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Research Article | Volume 13 Issue 8 (August, 2023) | Pages 473 - 478
Study of the clinical profile, management strategies and predictors of outcome in patients with Emphysematous Pyelonephritis from Territory Care Centre in South India
Under a Creative Commons license
Open Access
Received
July 1, 2023
Revised
July 10, 2023
Accepted
July 20, 2023
Published
Aug. 23, 2023
Abstract

Introduction: Urinary tract infections are commonly encountered and managed worldwide, and emphysematous pyelonephritis (EPN) is among the most serious types of urinary tract infections. EPN is an acute necrotizing infection of the kidney, often associated with high rates of renal loss and mortality. Aims: This retrospective study aimed to study on clinical information, management strategies and predictors of outcome Emphysematous pyelonephritis. Materials and methods: 90 consecutive patients were diagnosed with EPN with there demographic characteristics, clinical presentations, management strategies, and final outcomes were analyzed retrospectively. Results: There are 36 men and 54 women among the 90 patients. The average patient age is 58 years old. 96% of patients have diabetes, and 22% of those patients also have renal calculi. 4% of patients do not have diabetes. The majority of patients (91%) present with a fever, followed by flank pain (75%), decreased urine output, lower urinary symptoms, shock, and altered sensorium. The most typical organism found in urine (71% of the time) is E. coli. 37 percent of patients had class 2 EPN, 35 percent had class 3, and 14 percent had class 4 EPN. In 46% of patients, left sided EPN, right sided EPN, and bilateral EPN were all present. Shock, thrombocytopenia, altered sensorium, serum creatinine, and symptoms that had only been present for seven days or less at the time of presentation were. The majority of people who have experienced an episode of EPN have advanced to CKD. The majority of patients are treated with minimally invasive procedures such PCD/PCN insertion and DJ stenting together with antibiotics. Only 2 patients underwent nephrectomy. Six patients died before invasive therapy was attempted, and eight of the 14 patients died within 48 hours. Conclusions: Serum creatinine level is the most reliable predictor of outcome in patients with emphysematous pyelonephritis. Most of the patients are treated by minimal invasive surgery like DJ stenting, PCD/PCN insertion in combination with antibiotics.

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