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The Journal of Pediatrics Jan 2023Acute kidney injury occurs frequently during pediatric diabetic ketoacidosis (DKA). We reviewed urinalyses from 561 children with DKA; pyuria was detected in 19% overall... (Review)
Review
Acute kidney injury occurs frequently during pediatric diabetic ketoacidosis (DKA). We reviewed urinalyses from 561 children with DKA; pyuria was detected in 19% overall and in 40% of children with more comprehensive urine testing (≥3 urinalyses) during DKA.
Topics: Child; Humans; Diabetic Ketoacidosis; Pyuria; Diabetes Mellitus, Type 1; Acute Kidney Injury
PubMed: 36084731
DOI: 10.1016/j.jpeds.2022.08.054 -
Annals of Laboratory Medicine May 2020Pyuria seems to be common in chronic kidney disease (CKD), irrespective of urinary tract infection (UTI). It has been hypothesized that sterile pyuria occurs in CKD...
BACKGROUND
Pyuria seems to be common in chronic kidney disease (CKD), irrespective of urinary tract infection (UTI). It has been hypothesized that sterile pyuria occurs in CKD because of chronic renal parenchymal inflammation. However, there are limited data on whether CKD increases the rate of pyuria or how pyuria in CKD should be interpreted. We investigated the prevalence and characteristics of asymptomatic pyuria (ASP) in CKD via urinary white blood cell (WBC) analysis.
METHODS
Urine examination was performed for all stable hemodialysis (HD) and non-dialysis CKD patients of the outpatient clinic (total N=298). Patients with infection symptoms or recent history of antibiotic use were excluded. Urine culture and WBC analysis were performed when urinalysis revealed pyuria.
RESULTS
The prevalence of ASP was 30.5% (24.1% in non-dialysis CKD and 51.4% in HD patients). Over 70% of the pyuria cases were sterile. The majority of urinary WBCs were neutrophils, even in sterile pyuria. However, the percentage of neutrophils was significantly lower in sterile pyuria. In multivariate logistic regression analysis, the degree of pyuria, percentage of neutrophils, and presence of urinary nitrites remained independently associated with sterile pyuria.
CONCLUSIONS
The prevalence of ASP was higher in CKD patients and increased according to CKD stage. Most ASP in CKD was sterile. Ascertaining the number and distribution of urinary WBCs may be helpful for interpreting ASP in CKD.
Topics: Aged; Area Under Curve; Asymptomatic Diseases; C-Reactive Protein; Creatinine; Cross-Sectional Studies; Female; Glomerular Filtration Rate; Humans; Logistic Models; Male; Middle Aged; Neutrophils; Prevalence; Pyuria; ROC Curve; Renal Dialysis; Renal Insufficiency, Chronic
PubMed: 31858764
DOI: 10.3343/alm.2020.40.3.238 -
Journal of the Turkish German... 2015The purpose of this study is to evaluate the clinical presentation, laboratory findings, and response to treatment in girls with labial adhesion younger than 23 months.
OBJECTIVE
The purpose of this study is to evaluate the clinical presentation, laboratory findings, and response to treatment in girls with labial adhesion younger than 23 months.
MATERIAL AND METHODS
A retrospective chart review of all girls younger than 23 months with the diagnosis of labial adhesion was referred to Dr Sheikh children's clinic in Mashhad in northeast Iran between 1998 and 2013.
RESULTS
Sixty-three patients were diagnosed with labial adhesion during the review period. Most patients were diagnosed by physicians during the physical examination or during the evaluation for their voiding problems. The most prevalent symptom among patients was dysuria and restlessness while voiding. Twenty-one (33.3%) patients had a history of urinary tract infection. 17 (26.9%) patients had sterile pyuria and 69.8% showed presence of bacteria in their urine samples.
CONCLUSION
Physicians may frequently encounter pre-pubertal girls whose urinalysis may show sterile pyuria or presence of bacteria with colony counts <105 in the absence of urinary tract infection symptoms. In these cases, labial adhesion should always be suspected and genital examination should be performed.
PubMed: 26097386
DOI: 10.5152/jtgga.2015.15222 -
Postgraduate Medical Journal Nov 1935
PubMed: 21312982
DOI: 10.1136/pgmj.11.121.395 -
Archives of Disease in Childhood Jun 1967
Comparative Study
Topics: Adolescent; Bacteriological Techniques; Bacteriuria; Centrifugation; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Leukocyte Count; Male; Pyuria; Specimen Handling; Urinary Catheterization; Urinary Tract Infections
PubMed: 5337814
DOI: 10.1136/adc.42.223.275 -
Canadian Medical Association Journal Jan 1965Four patients who had ingested large amounts of phenacetin-salicylate medications were studied during a 12-month period. Renal failure had progressed slowly over a...
Four patients who had ingested large amounts of phenacetin-salicylate medications were studied during a 12-month period. Renal failure had progressed slowly over a number of years. All patients took the drug because of psychogenic headache. Considerable skill was required to elicit the history of drug habituation. The major features of the nephropathy were multiple episodes of metabolic acidosis, minimal proteinuria, pyuria but no bacteriuria, and polyuria and polydipsia early in the course of drug ingestion. Papillary necrosis was not a prominent clinical feature of this series. Discontinuation of drug ingestion by one patient was associated with recovery of a considerable degree of renal function. Preliminary experimental evidence obtained in the dog suggests that salicylate impaired the efficiency of the counter-current multiplier by decreasing sodium transport in the ascending limb of Henle, and decreased the permeability to water of the distal convoluted and collecting tubule; phenacetin had no such effect.
Topics: Acidosis; Animals; Aspirin; Bacteriuria; Biological Transport; Caffeine; Codeine; Dogs; Drug Therapy; Headache; Humans; Kidney Diseases; Kidney Papillary Necrosis; Kidney Tubules; Metabolism; Neoplasm Recurrence, Local; Neoplasms; Phenacetin; Polyuria; Proteinuria; Pyuria; Salicylates; Sodium; Toxicology
PubMed: 14228236
DOI: No ID Found -
NDT Plus Feb 2010Turbid white urine 'albinuria' is defined as a urine discoloration described as milky or cloudy. One of the most frequent causes of turbid white urine is chyluria...
Turbid white urine 'albinuria' is defined as a urine discoloration described as milky or cloudy. One of the most frequent causes of turbid white urine is chyluria complicating filariasis (Table 1). The extant causes of albinuria are non parasitic and rare. Amongst their aetiologies stand excessive mineral sediment excretion such as calciuria and phosphaturia, massive pyuria and fungal infections, and rarely congenital malformations of the lymphatic vessels. Malingering is also possible, in patients adding milk to their urine. We observed a case of albinuria in which the diagnostic work up led to diagnosing an exceptional cause of chyluria in a patient living in a region of Colombia where filariasis is not endemic.
PubMed: 25949403
DOI: 10.1093/ndtplus/sfp135 -
BMC Pregnancy and Childbirth Apr 2020Asymptomatic bacteriuria (ASB) and sterile pyuria (SP) are complexities of UTI whose prevalence are not known in the northern sector of Ghana. Our aim was to determine...
BACKGROUND
Asymptomatic bacteriuria (ASB) and sterile pyuria (SP) are complexities of UTI whose prevalence are not known in the northern sector of Ghana. Our aim was to determine the occurrence of sterile pyuria and asymptomatic bacteriuria among pregnant women accessing antenatal care at a secondary and tertiary care hospitals in Tamale, northern Ghana.
METHODS
A cross sectional study was conducted by screening 530 pregnant women with no signs of acute urinary tract infection attending antenatal clinic for a period of 6 months. Midstream urine was collected for microscopy, quantitative urine culture and antibiotic susceptibility testing. Data analysis was carried out using the Statistical Package for Social Sciences version 20.
RESULTS
Asymptomatic bacteriuria was respectively 20 and 35.5% at Tamale Central and Tamale Teaching Hospital out of the 390 and 90 women screened. Sterile pyuria was found among 66% of the 50 women presenting at Tamale Central Hospital. More than 64% of isolates recovered from ASB patients were S. aureus and coagulase negative Staph. (CoNS). Escherichia coli was the dominant species among members of the enterobacteriaceae isolated. Highest susceptibility was recorded against gentamicin and amikacin while most resistance was to Ampicillin, cotrimoxazole, chloramphenicol and nitrofurantoin. Resistance to imipenem and vancomycin were 28.8 and 52%, with strains showing multiple drug resistance of between 81 and 92%.
CONCLUSION
The prevalence of asymptomatic bacteriuria is appreciably higher (20-35.5%) than documented rates in the southern sector of the country. The presence of sterile pyuria which may be an indication of asymptomatic renal impairment and most often overlooked in antenatal management is 66%. Empirical treatment of UTIs at the Tamale Central and Teaching Hospital without confirmation of susceptibility may result in treatment failure. It is necessary to screen and treat pregnant women for ASB and SP due to the complications associated with these conditions.
Topics: Adult; Anti-Bacterial Agents; Bacteriuria; Cross-Sectional Studies; Escherichia coli; Female; Ghana; Hospitals; Humans; Microbial Sensitivity Tests; Middle Aged; Pregnancy; Pregnancy Complications, Infectious; Prenatal Care; Prevalence; Pyuria; Staphylococcus aureus; Urinary Tract Infections; Young Adult
PubMed: 32321461
DOI: 10.1186/s12884-020-02936-6 -
Kidney360 Mar 2022Autosomal dominant polycystic kidney disease (ADPKD) has phenotypic variability only partially explained by established biomarkers that do not readily assess...
BACKGROUND
Autosomal dominant polycystic kidney disease (ADPKD) has phenotypic variability only partially explained by established biomarkers that do not readily assess pathologically important factors of inflammation and kidney fibrosis. We evaluated asymptomatic pyuria (AP), a surrogate marker of inflammation, as a biomarker for disease progression.
METHODS
We performed a retrospective cohort study of adult patients with ADPKD. Patients were divided into AP and no pyuria (NP) groups. We evaluated the effect of pyuria on kidney function and kidney volume. Longitudinal models evaluating kidney function and kidney volume rate of change with respect to incidences of AP were created.
RESULTS
There were 687 included patients (347 AP, 340 NP). The AP group had more women (65% versus 49%). Median ages at kidney failure were 86 and 80 years in the NP and AP groups (log rank, =0.49), respectively, for patients in Mayo Imaging Class (MIC) 1A-1B as compared with 59 and 55 years for patients in MIC 1C-1D-1E (log rank, =0.02), respectively. Compared with the NP group, the rate of kidney function (ml/min per 1.73 m per year) decline shifted significantly after detection of AP in the models, including all patients (-1.48; <0.001), patients in MIC 1A-1B (-1.79; <0.001), patients in MIC 1C-1D-1E (-1.18; <0.001), and patients with (-1.04; <0.001). Models evaluating kidney volume rate of growth showed no change after incidence of AP as compared with the NP group.
CONCLUSIONS
AP is associated with kidney failure and faster kidney function decline irrespective of the ADPKD gene, cystic burden, and cystic growth. These results support AP as an enriching prognostic biomarker for the rate of disease progression.
Topics: Adult; Biomarkers; Disease Progression; Female; Glomerular Filtration Rate; Humans; Inflammation; Kidney Failure, Chronic; Polycystic Kidney, Autosomal Dominant; Prognosis; Pyuria; Retrospective Studies
PubMed: 35582184
DOI: 10.34067/KID.0004292021