Treatment Of Chronic Pyelonephritis Research Articles

POS-436 CLINICAL EFFECTIVENESS OF VARIOUS ANTI-RELAPSE THERAPY REGIMENS IN CHILDREN WITH PYELONEPHRITIS

Relevance: Currently, pyelonephritis (PN) remains one of the most common bacterial infections in children. Treatment of chronic PN (CP) should be based on the principles of staging, continuity and succession.

Relationships between changes in uric acid parameters metabolism and parameters of immunity and microbiota in patients with neuroendocrine-immune complex dysfunction

Background. Previously by screening correlation links between uricemia and uricosuria, on the one hand, and immunity and microbiota parameters, on the other, registered in patients with chronic pyelonephritis and cholecystitis in remission twice (before and after ten days of balneotherapy), we found that raw uricemia determines by 28% nine parameters of immunity as well as bacteriuria and content in E. coli feces. Uricemia, normalized by sex and age, determines by 25% another constellation of immunity parameters as well as content in E. coli feces with impaired enzymatic activity and Klebsiela&Proteus. Instead, uricosuria determines only four parameters of immunity and only by 11,5%. The purpose of this study is to analyze the correlation between individual changes in the two parameter sets caused by balneotherapy. Material and Methods. The object of observation were 34 men and 10 women aged 24-70 years old, who came to the Truskavets’ spa for the rehabilitation treatment of chronic pyelonephritis combined with cholecystitis in remission. The serum and daily urine levels of the uric acid by uricase method were determined. Immune status evaluated on a set of I and II levels recommended by the WHO. The condition of microbiota is evaluated on the results of sowing of feces and urine. Results. It is found that individual changes in uricemia correlate inversely with changes in the level of T-helpers in blood as well as IgA and IgS in saliva while positively with changes in the level of Monocytes with the almost same force as their static levels. Instead, inverse links with changes in inflammatory markers and positive connections with changes in CIC and T-killers that are absent with respect to static parameters are revealed. However, no association was found between changes in uricemia and the intensity of Staph. aureus phagocytosis by blood neutrophils. Changes in uricosuria correlate with changes in only three immune parameters, and even at the limit of significance. Taking into account other relationships, we find that balneotherapy-induced changes in uricemia and uricosuria determine changes in immune status by 60%. Conclusion. Endogenous uric acid has a modulating effects on a number of immune parameters in patients with neuroendocrine-immune complex dysfunction on background of chronic inflammatory diseases.

Optimazation of antibiotic therapy in patients with chronic pyelonephritis combined with pancreatic diabetes of the 2 type by evaluation of the expression of plasmid resistance genes

The resistance caused by the transfer of resistance genes among the uropathogenes with a help of plasmids in the treatment of chronic pyelonephritis (CP) combined with pancreatic diabetes (PD) of the 2 type increased last years. The aim of research was an optimization of methods of differentiated prescription of antibiotic therapy (ABT) for patients with CP and contaminant PD of the 2 type depending on expression of plasmid-induced genic mechanisms of antibiotic resistance. Methods. There were examined 105 patients with chronic pyelonephritis, 73 of them – against the background of PD of the 2 type. The sensitivity of isolated cultures to antibiotics was carried out by the disco-diffuse method of Bauer-Kirbi on the medium of Hinton-Muller using commercial discs. The study of plasmid-induced mechanisms of resistance was carried out by the method of polymerase chain reaction (PCR). Results. Detectability of plasmid-induced mechanisms in patients with CP and PD of the 2 type is 31,5 %. Β-lactamase of extended spectrum (βLES) – were the most diffuse detected genes. The highest inhibitory activity against the strains with plasmid genes was shown by meropenem, fosfomicyn, nitroxolinum, 4 th generation of cephalosporins and the 3th generation of fluoroquinolones. According to received results it was elaborated an algorithm of differentiated prescription of ABT for patients with CP and PD of the 2 type depending on expression of plasmid-induced resistance genes. Conclusions. There was studied the prevalence of plasmid-induced resistance mechanisms and elaborated the methods for increase an efficiency of empirical ABT for patients with CP and contaminant PD of the 2 type.

Renal disorders : progress in diagnosis and treatment. 4. Tubular and interstitial disorders. 2. Pathological picture and treatment of chronic pyelonephritis.

Renal disorders : progress in diagnosis and treatment. 4. Tubular and interstitial disorders. 2. Pathological picture and treatment of chronic pyelonephritis.

Effect of ultrasound on the functional state of the kidneys in the treatment of chronic dysmetabolic pyelonephritis in children

We studied the effect of ultrasound on the functional state of the kidneys, dysmetabolic disorders, membranolysis processes in the treatment of chronic pyelonephritis in children. We examined 27 children aged from 5 to 14 years old with chronic secondary dysmetabolic pyelonephritis caused by hyperoxaluria in combination with hypercalciuria in the active phase of the process. The functional state of the kidneys was determined by glomerular filtration, calcium and phosphorus excretion, ammonia and titratable acidity. The nature and degree of dysmetabolic disorders were assessed by urinary excretion of oxalate, calcium, uric acid. Membranolysis processes were judged by urinary excretion of ethanolamine and diene conjugates.

About pathogenetic therapy of chronic pyelonephritis after cystectomy

Treatment of chronic pyelonephritis after cystectomy is a complex and unresolved problem. Its difficulty lies in the fact that, firstly, regardless of the methods of urine removal, all patients after cystectomy develop urodynamic disorders of the upper urinary tract, which, being the main pathogenetic factor of secondary chronic pyelonephritis, contribute to its occurrence and further progression. Secondly, the majority of patients undergoing bladder removal surgery for malignant neoplasms have secondary chronic pyelonephritis. Thirdly, etiotropic treatment of chronic pyelonephritis without restoring the impaired urodynamics of the urinary tract is ineffective and does not prevent the progression of the pathological process. This explains the high mortality from chronic renal failure in patients who successfully underwent cystectomy.

The treatment of chronic pyelonephritis with carindacillin

Forty-two patients with a radiologically confirmed diagnosis of chronic pyelonephritis were treated with 1 g carindacillin every 6 hours over a period of 6 weeks. An underlying urological disease was present in 84% of the 38 patients for whom sufficient data were available for evaluation. The results of carindacillin treatment, as judged by bacteriological evaluation 1 month post-treatment, were good in 12 (32%) and moderate in 9 of the patients. This success rate was remarkable in that all of the patients had been treated previously with one or more other antibiotics and chemotherapeutic agents with little or no response. The authors recommend that, because carindacillin has proved so valuable in treating chronic as well as acute urinary tract infections, its use should be limited to patients with serious disease who have not responded to other treatment.

Treatment of chronic pyelonephritis with urovalidin.

Results of the treatment with Urovalidin in 55 patients suffering from chronic pyelonephritis are reported. In 34 of the patients the renal function was compensated, in 10 there was initial renal failure and in 11 the renal failure was moderately severe. Urovalidin was administered at a dosage of 4 tablets per day in courses of 12–16 days. Generally, it was well tolerated by the patients. The results of the reatment were recorded on the second or third day (early results), and after 2–3 weeks (late results). Urovalidin seems to be a good therapeutic agent for the suppression of exacerbations in chronic pyelonephritis, against the possible super-or reinfection. The late results are, however, less satisfactory. Owing to its good tolerance, Urovalidin is a suitable preparation for alternating or long-term treatment

Long‐term Treatment of Chronic Pyelonephritis

Long‐term Treatment of Chronic Pyelonephritis

Epidemiology of urinary-tract infections. A pilot study of 3057 school children.

THE treatment of chronic pyelonephritis is one of the most distressing problems in clinical medicine. Antimicrobial therapy has, in the main, been disappointing, particularly when patients have established abnormalities of the urinary tract or irreversible renal damage.1 , 2 The early detection, characterization and treatment of pyelonephritis is therefore of great importance if chronic disease is to be prevented.In recent years quantitation of bacteria in the urine has been shown to be the most useful means of detecting urinary-tract infections.3 4 5 6 7 This technic, combined with procurement of a fresh, clean-voided specimen of urine, has been widely employed to determine the prevalence of . . .

Intensive Treatment of Chronic Pyelonephritis

Intensive Treatment of Chronic Pyelonephritis

On the treatment of chronic pyelonephritis with so-called long-term therapy

On the treatment of chronic pyelonephritis with so-called long-term therapy