Pyelonephritis: Its Relation to Vascular Lesions and to Arterial Hypertension

Weiss, Soma; Parker, Frederick B.

doi:10.1097/00005792-193909000-00001

Cited by 313 publications

(47 citation statements)

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“…In both cases, the inflammation is interstitial and extends in a wedge shaped fashion from its base in the cortex down to the medulla (5). In rats, as in man, it was also found that urinary findings may be normal despite extensive infection in the interstitial tissue of the kidney (6). The acute pyelonephritis in rats within the group examined on a given day; no rat was subjected to cystotomy more than once for the first 6 weeks.…”

Section: Resultsmentioning

confidence: 93%

“…The syndrome of fever, chills, sweats, and bacteriuria occurring in the absence of flank pain, costovertebral angle tenderness, and pyuria is not uncommonly produced by E. coli. The course of this disease is generally self-limited to a few days or weeks, but may recur for many years and lead to chronic pyelonephritis (6). In this connection, it is of interest that in the experimental infection, there was not only a lack of immunity against subsequent attacks of E. coli pyelonephritis, but also evidence which suggested that the pyelonephritic changes may first appear as the infection vanishes (Table III).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Hematogenous Pyelonephritis in Rats. I. Its Pathogenesis When Produced by a Simple New Method 12

Braude¹,

Shapiro²,

Siemienski³

1955

J. Clin. Invest.

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The study of experimental pyelonephritis has been generally restricted to that form of the disease which develops after ligation of the ureter (1-3). When pyelonephritis is complicated by ureteral ligation, however, a clear distinction cannot be made between the effects of urinary obstruction and those of infection. We have attempted, therefore, to establish experimental pyelonephritis in the absence of hydronephrosis and have succeeded by subjecting rats to a simple new technique requiring only two steps: 1) Injection of bacteria into the blood and 2) Massage of the kidneys through the intact abdominal wall. This method has provided an experimental model which appears to reproduce closely that form of human pyelonephritis occurring in patients with no manifest hydronephrosis. In addition, it dispenses with the cumbersome surgical procedures previously required for the production of experimental pyelonephritis.This report describes the pathogenesis of pyelonephritis in rats when renal massage is combined with the inoculation of strains of Escherichia coli isolated from human infections. METHODSI. The effect of renal massage on the incidence of pyelonephritis in rats inoculated uith E. coli Sprague-Dawley rats weighing 150 to 200 gm. were divided into two groups of 15 each, and inoculated intracardially with 0.5 ml. of an 18-hour tryptose broth culture of E. coli, or approximately 10' living bacterial cells as determined by plate counts. This strain of E. coli had been isolated from the blood of a patient a few days before the experiment and had been subcultured only twice. Immediately after the bacterial inoculation, one group of 15 rats were subjected to bilateral renal massage. The kidneys of each rat were grasped by thumb 1 Aided by research grant from Public Health Service, H-1955. 2 Presented in part at the 27th Annual Meeting of The Central Society for Clinical Research, October 30, 1954. and forefinger through the intact abdominal wall (Figure 1) and gently but firmly massaged during ether anesthesia for exactly 5 minutes. In order to maintain a uniform degree of pressure on the massaged kidneys, each period of 5 minutes was divided between two of us instead of confining the total period of massage for each animal to one of several persons. The 15 rats in the second group were anesthetized under ether for 5 minutes but their kidneys were not massaged. The kidneys of a third group were massaged for 5 minutes under ether anesthesia but the rats were not inoculated with bacteria. This third group also served as controls for the experiments in section 3b and are described there.Within 48 hours, 4 rats in each group had died after the inoculation of E. coli. The survivors recovered fully and appeared in excellent condition. At the end of two weeks, the rats were sacrificed by exposure to ether and exsanguination. Approximately 1.0 ml. of blood was divided between trypticase soy broth and blood agar for culture and 0.5 ml. was used for determining urea nitrogen. The kidneys were examined grossly and then each...

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

Hematogenous Pyelonephritis in Rats. I. Its Pathogenesis When Produced by a Simple New Method 12

Braude¹,

Shapiro²,

Siemienski³

1955

J. Clin. Invest.

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show abstract

“…It has long been recognized that chronic pyelonephritis may lead to serious renal damage in patients with only minimal signs and symptoms of infection (20,21), and it has appeared enigmatic that the clinical course of this disease could be so benign despite persistent renal infection and tissue damage by virulent pyrogenic bacteria. The present data suggest that this relatively benign clinical course may partially result from tolerance to the effects of endotoxin in addition to the development of specific antibodies to the infecting organism (22,23).…”

Section: Discussionmentioning

confidence: 99%

Endotoxin Tolerance. Ii. Its Occurrence in Patients With Pyelonephritis*

McCabe¹

1963

J. Clin. Invest.

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“…The late onset of renal failure in these patients can be partly attributed to the failure can be found in even more patients (67%) [27]. These changes in bladder function were not limited to metabolic demands of puberty [33]. However, renal deterioration can occur before the period of maximal body those with incontinence; 50-75% of patients with treated PUV who were asymptomatic had abnormal urodynamic growth.…”

Section: Late Complicationsmentioning

confidence: 99%