Acute bilateral non-obstructive bacterial pyelonephritis with acute kidney injury in the elderly: role of non-invasive studies in its diagnosis

Abstract

Nine elderly patients who presented with features suggestive of acute pyelonephritis were studied with the help of laboratory and imaging investigations. All patients had acute kidney injury of variable severity at presentation. Renal imaging helped us in revealing bilateral involvement and the findings are discussed. The infection was treated with appropriate antibiotics. Because of severe renal failure, five patients were supported with hemodialysis, of them, three became dialysis independent. The remaining two patients were dialysis dependent at discharge. However, none of them came to us for follow-up.

Unilateral and bilateral acute pyelonephritis: differences in clinical presentation, progress and outcome

“…AKI in bilateral APN was more frequent and severe than that in unilateral APN 14. All types of pre-renal injury, acute tubular necrosis and acute tubulo-interstitial nephritis may be considered as possible underlying mechanisms of AKI in APN 14 16. In this study, the reason why patients with bilateral APN experienced more severe clinical and laboratory manifestations and outcomes compared with those with unilateral APN is unclear.…”

“…Regarding the clinical significance of bilateral APN, an association between AKI and bilateral APN has been reported 14 16. AKI in bilateral APN was more frequent and severe than that in unilateral APN 14.…”