Abstract
Previous work has indicated the imporiance of vesicoureterie reflux (VUR) with intravenal reflux (TPR) in the presence of urinary infection for the development of pyelonenheitic scarring. The distribution of such scars is determined by individual panillary morphology which relates to their vulnerability to IPR. This study examines the initiation of the scarring process and the influence of early antimicrobial treatment. Urinary in fection was introduced in 45 piglets with unilateral VUR and IRR. Control animals (no antimicrobial treatment: n = 27) were examined after 1, 2, 3 and 1 weeks of infection. In 2 groups urinary infection was eliminated after 1 week using in one (n = 8) a combination of gentamicin and chloramnhenicol and in the other (n = 5) nitrofurantoin and these were examined at 4 weeks. Parenchymal damage was present in half the control animals after 1 week and established scarring in all but 1 between 2 and 4 weeks. Of the treated animals some scarring was present in approximately half, but it was much less extensive and different in character. In the presence of infected reflux. segmental scarring occurs with dramatic speed but the process may be modified by very early treatment with antimicrobial drugs.
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