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Effect of Bacteriuria on Renal Concentrating Mechanisms

ALLAN R. RONALD, M.D.; RALPH E. CUTLER, M.D., F.A.C.P.; and MARVIN TURCK, M.D., F.A.C.P.
Ann Intern Med. 1969;70(4):723-733. doi:10.7326/0003-4819-70-4-723
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SUMMARY:

To examine the relationship between renal and vesical bacteriuria and maximal urinary concentrating ability (Umax), 38 patients with well-documented urinary tract infections were studied by bilateral ureteral catheterizations. Umax was evaluated by the response to 5 units of vasopressin in oil followed by a 36-hr period of fluid deprivation. With this technic, values of Umax below 800 mOsm/kg are considered abnormal. Individuals with infection localized to the bladder (913 mOsm/kg) concentrated significantly better than those with renal infection (771 mOsm/kg). The noninfected side (875 mOsm/kg) in patients with unilateral bacteriuria concentrated better than its infected counterpart (675 mOsm/kg). Seven of 12 patients with renal infection improved their overall concentrating ability by at least 100 mOsm/kg after eradication of bacteriuria. These studies provide information that demonstrates that renal but not bladder bacteriuria is associated with decreased urinary concentrating ability and show that the defect may be reversible with effective antimicrobial therapy.

Topics

bacteriuria ; kidney

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