Predictive factors for mortality and need for nephrectomy in patients with emphysematous pyelonephritis

BJU International
Rakesh KapoorAneesh Srivastava

Abstract

To analyse the factors predicting the mortality and need for nephrectomy in patients with emphysematous pyelonephritis (EPN). Clinical features, laboratory variables, imaging studies, management strategy and the final outcomes were analysed in 39 consecutive patients with EPN. The mean (sd) age was 57 (7.2) years and the male to female ratio was 2:11. The baseline risk factors (clinical, laboratory and radiological) were compared among three groups; group 1, survived with renal salvage (26); group 2, survived after nephrectomy (eight); and group 3, died (five). The overall survival rate was 87% (34/39) and the kidney was salvaged in 67% (26) patients at a median follow-up of 18 months. Altered mental status, thrombocytopenia, renal failure and severe hyponatremia at presentation were significantly associated with mortality rate. There was no significant difference in final outcome based on radiological classification. Extensive renal parenchymal destruction of >50% (based on computed tomography) significantly predicted the need for nephrectomy (P < 0.001) and death (P = 0.02). Early (<1 week) nephrectomy resulted in a higher mortality rate (three of seven patients) than initial conservative management. There were no deaths in s...Continue Reading

References

Jan 1, 1986·Southern Medical Journal·F A KleinV Schneider
Oct 1, 1986·The Journal of Urology·M A HudsonW J Catalona
Dec 1, 1985·The Journal of Urology·T E AhleringD G Skinner
Feb 1, 1984·The Journal of Urology·J MichaeliM Caine
Jan 1, 1995·British Journal of Urology·A R PontinD Kahn
Mar 1, 1997·Urology·A A ShokeirT El-Diasty
Jul 2, 1998·The Journal of Urology·Y L WanT Y Lee
Mar 4, 2005·Journal of the Chinese Medical Association : JCMA·Pei-Hui ChanShei-Chain Tseng
Jul 17, 2007·The Journal of Urology·Matthew E FalagasIlias I Siempos
Mar 29, 2008·Urology·Karthikeyan AswathamanAntony Devasia

❮ Previous
Next ❯

Citations

May 30, 2013·Indian Journal of Nephrology·R FatimaB Ramsubbarayudu
May 9, 2014·Case Reports in Medicine·Camelia ArseneGregory Berger
May 10, 2015·The American Journal of Emergency Medicine·Ji Ning SunBin Wang
Jul 3, 2013·Asian Journal of Surgery·James Hok-Leung TsuMing-Kwong Yiu
Dec 25, 2012·Actas urologicas españolas·D Olvera-PosadaF Rodríguez-Covarrubias
Apr 20, 2012·Urology·Marc A BjurlinCourtney M P Hollowell
Sep 17, 2013·International Journal of Urology : Official Journal of the Japanese Urological Association·Yu-Chuan LuChao-Yuan Huang
Feb 4, 2015·Hemodialysis International·Georgios VlachopanosAthanasios Agrafiotis
Oct 30, 2013·ANZ Journal of Surgery·Simon P Rowland, Hemant Sheth
Dec 23, 2015·Urology Annals·Mada AlsharifSalahadin Lamy
Apr 15, 2014·Urology·Daniel Olvera-PosadaFrancisco Rodríguez-Covarrubias
May 29, 2015·Arab Journal of Urology·Omar M AboumarzoukBhaskar Somani
Jul 2, 2016·Indian Journal of Endocrinology and Metabolism·Raiz Ahmad MisgarBashir Ahmad Laway
Jul 31, 2014·BMC Infectious Diseases·Yu-Chuan LuYeong-Shiau Pu
Sep 14, 2018·BMJ Case Reports·Stuart DeorajConstantinos Missouris
Sep 15, 2019·BMJ Case Reports·Amit JainLalgudi Narayanan Dorairajan
Feb 29, 2020·World Journal of Urology·Ayse BatirelRajeev Kumar
May 7, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Demet AlaygutBelde Kasap-Demir
Aug 13, 2021·BMJ Case Reports·Katie ListonConor P Woods
Feb 2, 2022·International Urology and Nephrology·Rajeev Desai, Deepak Batura

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.