treatment are described. The xanthogranulomatous pyelonephritis is a rare form of chronic inflammatory disease of the kidney, in which pre-operative differential diagnosis with renal cancer or with extra renal neoplastic and inflammatory diseases is very difficult. The signs and symptoms are not characteristic, such as renal tumour, recurrent UTI, abdominal pain, fever. Also non characteristic are the findings, performed with diagnostic ultra sound and computed tomography. The surgical treatment is always effective in the xanthogranulomatous pyelonephritis. About 500 cases are described in adults and about 80 cases in children, from the first description in 1963. The first of our cases, occurring in a boy 6 years old, was treated with nephrectomy, because of the pre-operatory aspect was like tumour. In the second of the cases described, occurring in a girl 11 years old, the nephrectomy was performed because the chronic purulent inflammatory process had involved all the kidney. In the post-operative, in the first case was performed a relaparotomy for intestinal occlusion in 12th day, in the second case the post-operative was uneventful. The Authors emphasize the importance of the xanthogranulomatous pyelonephritis in the differential diagnosis in children with recurrent UTI, renal masses, fever, in the clinical history.

Child↗

PubMed1996

[Characteristic clinical features of pyelonephritis caused by Enterococcus faecalis].

A clinical study was performed in 13 cases of refractory Enterococcus faecalis pyelonephritis that were detected in the Department of Urology, Hiratsuka Municipal Hospital, from April 1975 to March 1995. The characteristic features were that pyelonephritis was commonly seen in females, and clinical symptoms (low-grade intermittent fever, low back pain, general malaise, etc.) were continuously refractory. Bacteriuria or polymicrobial infections were often found, and bacterial count was often as high as 10(2)-10(4)/ml. Nevertheless we considered that E. faecalis caused of refractory pyelonephritis must not have week adherence and pathogenesis to the kidney, owing to the clinical symptoms and the basic subjects. Furthermore this infection was difficult to cure completely with antimicrobials having activity against E. faecalis, and long-term treatment was needed. Therefore, we recommend that treatment for refractory E. faecalis pyelonephritis be carefully selected according to clinical symptoms and the bacterial density of this strain.

Adolescent↗

PubMedDate not supplied

[The prognostic significance of factors predisposing to the occurrence of pyelonephritis].

With the purpose of studying factors which might be pathogenetically interrelated with predisposition to pyelonephritis and used in clinical settings for diagnosis, the authors analyzed 275 records of pediatric patients having been examined in an in-patient facility for pyelonephritis. Clinical records of 106 children free from uronephrologic pathology were used as a comparison group. The examination was done by clinical, laboratory and biochemical, immunologic, functional and roentgenoradiologic techniques, as well as by making use of a medicogenetic approach. The analysis done allowed identification of both eliminable and uneliminable risk factors for pyelonephritis in the children, with the assessment-prognostic table having been provided for giving prognosis of risk of pyelonephritis development in children in each particular case, to be used in clinical settings.

Child↗

PubMed1996

DMSA renal scans in adults with acute pyelonephritis.

The 99mTc-DMSA scan is accepted as the most sensitive imaging modality for detecting areas of renal parenchymal scarring. More recently the DMSA scan has also been shown to be of value in imaging areas of renal parenchymal involvement in both children and adults with acute pyelonephritis. We assessed the acute DMSA scan findings in a consecutive series of 81 patients hospitalized with acute pyelonephritis. Acute pyelonephritis was diagnosed if the patient had a fever of > 37.8 degrees C, loin pain or tenderness and infected urine (99% Escherichia coli). Patients had a blood culture taken (8 positive), as well as a hematological (leukocytosis 75%) and biochemical screen, C-reactive protein (CRP) (increased in 57 of 66 [86%]) and urinary tract ultrasonography. If the initial DMSA scan was abnormal it was repeated after three months and in some instances again at six months. If persisting defects were noted an intravenous urogram was then undertaken. Of the 81 patients, 37 (46%) had an abnormality on the DMSA scan. Nineteen had a single defect, 12 multifocal defects, five features suggestive of pre-existing renal parenchymal scarring (all later shown to have reflux nephropathy) and one a shrunken kidney. Those patients with an abnormal scan had a higher CRP concentration than those with a normal scan. Of the 31 patients who had either a focal or multifocal defect on their initial DMSA scan there was adequate follow-up on 24 patients. In 18 of these the defects had resolved by six months (usually within three months), while of the remainder, three were shown to have reflux nephropathy, one had a large single renal cyst and another an area of parenchymal calcification. Fifty-three of 76 patients (70%) had normal ultrasonography. In adults with acute pyelonephritis, the DMSA scan may prove to be the most useful renal imaging procedure.

Acute Disease↗