The patient with acute renal problems
Peate Ian, Dutton Helen in 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.
Urolithiasis
Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed in MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
Q21–27. Treatment options for urinary tract stonesObservationMedical expulsive therapy (according to EAU guidelines)Extracorporeal shockwave lithotripsyPrimary ureteroscopic stone removalPercutaneous nephrolithotomyUreteric stentUrinary alkalinisationPercutaneous nephrostomyOpen stone removalLaparoscopic stone removalNephrectomy
The Urinary System and Its Disorders
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
Since the urinary system eliminates such a variety of wastes, alterations in urinary function can quickly alter the composition of the blood. Along with the lungs, the kidneys perform a significant function in maintaining acid-base balance in the body, primarily by tubular reabsorption of filtered bicarbonate and excretion of hydrogen ions released by nonvolatile acids. Thus, the urinary system is involved in metabolic acidosis of several types. Renal tubularacidosis is hypokalemic (abnormally low serum potassium) in nature, while hypoaldosteronism can lead to metabolic acidosis, which is hyperkalemic. Starvation can lead to ketoacidosis, and kidney failure leads to lactic acidosis.
Modified Zhibai Dihuang pill alleviated urinary tract infection induced by extended-spectrum β-lactamase Escherichia coli in rats by regulating biofilm formation
Published in Pharmaceutical Biology, 2023
Kaifa Chen, Yongsheng Zhu, Hongwei Su, Hao Jiang, Xin Liu
Urinary tract infections (UTIs) are infectious diseases caused by the abnormal reproduction of various pathogenic microorganisms in the urinary tract (Gupta et al. 2017). Complicated UTIs often lead to prolonged infection and eventually cause renal function damage and serious health hazards (Tandogdu and Wagenlehner 2016; Millner and Becknell 2019). Uropathogenic Escherichia coli (UPEC) is a typical bacterial UTI pathogen (Herrmann et al. 2002). Various virulence factors in the pathological group of UPEC provide more opportunities for bacterial survival (Behzadi et al. 2020). Currently, the main intervention measures for the clinical treatment of UTI are antibacterial drugs (Flores-Mireles et al. 2019). Approximately 60% of antibiotics are β-lactams, which have various chemical structures and are often used to treat different types of bacterial infectious diseases (Behzadi et al. 2020). The application of antimicrobials has led to β-lactamase production, resulting in drug-resistant bacterial strains (Issakhanian and Behzadi 2019). In a clinical study, 86% of ESBL-producing strains were isolated from UPEC, and there was neither a pattern of resistance nor ESBL production in UTI (Khonsari et al. 2021). The presence of extended-spectrum β-lactamase (ESBLs) E. coli makes the most common antimicrobial agent less effective in treating UTIs (Zowawi et al. 2015). Therefore, there is an urgent clinical need for alternative treatment options that target UTI pathogenesis.
High-intensity focused ultrasound therapy for pediatric and adolescent vulvar lichen sclerosus
Published in International Journal of Hyperthermia, 2022
Vulvar lichen sclerosus (VLS) is a chronic inflammatory disease, and its etiology is unclear and complex. It has a bimodal starting age, in prepubertal and postmenopausal age groups. There is a clear peak of incidence in girls aged four to six years old, which represents 7–15% of all VLS cases [1]. The main clinical manifestations are vulvar pruritus, irritation and pain, bleeding due to skin fissures and constipation [2,3]. Urinary tract symptoms, including dysuria, holding urine for fear of voiding and overflow incontinence may also be presenting features [4]. VLS has also been associated with a reduced quality of life among premenarchal girls. Since the symptoms of VLS can mimic other conditions, it is often initially misdiagnosed [5], and its diagnosis in girls is often delayed by an average of 1–2 years from the onset of symptoms to a final diagnosis. However, early diagnosis and treatment are crucial in improving symptoms and reducing the long-term sequelae of scarring.
The clinical implications and importance of anemia in older women
Published in Acta Clinica Belgica, 2022
Osman Kara, Lee Smith, Semen Gokce Tan, Pinar Soysal
Patients’ age, gender, education level, and comorbidities were recorded. In addition, comorbidity status of the patients was evaluated using the Charlson Comorbidity Index (CCI). All the participants underwent the CGA including Mini-Mental State Examination (MMSE), Geriatric Depression Scale-15 for neurocognitive evaluation, Basic and Instrumental Activities of Daily Living (BADL and IADL) for functional evaluation, Tinetti Performance-Oriented Assessment of Mobility (POMA) and Timed Up and Go Test (TUG) for mobility evaluation. Mini Nutritional Assessment (MNA) was performed in all patients to detect nutritional status. If the total MNA score was > 23.5 and ≤23.5, the patient was categorised as ‘well nourished’ and ‘poor nutritional status’, respectively. While the number of drugs used by the patients was recorded, the drugs and their subgroups were not recorded in detail. Using five or more drugs was considered as polypharmacy. Urinary incontinence was defined as involuntary urinary leakage in the last 3 months except for urinary tract infection. Repeated falls were considered positive if the patient had fallen at least twice in the previous year except for slipping on a carpet or on wet ground [9]. Depression was diagnosed using the geriatric depression scale-15 (GDS-15). A score of ≥5 on the GDS-15 was considered as depression [14]. MMSE scores < 24 was considered as cognitive impairment [15].
Related Knowledge Centers
- Bladder
- Metabolite
- Nephron
- Renal Artery
- Ureter
- Renal Vein
- Urethra
- Kidney
- Electrolyte
- Acid–Base Homeostasis