Skip to main content
The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1970 Jan;49(1):21–30. doi: 10.1172/JCI106218

Water, acidosis, and experimental pyelonephritis

Vincent T Andriole 1
PMCID: PMC322440  PMID: 4902827

Abstract

The effect of water restriction and ammonium chloride acidosis on the course of Escherichia coli pyelonephritis was determined in the nonobstructed kidney of the rat. To alter the chemical composition of the renal medulla, water intake was reduced in rats to one-half the normal daily intake. Water restriction increased the incidence of coliform pyelonephritis. Systemic acidosis, produced by giving a 300 mM solution of ammonium chloride, increased urinary osmolality to values comparable to water restriction and also predisposed to pyelonephritis. However, when rats were fed the same solution of ammonium chloride but were allowed access to tap water ad lib., urinary osmolality values were comparable to those observed in normal animals, and susceptibility to pyelonephritis was reduced or eliminated despite a degree of systemic acidosis similar to that observed in rats fed ammonium chloride solution without access to tap water. These results suggest that water diuresis may overcome the inactivation of complement produced by ammonium chloride acidosis and that renal medullary hypertonicity, produced by either water restriction or ammonium chloride acidosis, is a major determinant of this tissue's unique susceptibility to infection.

Full text

PDF
23

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ABBRECHT P. H., MALVIN R. L. Effects of GFR and renal plasma flow on urine osmolarity. Am J Physiol. 1961 Oct;201:754–758. doi: 10.1152/ajplegacy.1961.201.4.754. [DOI] [PubMed] [Google Scholar]
  2. ANDRIOLE V. T., COHN G. L. THE EFFECT OF DIETHYLSTILBESTROL ON THE SUSCEPTIBILITY OF RATS TO HEMATOGENOUS PYELONEPHRITIS. J Clin Invest. 1964 Jun;43:1136–1145. doi: 10.1172/JCI104998. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. ANDRIOLE V. T., EPSTEIN F. H. PREVENTION OF PYELONEPHRITIS BY WATER DIURESIS: EVIDENCE FOR THE ROLE OF MEDULLARY HYPERTONICITY IN PROMOTING RENAL INFECTION. J Clin Invest. 1965 Jan;44:73–79. doi: 10.1172/JCI105128. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Acquatella H., Little P. J., de Wardener H. E., Coleman J. C. The effect of urine osmolality and pH on the bactericidal activity of plasma. Clin Sci. 1967 Dec;33(3):471–480. [PubMed] [Google Scholar]
  5. Andriole V. T. Acceleration of the inflammatory response of the renal medulla by water diuresis. J Clin Invest. 1966 Jun;45(6):847–854. doi: 10.1172/JCI105400. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Andriole V. T. Effect of water diuresis on chronic pyelonephritis. J Lab Clin Med. 1968 Jul;72(1):1–16. [PubMed] [Google Scholar]
  7. Andriole V. T., Lytton B. The effect and critical duration of increased tissue pressure on susceptibility to bacterial infection. Br J Exp Pathol. 1965 Jun;46(3):308–317. [PMC free article] [PubMed] [Google Scholar]
  8. Asscher A. W., Sussman M., Waters W. E., Davis R. H., Chick S. Urine as a medium for bacterial growth. Lancet. 1966 Nov 12;2(7472):1037–1041. doi: 10.1016/s0140-6736(66)92023-x. [DOI] [PubMed] [Google Scholar]
  9. BEESON P. B. Factors in the pathogenesis of pyelonephritis. Yale J Biol Med. 1955 Nov;28(2):81–104. [PMC free article] [PubMed] [Google Scholar]
  10. BEESON P. B., GUZE L. B. Experimental pyelonephritis. I. Effect of ureteral ligation on the course of bacterial infection in the kidney of the rat. J Exp Med. 1956 Dec 1;104(6):803–815. doi: 10.1084/jem.104.6.803. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. BEESON P. B., ROWLEY D. The anticomplementary effect of kidney tissue; its association with ammonia production. J Exp Med. 1959 Nov 1;110:685–697. doi: 10.1084/jem.110.5.685. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. BOYLAN J. W., ASSHAUER E. Depletion and restoration of the medullary osmotic gradient in the dog kidney. Pflugers Arch Gesamte Physiol Menschen Tiere. 1962;276:99–116. doi: 10.1007/BF00363327. [DOI] [PubMed] [Google Scholar]
  13. Bulger R. J. Inhibition of human serum bactericidal action by a chemical environment simulating the hydropenic renal medulla. J Infect Dis. 1967 Dec;117(5):429–432. doi: 10.1093/infdis/117.5.429. [DOI] [PubMed] [Google Scholar]
  14. CHERNEW I., BRAUDE A. I. Depression of phagocytosis by solutes in concentrations found in the kidney and urine. J Clin Invest. 1962 Oct;41:1945–1953. doi: 10.1172/JCI104652. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. COHN Z. A. Determinants of infection in the peritoneal cavity. III. The action of selected inhibitors on the fate of Staphylococcus aureus in the mouse. Yale J Biol Med. 1962 Aug;35:48–61. [PMC free article] [PubMed] [Google Scholar]
  16. FREEDMAN L. R., BEESON P. B. Experimental pyelonephritis. IV. Observations on infections resulting from direct inoculation of bacteria in different zones of the kidney. Yale J Biol Med. 1958 Jun;30(6):406–414. [PMC free article] [PubMed] [Google Scholar]
  17. FREEDMAN L. R., BEESON P. B. Experimental pyelonephritis. VIII. The effect of acidifying agents on susceptibility to infection. Yale J Biol Med. 1961 Feb;33:318–332. [PMC free article] [PubMed] [Google Scholar]
  18. FREEMAN B. A., MUSTEIKIS G. M., BURROWS W. Protoplast formation as the mechanism for immune lysis of Vibrio cholerae. Proc Soc Exp Biol Med. 1963 Jul;113:675–680. doi: 10.3181/00379727-113-28459. [DOI] [PubMed] [Google Scholar]
  19. Freedman L. R. Experimental pyelonephritis. 13. On the ability of water diuresis to induce susceptibility to E. coli bacteriuria in the normal rat. Yale J Biol Med. 1967 Feb;39(4):255–266. [PMC free article] [PubMed] [Google Scholar]
  20. GUZE L. B., GOLDNER B. H., KALMANSON G. M. Pyelonephritis. I. Observations on the course of chronic non-obstructed enterococcal infection in the kidnev of the rat. Yale J Biol Med. 1961 Apr;33:372–385. [PMC free article] [PubMed] [Google Scholar]
  21. JARAUSCH K. H., ULLRICH K. J. Untersuchungen zum Problem der Harnkonzentrierung und Harnverdünnung; Uber die Verteilung von Elektrolyten (Na, K, Ca, Mg, Cl, anorganischem Phosphat), Harnstoff, Aminosäuren und exogenem Kreatinin in Rinde und Mark der Hundeniere bei verschiedenen Diuresezuständen. Pflugers Arch. 1956;262(6):537–550. doi: 10.1007/BF00362116. [DOI] [PubMed] [Google Scholar]
  22. Kaye D. Antibacterial activity of human urine. J Clin Invest. 1968 Oct;47(10):2374–2390. doi: 10.1172/JCI105921. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Keane W. F., Freedman L. R. Experimental pyelonephritis. XIV. Pyelonephritis in normal mice produced by inoculation of E. coli into the bladder lumen during water diuresis. Yale J Biol Med. 1967 Dec;40(3):231–237. [PMC free article] [PubMed] [Google Scholar]
  24. LEVITIN H., GOODMAN A., PIGEON G., EPSTEIN F. H. Composition of the renal medulla during water diuresis. J Clin Invest. 1962 May;41:1145–1151. doi: 10.1172/JCI104567. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. MILES A. A., MILES E. M., BURKE J. The value and duration of defence reactions of the skin to the primary lodgement of bacteria. Br J Exp Pathol. 1957 Feb;38(1):79–96. [PMC free article] [PubMed] [Google Scholar]
  26. MUSCHEL L. H., TREFFERS H. P. Quantitative studies on the bactericidal actions of serum and complement. II. Some implications for the mechanism of the bactericidal reaction. J Immunol. 1956 Jan;76(1):11–19. [PubMed] [Google Scholar]
  27. Macknight A. D., Macknight J. M., Robinson J. R. The effect of urinary output upon the excretion of ;ammonia' in man. J Physiol. 1962 Sep;163(2):314–323. doi: 10.1113/jphysiol.1962.sp006977. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Moffat D. B. Medullary blood flow during hydropenia. Nephron. 1968;5(1):1–6. doi: 10.1159/000179612. [DOI] [PubMed] [Google Scholar]
  29. PERILLIE P. E., FINCH S. C. The local exudative cellular response in leukemia. J Clin Invest. 1960 Sep;39:1353–1357. doi: 10.1172/JCI104153. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. ROCHA H., FEKETY F. R., Jr ACUTE INFLAMMATION IN THE RENAL CORTEX AND MEDULLA FOLLOWING THERMAL INJURY. J Exp Med. 1964 Jan 1;119:131–138. doi: 10.1084/jem.119.1.131. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. ROCHA H., FEKETY F. R., Jr ACUTE INFLAMMATION IN THE RENAL CORTEX AND MEDULLA FOLLOWING THERMAL INJURY. J Exp Med. 1964 Jan 1;119:131–138. doi: 10.1084/jem.119.1.131. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. ROCHA H., GUZE L. B., BEESON P. B. Experimental pyelonephritis. V. Susceptibility of rats to hematogenous pyelonephritis following chemical injury of the kidneys. Yale J Biol Med. 1959 Nov;32:120–125. [PMC free article] [PubMed] [Google Scholar]
  33. ROCHA H., GUZE L. B., FREEDMAN L. R., BEESON P. B. Experimental pyelonephritis. III. The influence of localized injury in different parts of the kidney on susceptibility to bacillary infection. Yale J Biol Med. 1958 Apr;30(5):341–354. [PMC free article] [PubMed] [Google Scholar]
  34. SHELDON W. H., BAUER H. The development of the acute inflammatory response to experimental cutaneous mucormycosis in normal and diabetic rabbits. J Exp Med. 1959 Dec 1;110:845–852. doi: 10.1084/jem.110.6.845. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. THURAU K., DEETJEN P., KRAMER K. [Hemodynamics of kidney medullary substance. Part II. Interrelationships between the vascular and tubular counter-flow system in arterial pressure increases, water diuresis and osmotic diuresis]. Pflugers Arch Gesamte Physiol Menschen Tiere. 1960;270:270–285. [PubMed] [Google Scholar]

Articles from Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation

RESOURCES