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Renal imaging in pyelonephritis.

Yvonne Shen1, Mark A Brown

  • 1St George Hospital, Sydney and University of New South Wales, New South Wales, Australia.

Nephrology (Carlton, Vic.)
|March 5, 2004
PubMed
Summary
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All hospitalized pyelonephritis patients need renal imaging. Early imaging is cost-effective, identifying urinary tract obstruction, and guiding antibiotic choice, as many E. coli strains are ampicillin-resistant.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Radiology

Background:

  • Pyelonephritis is a common cause of hospital admission.
  • Optimal diagnostic strategies, particularly the role of renal imaging, remain debated.
  • Identifying clinical predictors for significant renal abnormalities in hospitalized patients is needed.

Purpose of the Study:

  • To evaluate the utility of renal imaging in hospitalized pyelonephritis patients.
  • To determine if clinical parameters can predict significant renal abnormalities.
  • To assess the cost-effectiveness of early renal imaging.

Main Methods:

  • Retrospective study of 60 consecutive hospitalized pyelonephritis patients.
  • Data collection included clinical parameters and renal ultrasound findings.

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  • Analysis focused on identifying predictors of abnormal imaging and outcomes.

    • Main Results:

    • 16% of patients had significant renal abnormalities, primarily urinary tract obstruction.
    • No significant clinical parameters predicted abnormal renal imaging findings.
    • High resistance of E. coli to ampicillin (46%) was observed.

    Conclusions:

    • Early renal imaging is recommended for all hospitalized pyelonephritis patients.
    • Early imaging appears to be a cost-effective management strategy.
    • Initial empirical therapy should favor cephalosporins over ampicillin due to resistance patterns.