Risk Factors Associated with Acute Pyelonephritis in Healthy Women

Scholes, Delia; Hooton, Thomas M.; Roberts, Pacita L.; Gupta, Kalpana; Stapleton, Ann E.; Stamm, Walter E.

doi:10.7326/0003-4819-142-1-200501040-00008

Cited by 207 publications

(187 citation statements)

References 26 publications

(33 reference statements)

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“…We have shown before that only 0.5% of diabetic patients with a UTI had clinical symptoms of a pyelonephritis (17) compared with 0.2% in control subjects. Others have demonstrated that the risk ratio for pyelonephritis in patients with compared with those without diabetes ranges from 1.86 to 4.4 (18,19). These numbers make clear that even when more women with diabetes had clinical symptoms of a pyelonephritis and therefore were treated with norfloxacin during a longer period, this cannot totally explain the demonstrated differences.…”

Section: Secondary Analysesmentioning

confidence: 99%

Differences in the Pattern of Antibiotic Prescription Profile and Recurrence Rate for Possible Urinary Tract Infections in Women With and Without Diabetes

Schneeberger

Stolk

DeVries³

et al. 2008

Diabetes Care

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OBJECTIVE -Women with diabetes have a high incidence and complication rate of urinary tract infections (UTIs). Our aims were to compare current treatment strategies with respect to recurrence rates in women with diabetes with those without diabetes.RESEARCH DESIGN AND METHODS -We used a Dutch registration database containing pharmacy dispensing data. A total of 10,366 women with diabetes (17.5% premenopausal) (aged Յ55 years) and 200,258 women without diabetes (68% premenopausal) who received a first course of trimethoprim, nitrofurantoin, fosfomycin, or norfloxacin between January 1999 and January 2006 were included. We compared short (Յ5 days) with long (Ͼ5 days) prescriptions and norfloxacin with trimethoprim, nitrofurantoin, and fosfomycin. A recurrence was defined as a second prescription for one of the above-mentioned agents or a first with amoxicillin (clavulanic acid), fluoroquinolones, or trimethoprim/sulfamethoxazole between 6 and 30 days after inclusion.RESULTS -Premenopausal women with diabetes more often received a long (26.5 vs. 19.2%; P Ͻ 0.001) treatment with norfloxacin (10.7 vs. 6.2%; P Ͻ 0.001) but still had a higher recurrence rate (16.1 vs. 12.2%; P ϭ 0.003) compared with those without diabetes. Similarly, postmenopausal women with diabetes more often received a longer (32.8 vs. 28.8%; P Ͻ 0.001) treatment with norfloxacin (15.2 vs. 12.7%; P Ͻ 0.001) but had a higher recurrence rate (19.1 vs. 16.4%; P Ͻ 0.001) compared with those without diabetes.CONCLUSIONS -Despite the fact that patients with diabetes more often received longer and more potent initial treatment than patients without diabetes, pre-and postmenopausal women with diabetes more often had recurrences of their UTIs.

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Section: Secondary Analysesmentioning

confidence: 99%

Differences in the Pattern of Antibiotic Prescription Profile and Recurrence Rate for Possible Urinary Tract Infections in Women With and Without Diabetes

Schneeberger

Stolk

DeVries³

et al. 2008

Diabetes Care

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“…MSK is found in 20% of patients with kidney stones and more than 70% of patients with MSK develop stones (7,9). Nephrolithiasis in MSK facilitates urinary tract infection (3).Dilatation of collecting tubules in MSK also plays role in recurrent pyelonephritis (10).…”

Section: Discussionmentioning

confidence: 99%

A Case of Medullary Sponge Kidney Diagnosed at an Older Age

Eken¹,

Özkök²,

Arslan³

et al. 2015

Turk Neph Dial Transpl

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Medullary sponge kidney (MSK) is known as a congenital disesase with dilatation of collecting tubules. MSK is usually asymptomatic but various clinical manifestations may occur including nephrocalcinosis, renal tubular acidosis, impaired urine concentrating ability, urinary tract stones and infections. Although MSK is a congenital disorder, it is usually diagnosed in second or third decade. A 53-year-old woman presented with recurrent dysuria and bilateral costovertebral pain radiating to the groin region. Pyuria and hematuria were found. On ultrasonography, hyperechogenic densities of multiple calculi in the calyces of both kidneys, and minimal pelvicaliectasis were detected. Computed tomography revealed multiple punctate calcifications aligned concentrically in the medulla of both kidneys. On clinical and radiological grounds, the diagnosis of MSK was established. The patient's complaints were resolved with antibiotherapy for urinary tract infection. Thiazide or potassium citrate was not prescribed since hypercalciuria or hypocitraturia was not present. In conclusion, MSK should be considered in the differential diagnosis of nephrocalcinosis, nephrolithiasis and recurrent urinary tract infections in older patients, even in the fifth decade. ÖzMedüller sünger böbrek (MSB), renal papilladaki toplayıcı kanalların dilatasyonuyla karakterize konjenital bir hastalıktır. MSB genellikle asemptomatiktir fakat nefrokalsinozis, renal tübüler asidoz, idrarı konsantre etme kapasitesinde bozulma, böbrek taşları ve enfeksiyonları içeren çeşitli klinik durumlarla ortaya çıkabilir. MSB konjenital bir hastalık olmasına rağmen, genellikle 2. veya 3. dekada kadar tanı konulamaz. Bu olgu bildiriminde, 53 yaşında MSB tanısı konan bir kadın olguyu tartışmayı amaçladık. Hastamız, tekrarlayan idrarda yanma ve kasık bölgesine yayılan çift taraflı yan ağrısı şikayetiyle başvurdu. Tetkiklerinde piyüri ve hematüri saptandı. Ultrasonografide her iki böbrek kalikslerinde birden fazla taşla uyumlu hiperekojen dansiteler ile birlikte minimal pelvikaliektazi tespit edildi. Bilgisayarlı tomografide, her iki böbrek medüllasında çok sayıda noktasal kalsifikasyonlar saptandı. Hastaya klinik ve radyolojik kriterlerle MSB tanısı kondu. Uygun antibiyotik tedavisiyle idrar yolu enfeksiyonu tedavi edildi ve hastanın şikayetleri geriledi. Hiperkalsiüri veya hipositratüri saptanmadığı için tiazid veya potasyum sitrat tedavileri başlanmadı. Sonuç olarak, hastalar ileri yaşta olsa bile, MSB, nefrokalsinozis, nefrolitiazis ve tekrarlayan idrar yolu enfeksiyonu ayırıcı tanısında düşünülmelidir.

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“…Anatomical anomalies such as vesicoureteral refl ux correlate strongly with acute pyelonephritis in children (Jantunen et al 2001;Lai and Ng 2003). In young or middleaged adults, acute pyelonephritis correlates with several well-known risk factors such as female gender, co-existing diabetes mellitus, pregnancy, urinary incontinence, sexual behavior and urolithiasis (Nicolle et al 1996;Hill et al 2005;Scholes et al 2005;Pertel and Haverstock 2006). In contrast, acute pyelonephritis has been relatively little evaluated in geriatric populations.…”

Section: Statistical Analysesmentioning

confidence: 99%

The Characteristics of Acute Pyelonephritis in Geriatric Patients: Experiences in Rural Northeastern Taiwan

Kang¹,

Tsao²,

Liu³

et al. 2008

Tohoku J. Exp. Med.

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Acute pyelonephritis causes hospitalization and is a commonly-ignored cause of death in geriatric patients. It has been well studied in young-adult populations but rarely in geriatric populations. The aim of our study was to analyze the characteristics of acute pyelonephritis in geriatric patients. The electronic admission records of a community hospital in northeastern Taiwan were retrospectively screened from July 1, 2003 to June 30, 2006. The basic characteristics, laboratory fi ndings and infectious microorganisms of all subjects were evaluated. Sixty-fi ve subjects (mean age 71.6 ± 4.9 years; range 65-84 years) and 73 admission records contributed by them were enrolled. These 65 subjects, including one who died in hospital, were predominantly female (52 subjects; 80%). Twenty-two subjects (33.8%) had co-existing diabetes mellitus, 9 subjects (13.8%) had co-existing tumors, and 19 subjects (29.2%) had a history of intra-abdominal surgery. The admission records revealed right kidney involvement (52.1%), co-existing urolithiasis (50.7%) and admission to wards of internal medicine (57.5%). Urological procedures were performed on 20 (27.4%) of all 73 admission records. Escherichia coli was the most common infecting microorganism (19.2% of all records; 42.4% of records with positive microorganism culture). Hemoglobin < 10 g/dl was a signifi cant predictive factor for both hospital stay > 7 days and serum creatinine > 2.0 mg/dl ( p = 0.003 and 0.002, respectively). Positive microorganism culture was also a signifi cant predictive factor for hospital stays > 7 days ( p < 0.001). In our geriatric patients with acute pyelonephritis, low hemoglobin levels implied co-existing renal insuffi ciency and prolonged hospitalization. Positive microorganism culture also implied prolonged hospitalization.

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Risk Factors Associated with Acute Pyelonephritis in Healthy Women

Cited by 207 publications

References 26 publications

Differences in the Pattern of Antibiotic Prescription Profile and Recurrence Rate for Possible Urinary Tract Infections in Women With and Without Diabetes

Differences in the Pattern of Antibiotic Prescription Profile and Recurrence Rate for Possible Urinary Tract Infections in Women With and Without Diabetes

A Case of Medullary Sponge Kidney Diagnosed at an Older Age

The Characteristics of Acute Pyelonephritis in Geriatric Patients: Experiences in Rural Northeastern Taiwan

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