Outcome of Nephrectomy and Kidney-Preserving Procedures for the Treatment of Emphysematous Pyelonephritis

Park, B.S.; Huh, Jung–Sik; Jeon, S.H.; Lee, S.J.; Kim, J.I.; Chang, Shang-Jen

doi:10.1016/s1569-9056(06)60496-x

Cited by 12 publications

(17 citation statements)

References 16 publications

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“…Diabetes mellitus was the most frequently reported predisposing factor for developing EPN, as it constituted 80-100% of patients [5,14,15]. Of the present patients, 77% were diabetic, and the second predisposing factor was urolithiasis; the same was reported by Kapoor et al [12].…”

Section: Discussionsupporting

confidence: 79%

194 Kidney preservation protocol for management of emphysematous pyelonephritis: Treatment modalities and follow-up

El-Nahas¹,

Shokeir²,

Barakat³

et al. 2012

European Urology Supplements

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Section: Discussionsupporting

confidence: 79%

194 Kidney preservation protocol for management of emphysematous pyelonephritis: Treatment modalities and follow-up

El-Nahas¹,

Shokeir²,

Barakat³

et al. 2012

European Urology Supplements

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“…1). Full reports were evaluated in 48 studies, of which 32 were included in the systematic review [1][2][3][6][7][8][10][11][12][13][14][15][16][17][18][19][20][21][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. Most of the studies were published within the last 10 years, reflecting the increased awareness of EPN and the associated controversy.…”

Section: Resultsmentioning

confidence: 99%

670 Emphysematous pyelonephritis: Time for a management plan with an evidence based approach

Aboumarzouk¹,

Zreik²,

Hughes³

et al. 2014

European Urology Supplements

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Introduction: Emphysematous pyelonephritis (EPN) is a life-threatening necrotising kidney infection, but there is no consensus on the best management.Methods: We systematically reviewed previous articles published from 1980 to 2013 that included studies reporting on EPN, and applying the Cochrane guidelines, we conducted a meta-analysis of the results.Results: In all, 32 studies were included, with results for 628 patients (mean age 56.6 years, range 33.8-79.9). There were 462 women, outnumbering men by 3:1. Diabetes was present in 85% of the cases. Fevers and rigor (74.7%), pyuria (78.2%) and pain (70.4%) were the most common symptoms. Shock was associated with 54.4% of deaths while obstructive uropathy was associated with 15.1% of deaths. Computed tomography was diagnostic in all the cases. Percutaneous drainage (PCD) and medical management (MM) alone were associated with a significantly lower mortality rate than was emergency nephrectomy (EN), with an odds ratio (95% confidence interval) for PCD vs. EN of 3.13 (1.89-5.16; P < 0.001), for EN vs. MM of 2.84 (1.62-4.99; P = 0.001), and of 0.91 (0.53-1.56; P = 0.73, i.e., no difference) for * Corresponding author. Tel.: +44 7886885677. E-mail address: aboumarzouk@gmail.com (O.M. Aboumarzouk). Peer review under responsibility of Arab Association of Urology. Production and hosting by ElsevierArab Journal of Urology (2014) PCD vs. MM. Open drainage also had a significantly lower mortality rate than EN, with a ratio of 0.12 (0.02-0.91; P < 0.04).Conclusion: The overall mortality rate was %18%; shock was associated with a high mortality rate and therefore should be managed aggressively. PCD and MM were associated with significantly higher survival rates than EN, and therefore EN should only be considered if the patient does not improve despite other treatments. ª 2013 Production and hosting by Elsevier B.V. on behalf of Arab Association of Urology.

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“…4 Whether calculus disease is responsible for urinary tract obstruction in these cases remains unclear. 5,6 Nondiabetic patients with EPN have a higher incidence of urinary obstruction.…”

Section: Discussionmentioning

confidence: 99%

Emphysematous pyelonephritis with complete duplication of the left urinary tract

Yamasaki

Koga²,

Minami

et al. 2013

CUAJ

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Emphysematous pyelonephritis (EPN) is a life-threatening bacterial infection and should be treated rapidly and carefully. We report a case of EPN with complete duplication of the left urinary tract. A 68-year-old woman was admitted to our hospital complaining of high-grade fever and left flank pain. An abdominal computed tomography scan showed gas was presented in the renal parenchyma, not only the pelvis and ureter. Based on these findings, a diagnosis of left EPN was made. A partial nephrectomy of the affected left upper pole moiety was performed and the patient underwent additional medical management. Other 83 cases of EPN from the Japanese literature were reviewed.

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Outcome of Nephrectomy and Kidney-Preserving Procedures for the Treatment of Emphysematous Pyelonephritis

Cited by 12 publications

References 16 publications

194 Kidney preservation protocol for management of emphysematous pyelonephritis: Treatment modalities and follow-up

194 Kidney preservation protocol for management of emphysematous pyelonephritis: Treatment modalities and follow-up

670 Emphysematous pyelonephritis: Time for a management plan with an evidence based approach

Emphysematous pyelonephritis with complete duplication of the left urinary tract

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