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Urinary Tract Infection (UTI)
Published in Charles Theisler, Adjuvant Medical Care, 2023
UTIs are one of the most common infections in seniors especially those who have a catheter or reside in a hospital or care facility. Asymptomatic bacteriuria and pyuria are also common in older adults. Serious UTI complications include kidney infections and sepsis. Antibiotics are the primary treatment for UTIs. However, overutilization of antibiotics can lead to negative consequences, including development of multidrug resistant organisms and unwanted side effects (e.g., Clostridium difficile infection).
A busy haematuria clinic
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Unless about 2 weeks of antibiotics are given, the infection can recur a few days after giving too short a course of even an appropriate antibiotic. This long course of antibiotics, as opposed to the normal 3-day course for a straightforward UTI, is needed because microabscesses form in pyelonephritic kidneys. Until these have healed, they will contain living bacteria because the antibiotic cannot penetrate the abscess. Kidney infections are very prone to cause systemic symptoms, which are often severe. A simple explanation for this is the ‘bursting’ of microabscesses in a confined space so that toxins or even pus can gain access to the bloodstream.
The patient with acute renal problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
One of the most common kidney infections is pyelonephritis. In many cases, this is caused by the spread of bacteria such as Escherichia coli from the gut and, as with most urinary tract infection, it is more commonly seen in females, due to the short urethra and the close proximity of the rectal and urethral openings. With pyelonephritis, the infection ascends into the bladder and then progresses to the ureters and eventually the kidneys, affecting the renal tubules and blood vessels. The symptoms are similar to those of all urinary tract infections, in that they may include increased urgency and frequency of urination, pyrexia, back pain, increased leucocytes in the blood, dysuria and cloudy urine, with bacteria present. If the infection becomes a chronic problem, scar tissue can form on the kidneys and lead to impaired function (McCance and Huether 2018). Once infection is established, treatment is required in order to prevent long-term renal damage. This includes increased fluid intake to ‘flush’ the system (instigated for most patients, unless there are specific reasons not to do so, such as fluid overload), antibiotic therapy and the prescription of antispasmodic drugs.
Trajectory of AKI and hospital mortality among patients with COVID-19
Published in Renal Failure, 2023
Seong Geun Kim, Chung Hee Han, Sung Bong Yu, Hyeseung Lee, Soie Kwon, Yerim Kim, Jeonghwan Lee, Dong Ki Kim, Yun Kyu Oh, Chun Soo Lim, Yon Su Kim, Byung Gun Kim, Jung Pyo Lee
The pathogenesis behind the impact of COVID-19 on kidney injury is understood to be multifaceted. One possible mechanism of kidney involvement could be similar to that observed during severe acute respiratory syndrome coronavirus (SARS-CoV) infection in the past, including cytokine release syndrome, inter-organ communication, and systemic effects [5–7]. The development of AKI is believed to be the result of both local and systemic inflammatory and immune responses, along with endothelial damage and activation of coagulation pathways and the renin-angiotensin system [8,9]. Although direct kidney infection by SARS-CoV-2 is still a matter of debate, a study largely based on autopsies revealed increased tubulointerstitial fibrosis in COVID-19 patients and suggested a direct kidney infection [10].
Similar efficacy, safety, and immunogenicity of the biosimilar BI 695501 and adalimumab reference product in patients with moderate-to-severe chronic plaque psoriasis: results from the randomized Phase III VOLTAIRE-PSO study
Published in Expert Opinion on Biological Therapy, 2021
Alan Menter, Petr Arenberger, Sigrid Balser, Stefan Beissert, Ashley Cauthen, Niklas Czeloth, Jennifer Soung, Sasha Jazayeri, Peter Weisenseel, Girish Jayadeva
Overall, three patients (0.9%; all in the adalimumab RP group) experienced at least one AESI during the trial (Table 2). Serious infection AESIs occurred in two patients (0.6%): one was a furuncle and the other was a kidney infection. The AESI in the third patient was toxic hepatitis. There were no reports of AESIs that met the criteria for hypersensitivity reaction, drug-induced liver injury, or anaphylactic reaction AESIs. The proportions of patients with serious infections, hypersensitivity reactions, and injection site reactions were at least as low in the BI 695501 group as in the adalimumab RP group (Table 2). The reported serious infections (each affecting one patient) were: abdominal abscess, oral herpes, and upper respiratory tract infection in the BI 695501 group, and furuncle, kidney infection, orchitis, and urinary tract infection in the adalimumab RP group. Hypersensitivity reactions comprised urticaria (one patient in the BI 695501 group), and allergic rhinitis, rash, and injection-related reaction (each affecting one patient in the adalimumab RP group).
Preoperative proteinuria may be a risk factor for postoperative acute kidney injury：a meta-analysis
Published in Renal Failure, 2021
Dan-Dan Huang, Yuan-Yuan Li, Zhe Fan, Yong-Gui Wu
Proteinuria is a common clinical manifestation of chronic kidney disease, as well as its relationship with AKI has also been confirmed by more and more studies. The pathophysiological explanation of the association between proteinuria independent of baseline glomerular filtration rate (GFR) and risk factors of primary diseases, especially the existence of AKI by hypertension or diabetes mellitus (DM). The first possibility is that proteinuria is thought to be caused by acute kidney infection or immune inflammation. Secondly, the possibility is that proteinuria can lead to hypoalbuminemia, and then the decrease of inflation pressure caused by hypoalbuminemia lead to the contraction of intravascular volume and susceptibility to AKI. In our meta-analysis, the comprehensive results demonstrate that preoperative proteinuria is an independent risk factor for postoperative AKI.