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Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis
Published on: July 18, 2017
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Emphysematous pyelonephritis: Time for a management plan with an evidence-based approach
Omar M Aboumarzouk1, Owen Hughes2, Krishna Narahari2
1Islamic University of Gaza, College of Medicine, Gaza, Palestine.
Arab Journal of Urology
|May 29, 2015
Summary
Emphysematous pyelonephritis (EPN) management has no consensus. Percutaneous drainage (PCD) and medical management (MM) show higher survival rates than emergency nephrectomy (EN), suggesting EN should be a last resort for EPN.
Area of Science:
- Nephrology
- Infectious Diseases
- Surgical Management
Background:
- Emphysematous pyelonephritis (EPN) is a severe necrotizing kidney infection.
- Optimal management strategies for EPN remain debated.
Purpose of the Study:
- To systematically review and meta-analyze the management and outcomes of Emphysematous Pyelonephritis.
- To compare the efficacy of different EPN treatment modalities.
Main Methods:
- Systematic review of articles from 1980-2013 reporting on EPN.
- Meta-analysis conducted following Cochrane guidelines.
- Inclusion of 32 studies with data from 628 patients.
Main Results:
- Diabetes was a prevalent comorbidity (85%).
- Common symptoms included fever, pyuria, and pain.
- Percutaneous drainage (PCD) and medical management (MM) demonstrated significantly lower mortality rates compared to emergency nephrectomy (EN).
- Shock was a significant predictor of mortality (54.4%).
Conclusions:
- Aggressive management of shock is crucial in EPN.
- PCD and MM are associated with higher survival rates than EN.
- Emergency nephrectomy should be reserved for refractory cases.
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