Functional Abnormalities in Experimental Pyelonephritis

Gonick, Harvey C.; Goldberg, Gussie; Rubini, Milton E.; Guze, Lucien B.

doi:10.1159/000179403

Cited by 22 publications

(11 citation statements)

References 14 publications

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“…In the control animals this fraction rose from cortex to papilla; the increment was somewhat greater in the unmicropunctured kidneys than in the micropunctured kidneys. In the pyelonephritic kidneys, the fractional contribution of urea to cortical tissue solute concentration was greater than in the control kidneys (a reflection of the increased plasma urea in the pyelonephritic animals); however, this fraction remained nearly constant from cortex to papilla and was significantly less in the inner medulla and papilla than in either group of control kidneys (P < 0.001), a finding consistent with previous observations by Gonick et al (17). DISCUSSION The generation and maintenance of a concentration gradient from cortex to papilla is essential for the ability of the normal kidney to raise the osmotic pressure of urine above that of plasma.…”

supporting

confidence: 90%

A study of the intrarenal recycling of urea in the rat with chronic experimental pyelonephritis.

Gilbert¹,

Weber²,

Turchin³

et al. 1976

J. Clin. Invest.

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A B S T R A C T The concentrating ability of the kidney was studied by clearance and micropuncture techniques and tissue slice analyses in normal rats with two intact kidneys (intact controls), normal rats with a solitary kidney (uninephrectomized controls), and uremic rats with a single pyelonephritic kidney. Urinary osmolality after water deprivation for 24 h and administration of antidiuretic hormone was 2,501+217 and 2,874±392 mosmollkg H20 in intact and uninephrectomized control rats, respectively, and 929±130 mosmol'kg H20 in pyelonephritic rats (P < 0.001 compared to each control group). Fractional water reabsorption and concentrating ability were significantly decreased in the pyelonephritic group, and, to achieve an equivalent fractional excretion of urea, a greater fractional excretion of water was required in the pyelonephritic rats than in the control rats.Whole animal glomerular filtration rate was 1.57 +0.19 ml/min and 1.39±0.18 ml/min in intact and in uninephrectomized controls, respectively, and 0.30 +0.07 ml/min in pyelonephritic rats (P < 0.001 compared to each control group). Single nephron glomerular filtration rate was 35.6±3.8 nl/min in intact control rats and was significantly increased (P < 0.05) in both uninephrectomized (88.0±10.8 nl/min) and pyelonephritic rats (71.5± 14.4 nl/min).

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supporting

confidence: 90%

A study of the intrarenal recycling of urea in the rat with chronic experimental pyelonephritis.

Gilbert¹,

Weber²,

Turchin³

et al. 1976

J. Clin. Invest.

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“…Two studies (3,4) have clearly demonstrated a urinary concentrating defect early in experimental pyelonephritis produced by intravenous inoculation of gram positive cocci (staphylococci and enterococci), but there is little information available on concentrating ability in early experimental pyelonephritis caused by gram negative bacilli. Furthermore, there are no studies on the rapidity of onset of the defect or reversibility with antimicrobial therapy and there is little information available on the correlations between the concentrating defect and the number of organisms in the kidney, the glomerular filtration rate, and the histological changes in the kidney.…”

Section: Introductionmentioning

confidence: 99%

Urinary concentrating ability in early experimental pyelonephritis

Kaye¹,

Rocha²

1970

J. Clin. Invest.

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A B S T R A C T The effect of early bilateral pyelonephritis on urinary concentrating ability was studied in rats injected intravenously with enterococci or Staphylococcus aureus and in rats inoculated with Escherichia coli into the medullae of both kidneys. The mean maximum urinary osmolality of normal rats was 2352 mOsm/kg of water. Inoculation of E. coli caused reversible pyelonephritis with sterilization of the kidneys within 12 wk. By 1 day after injection the mean maximum urinary osmolality had decreased to about 1100 mOsm, remained at this level for 3 wk, and then rose to normal by 12 wk. After injection of enterococci and staphylococci, the mean maximum urine osmolality decreased over 3-4 days to about 1000 and 800 mOsm respectively. In the enterococcal infection (which is chronic) the maximum urine osmolality remained about 1200 mOsm for at least 12 wk whereas in the staphylococcal infection (which is reversible) the osmolality gradually rose.Antimicrobial therapy of E. coli renal infection with colistimethate sodium and S. aureus infection with ampicillin rapidly reduced bacterial titers in the kidneys with an associated rise in maximum urinary osmolality. Therapy of enterococcal renal infection with ampicillin produced less impressive decreases in bacterial titers in the kidneys and little or no improvement in urinary concentrating ability. With antimicrobial therapy or with the self-limited infections, the rate of increase in concentrating ability was directly correlated with the rate of decrease of bacterial titers. However, there was poor correlation between histological findings in the kidneys and urinary concentrating ability.These studies demonstrate that early experimental pyelonephritis is associated with a concentrating defect This work was reported in part in abstract form; Kaye, D., and H. Rocha. 1969. Urine osmolality in experimental pyelonephritis. J. Clin. Invest. 48: 43a.

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“…The TmPAH data in the pres- Comments two previous undocumented urinary tract infections treated with urethral dilatations and short-term chemotherapy urethral dilatation at 37 months of age ent study are in agreement with the pathologic data obtained in rats subjected to experimental pyelonephritis. In these animals, hyperplasia was observed during the first week of the disease [13].…”

Section: Discussionmentioning

confidence: 95%

“…In contrast, recovery was less impressive in the children studied. PAH clearances were found to be reduced by 22 % in infected rats inoculated repetitively with enterococci every three weeks for 21 weeks, even though the creatinine clearance was unchanged throughout the course of infection [13]. On the basis of their experimental results, these investigators related the functional alterations to a progression of ischemic reaction in the cortex and the medulla.…”

Section: Discussionmentioning

confidence: 99%

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Alterations in Renal Cortical Blood Flow in Infants and Children with Urinary Tract Infections

et al. 1968

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ExtractThe present studies were designed to elucidate renal functional changes in infants and children with urinary tract infections. Twenty-three infants and children ranging in age from 4 months to 13 6 / 12 years with urinary tract infections were studied. Four children ranging in age from 2 to 6 10 / 12 years without documented urinary tract infections served as controls. Inulin clearances (Gi) were utilized for measurement of glomerular filtration rate. Renal plasma flow and tubular maximum excretory capacity were ascertained by the intravenous administration of para-aminohippurate (PAH). Second determinations performed in eight patients and a third determination in one patient provided longitudinal follow-up. Renal plasma flow measurements were low in 4 of 6 infants and in 6 of 17 children on initial testing; these decreased values were associated with normal glomerular filtration rates except in 3 subjects. In the 4 patients without documented urinary tract infections, G PAH values were within the normal range. G PAH values obtained initially in all subjects were compared on a surface area basis to those characteristic of normal children. Of the 27 experimental points, 21 were below the line representing the normal average C PAH for children. In this small series, only one of three infants failed to recover this function at the time of repeat testing. The recovery rate was less in the children studied. The data indicate that a decrease in renal plasma flow occurs prior to significant alterations in the other renal functional parameters measured.Twenty-two subjects were tested for both G PAH and Tm P AH-The ratio (G PAH /Tm PAH ) was lower in all three groups than the reported normal value of 7.7. In those patients demonstrating an initially reduced value, 13 of 16 showed normal G PAH values. These findings could represent renal ischemia of proximal tubular tissue.The persistence of renal vascular changes in the face of absent clinical and/or laboratory evidence of urinary tract infections emphasizes the need for caution in identifying the prognosis of children with pyelonephritis and the need for careful long-term evaluation. SpeculationAlthough it has been well documented that the renal medulla is the primary site of involvement in pyelonephritis, the current data suggest that the post-glomerular capillaries and tubular structures in the renal cortex are also early sites of involvement in infants and children. A question raised by the study is the relation of reduced renal plasma flow measurements to the natural history and pathogenesis of recurrent pyelonephritis. It is suggested that agents promoting a change toward normal renal circulation may reverse the pathologic process.

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Functional Abnormalities in Experimental Pyelonephritis

Cited by 22 publications

References 14 publications

A study of the intrarenal recycling of urea in the rat with chronic experimental pyelonephritis.

A study of the intrarenal recycling of urea in the rat with chronic experimental pyelonephritis.

Urinary concentrating ability in early experimental pyelonephritis

Alterations in Renal Cortical Blood Flow in Infants and Children with Urinary Tract Infections

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