Acute Renal Failure Secondary to Pyelonephritis

Turner, Mary Ellen; Weinstein, Jonathan; Kher, Kanwal K.

doi:10.1542/peds.97.5.742

Cited by 10 publications

(4 citation statements)

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“…Regarding kidney function, until now, the prevalence of AKI in previously healthy paediatric patients with fUTI was unknown, with only isolated case reports 12,26,27 . McGregor et al 28 estimate an incidence of AKI of 5% in non‐critical patients hospitalised for any reason.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, UTIs are sometimes associated with the deterioration of kidney function 2 . Furthermore, they can cause electrolyte disturbances such as hyponatremia and hyperkalaemia 12,13 . These potentially serious alterations can be aggravated by low fluid intake and increased insensible losses due to fever 14 .…”

Section: Introductionmentioning

confidence: 99%

“…2 Furthermore, they can cause electrolyte disturbances such as hyponatremia and hyperkalaemia. 12,13 These potentially serious alterations can be aggravated by low fluid intake and increased insensible losses due to fever. 14 Therefore, the main utility of blood testing in UTIs may be the detection of patients with electrolyte and kidney function disorders.…”

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confidence: 99%

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Blood analysis for screening of electrolyte and kidney function alterations in patients with febrile urinary tract infection

et al. 2023

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AimTo describe the prevalence, severity, risk factors, and clinical relevance of electrolyte disturbances and acute kidney injury (AKI) during febrile urinary tract infection (fUTI).MethodsRetrospective observational study of well/fair‐appearing patients between 2 months and 16 years, with no previous relevant medical history, diagnosed with fUTI in the paediatric emergency department (PED) with subsequent microbiological confirmation. Analytical alteration (AA) data were considered: AKI (creatinine elevation × 1.5 the median for age), plasma sodium alteration (≤130 or ≥150 mEq/L), and potassium alteration (≤3 or ≥6 mEq/L).ResultsWe included 590 patients, 17.8% presented AA (13 hyponatremia, 7 hyperkalaemia, and 87 AKI). No patient presented severe analytic alterations or a higher frequency of symptoms potentially attributable to these alterations (seizures, irritability, or lethargy). Risk factors associated with these AA were clinical dehydration (OR = 3.5 95% CI: 1.04–11.7; p = 0.044) and presenting a temperature >39°C (OR = 1.9 95% CI: 1.14–3.1; p = 0.013).ConclusionsElectrolyte and renal function disturbances are infrequent in the previously healthy paediatric population with a fUTI. If present, they are asymptomatic and not severe. Based on our results, performing systematic blood analysis to rule out AA appears no longer justified, especially in the absence of risk factors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Blood analysis for screening of electrolyte and kidney function alterations in patients with febrile urinary tract infection

et al. 2023

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“…Generally, pyelonephritis-induced acute kidney injury has been more commonly reported in the pediatric population due to anatomic variations. Contrastingly, non-obstructive pyelonephritis as a cause of acute kidney injury has an incidence of approximately 2-3%, with some literature reporting incidences as low as 0.7% [4][5][6][7]. Hence, the diagnosis of pyelonephritis leading to acute kidney injury is exceedingly rare and infrequently reported in the literature [4].…”

Section: Discussionmentioning

confidence: 99%

Acute Non-Obstructive Bilateral Pyelonephritis With Acute Kidney Injury Requiring Hemodialysis

Mainali

Adhikari

Chowdhury

et al. 2022

Cureus

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Acute pyelonephritis (APN) is considered a rare cause of acute kidney injury (AKI), especially when no anatomical abnormalities or predisposing factors are identified. Additionally, non-obstructive pyelonephritis is a very infrequent cause of rapidly progressive acute kidney injury. Herein, we present a rare case of a 55year-old female patient who was diagnosed with acute non-obstructive pyelonephritis leading to AKI eventually requiring hemodialysis. The patient eventually recovered with the administration of intravenous antibiotics with a significant recovery of renal function.

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Acute kidney injury from pyelonephritis in an elderly man: case report

et al. 2011

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Pyelonephritis is rarely considered in the differential diagnosis of acute kidney injury. Acute non-obstructed bacterial pyelonephritis is an infrequent and rarely considered cause of rapidly progressive acute kidney injury. A diagnostic challenge thus develops as it is difficult to clinically differentiate acute kidney injury secondary to ischemic or toxic acute tubular necrosis or papillary necrosis versus acute interstitial nephritis secondary to drugs or infectious pyelonephritis. We describe a case of acute kidney injury due to suppurative pyelonephritis in an elderly immunocompetent man who presented with dysuria, vomiting, and fever and later found to have histologic and radiologic proven pyelonephritis as the cause of acute kidney injury in the absence of hypotension, nephrotoxic agents, non-steroidal analgesics, immunosuppression, urinary tract obstruction, or other structural anomalies. The patient was managed with antimicrobial therapy, hemodialysis, and a short course of corticosteroids.

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Acute Renal Failure Secondary to Pyelonephritis

Cited by 10 publications

References 0 publications

Blood analysis for screening of electrolyte and kidney function alterations in patients with febrile urinary tract infection

Blood analysis for screening of electrolyte and kidney function alterations in patients with febrile urinary tract infection

Acute Non-Obstructive Bilateral Pyelonephritis With Acute Kidney Injury Requiring Hemodialysis

Acute kidney injury from pyelonephritis in an elderly man: case report

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