Neutrophil:Lymphocyte Ratio as a Predictive Factor for Success of Nephron-Sparing Procedures in Patients with Emphysematous Pyelonephritis

Punatar, Chirag B; Jadhav, Kunal; Kumar, Vijay; Joshi,; Sagade, SN

doi:10.7812/tpp/18-044

Cited by 5 publications

(3 citation statements)

References 12 publications

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“…Upon full‐text review, 34 articles were excluded due to lack of proper information, study design, and duplication. In total, 45 articles met the inclusion criteria, reporting the mortality rate and risk factors of mortality among EP patients and were included in the final cohort analysis, comprising 1303 patients and 177 mortalities [1–3, 5, 7–11, 14, 23–57]. The evidence acquisition flow chart is shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

Prevalence and Risk Factors of Mortality in Emphysematous Pyelonephritis Patients: A Meta‐Analysis

et al. 2022

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Background Emphysematous pyelonephritis (EP) is a severe necrotizing infection of the renal parenchyma which is associated with significant case mortality. We sought to identify the incidence and predictive risk factors associated with EP mortality. Methods Two electronic databases, PubMed and Web of Science, were searched from their inception until June 06, 2021 for relevant articles. Two independent teams reviewed abstracts and extracted data from the selected manuscripts. A meta-analysis has been reported in line with PRISMA 2020 and AMSTAR Guidelines. Results Of the 1080 retrieved abstracts, 79 underwent full-text review and 45 studies were included in the final analysis, comprising a total cohort of 1303 patients and 177 mortalities. The pooled prevalence of mortality among the patients with EP disease was 13%. Our analysis found a significantly decreasing trend in mortality rates, an increasing trend in minimally invasive intervention and decreasing trends in emergency nephrectomy in the EP studies from 1985 to 2020. Significant risk factors that were associated with a negative impact on survival of EP patients included sepsis (OR = 15.99), shock (OR = 15.57), disturbance of consciousness (OR = 12.11), thrombocytopenia (OR 7.85), acute renal failure (OR = 5.41), Wan classification I (OR = 4.57), emergency nephrectomy (OR = 3.73), Huang-Tseng classification III-IV (OR = 2.4) and medical management alone (OR = 2.04). Female sex (OR = 0.52) and minimally invasive intervention (OR = 0.47) (percutaneous nephrostomy or ureteral stent placement) were associated with decreased mortality rates. Conclusions Our study results demonstrated several significant risk factors that could help guide treatment to reduce the mortality risk of EP patients. Clinically, early treatment with a combination of minimally invasive intervention and appropriate medical management may be protective for reducing mortality risk in EP patients.

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Section: Resultsmentioning

confidence: 99%

Prevalence and Risk Factors of Mortality in Emphysematous Pyelonephritis Patients: A Meta‐Analysis

et al. 2022

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“…la mortalidad alcanza el 100% en aquellos que no se les brinda un tratamiento óptimo, mientras quienes reciben tratamiento tienen un porcentaje del 7-75%, logrando avances terapéuticos reduciendo la mortalidad hasta un 12%. 2 Sonia Chia-Gonzales y colaboradores encontraron en un estudio 15 pacientes con pielonefritis enfisematosa, los cuales presentaban factores de riesgo como "Diabetes Mellitus, mal control metabólico y presencia de infecciones urinarias recurrentes". En 27% de casos se realizó nefrectomía unilateral y la mortalidad fue de 13%.…”

Section: Resultsunclassified

Factores Asociados de Morbimortalidad en Pielonefritis Enfisematosa.

Guerra¹,

Cunza²,

Mejía³

2022

Rev. Gua. Uro.

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La pielonefritis enfisematosa se considera un cuadroclínico severo que compromete el riñón y la salud delpaciente. Se debe considerar esta patología en caso deinfección urinaria asociada a signos clínicos de gravedad,principalmente en diabéticos. Por tanto, es de gran interés para la institución el contar con una recopilación de los casos que se presentan, los factores asociados en nuestra población, así como su evolución y manejo.Materiales y métodos: los datos se obtuvieron retrospectivamente utilizando acceso a expediente clínico de los pacientes que consultaron en unidad de emergencia de Hospital General de ISSS y se catalogaron como pielonefritis enfisematosa entre los años 2015 a 2020. Resultados: Se analizaron 39 pacientes conpielonefritis enfisematosa, el rango de edad con mayorfrecuencia fue entre 50 a 59 años. El sexo femeninopredominó con el 62%. El factor de riesgo más asociado con el 36% es la Diabetes Mellitus, seguido por la obesidad en un 20%; en tercer lugar se encuentran las infecciones de vías urinarias recurrentes en un 14%.Conclusión: la población femenina es la más propensa a desarrollar esta patología asociada a factores como la Diabetes. La tendencia actual es realizar un diagnóstico temprano y utilizar tratamiento no quirúrgico.

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“…Additionally, in individuals with EPN, diabetic ketoacidosis is a significant predictor of death and people with thrombocytopenia can also experience poor outcomes [11,13]. According to Punatar et al, patients having a neutrophil-lymphocyte ratio greater than five at admission are at an increased risk of adverse outcomes by 1.8% [14]. The death rate is highest and extensive therapy is required when two or more factors are present [15].…”

Section: Discussionmentioning

confidence: 99%

Culture-Negative Emphysematous Pyelonephritis as a Complication of Uncontrolled Diabetes Mellitus: A Case Report

Omoleye¹,

Israr²,

Tazin³

et al. 2022

Cureus

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Emphysematous pyelonephritis (EPN) is a severe, necrotizing infection of the renal parenchyma. It is commonly found as a complication of uncontrolled diabetes mellitus (DM). EPN has a terrible prognosis unless promptly identified and treated. In this case study, a 38-year-old man with type 2 diabetes mellitus (T2DM) was admitted due to complaints of excruciating abdominal pain, vomiting, and non-adherent to his insulin medication. The patient was subsequently diagnosed with EPN. For most patients, the current course of treatment includes nephrectomy along with antimicrobial medications. In this case report, however, the patient improved with conservative treatment such as IV fluids, antibiotics, and blood glucose control.

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Neutrophil:Lymphocyte Ratio as a Predictive Factor for Success of Nephron-Sparing Procedures in Patients with Emphysematous Pyelonephritis

Cited by 5 publications

References 12 publications

Prevalence and Risk Factors of Mortality in Emphysematous Pyelonephritis Patients: A Meta‐Analysis

Prevalence and Risk Factors of Mortality in Emphysematous Pyelonephritis Patients: A Meta‐Analysis

Factores Asociados de Morbimortalidad en Pielonefritis Enfisematosa.

Culture-Negative Emphysematous Pyelonephritis as a Complication of Uncontrolled Diabetes Mellitus: A Case Report

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