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[Intravenous urography in acute pyelonephritis].
1Service de Médecine Interne à orientation néphrologique, Hôpital Ambroise Paré, Boulogne.
Annales De Medecine Interne
|January 1, 1990
Summary
Intravenous urography in acute pyelonephritis revealed significant abnormalities in 24% of patients, particularly those over 50 or with persistent fever. This suggests selective use of urography may be beneficial.
Area of Science:
- Nephrology
- Radiology
- Urology
Background:
- Acute pyelonephritis is a common kidney infection.
- Intravenous urography (IVU) is a diagnostic imaging technique.
- The utility of routine IVU in acute pyelonephritis is debated.
Purpose of the Study:
- To evaluate the diagnostic yield of intravenous urography in patients with acute pyelonephritis.
- To identify patient subgroups who might benefit most from IVU.
Main Methods:
- A prospective study of 50 consecutive patients with acute pyelonephritis.
- Systematic performance of intravenous urography for all patients.
- Analysis of IVU findings in relation to patient demographics and clinical course.
Main Results:
- IVU revealed abnormalities in 17 patients (34%), with significant findings in 12 (24%) leading to modified treatment or follow-up.
- Significant abnormalities were more frequent in patients over 50 years (46.2%) and those with persistent fever (66.6%) after antibiotic initiation.
- Echography and abdominal X-ray detected most significant lesions.
Conclusions:
- Selective use of intravenous urography in acute pyelonephritis patients, particularly women under 50, may be considered.
- Further studies are needed to confirm these findings before altering current systematic practice.