Cases Of Chronic Pyelonephritis Research Articles

Clinical, morphologic and histological features of chronic pyelonephritis: An 8-year review.

Urinary tract infection (UTI), especially pyelonephritis when inadequately treated may culminate in end-stage renal disease. The study aims to evaluate the risk factors for and clinico-pathologic features of chronic pyelonephritis (CPN) among patients in Aminu Kano Teaching Hospital, Kano, in North-Western Nigeria. Data on cases diagnosed as CPN between 2010 and 2017 in the study centre were retrieved from archives and analysed for risk factors and clinic-pathologic features. Forty-three cases of CPN were diagnosed in the study period and comprised 24 males and 19 females, with a male: female ratio of 1.3:1. The ages ranged from 3 to 80 years with a mean age of 37.0 ± 19.6 years. Urinary tract obstruction, poorly treated UTI, HIV infection and polycystic kidney disease were the risk factors in 21 (49%), 15 (35%), 6 (14%) and 1 (2%) cases, respectively. Proteinuria was seen in 10 (23.3%) of the patients, hypertension in 7 (16.3%) and haematuria in 3 (7.0%) of cases. Nephrectomy was done in 17 (39.5%) of the 43 CPN cases, indications for surgery were pus-filled, non-functioning kidneys. The diameters of the removed kidneys ranged from 10 to 28 cm and they weighed between 140 g and 2500 g. Scarring, reported in 79.0% of patients, was the most common pathological finding, followed by pus casts in 48.8% and focal segmental glomerulosclerosis in 27.9%. No statistically significant difference was found between age or gender and aetiology or risk factors of the disease (P > 0.05). CPN with pus-filled and non-functioning kidneys is a common indication for nephrectomy. Urinary tract obstruction, poorly treated UTI, and HIV infection were major risk factors seen in this environment. To prevent this complication there is a need for better training of clinicians in the diagnosis and adequate treatment of UTI.

PYLONEPHRITIS IN GIRLS: FEATURES AT THE MODERN STAGE

Girls performed the vast majority of patients with urinary system infections. The prevalence of acute disease and specific gravity of chronic kidney impartments have been increasing with the age and were often accompanied with concomitant urological, gynecological and sexual pathologies.
 The purpose of the work was to determine the etiological and clinical preconditions of relapse and chronic pyelonephritis in girls.
 Materials and methods. An analysis of the clinical course of187 cases ofpyelonephritis in girls of the age of1 - 18 years had been performing in period from 2008 to 2018 years. The 60 patients in observed group had acute process and 127 ones were with the chronic course of the disease.
 Rresults. E. coli was the main etiological factor of the inflammatory process in kidneys. Thus, cases of acute and chronic pyelonephritis composed 63,5% and 44,2% in observed group appropriately. Furthermore, the proportion of grampositive flora increased in the cases of chronic pyelonephritis. In addition, almost 56,7% ofall girls with pyelonephritis had sexually transmitted infections, more likely the patients with chronic forms of the disease (69,3% and 30,0%, respectively (p <0,01). There was domination of the Chlamydia infection in the structure of these pathogens. The research revealed Chlamydia pathogen in the majority of cases — in 29,2% of the examined for urogenital infections girls with pyelonephritis. The presence of mycoplasma infection - 22.1%, trichomonas - 11.5%, candidiasis - 19.5% was less common. 24.8% of girls had clinical signs of vulvitis without identifying the etiological factor
 Conclusions. E. coli prevails among the etiological factors of pyelonephritis in girls. Most of the girls with pyelonephritis with the recurrent and chronic course have urogenital infections. Moreover, association of bacterial microflora and sexually transmitted infections complicates the course of chronic pyelonephritis in girls; promotes the development and maintenance of urodynamic disorders, frequent relapses and progression of chronic inflammatory process in kidneys. In conclusion, urogenital infection examination should be mandatory for the girls with pyelonephritis.

A modified bladder washout test to improve diagnostic results in chronic urinary tract infections.

Bladder washout (BWO) and antibody-coated bacteria (ACB) tests were performed on 25 patients with radiological and/or clinical evidence of chronic upper urinary tract infection (UTI) and 12 patients with asymptomatic bacteriuria. Using a traditional single-washout procedure, the BWO test gave equivocal results in many cases of chronic pyelonephritis; this seemed mainly due to the lack of complete bladder sterilization. A modified procedure, including double sterilization and irrigation, biochemical typing of isolated bacteria, and evaluation of temporal pattern of bacteriuria recurrence, was then introduced. Although preliminary results of the modified BWO test demonstrated a general improvement in the diagnosis of the infection site, it seemed rather difficult, at least in chronic UTI, to establish localizing criteria based on definite numeric changes in bacterial counts after washout.

Percutaneous renal biopsy in children.

The results of 74 renal biopsies in children suffering from diverse medical conditions have been described. In the group of 46 cases of glomerulonephritis, 6 were of the acute variety presenting as the nephrotic syndrome, 35 of the subacute and 5 of chronic glomerulonephritis. The presentation of 3 cases of chronic pyelonephritis as the nephrotic syndrome and of 1 as renal osteodystrophy is interesting. Four cases of renal amyloidosis presented as the nephrotic syndrome.