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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: Is nephrectomy warranted?
Mada Alsharif1, Abdullah Mohammedkhalil1, Basim Alsaywid2
1Research Promotion and Education Section, King Abdullah International Research Center, Jeddah, Saudi Arabia.
Urology Annals
|December 23, 2015
Summary
Conservative management of emphysematous pyelonephritis (EPN) offers better outcomes and survival rates compared to nephrectomy. This approach preserves kidney function and reduces morbidity in EPN patients.
Area of Science:
- Nephrology
- Infectious Diseases
- Surgical Management
Background:
- Emphysematous pyelonephritis (EPN) is a severe renal infection with a high mortality rate (up to 25%).
- Optimal management strategies for EPN, including conservative versus nephrectomy, remain debated.
Purpose of the Study:
- To evaluate and compare the outcomes of conservative and surgical management for emphysematous pyelonephritis.
- To assess the impact of different EPN treatments on kidney function preservation and patient survival.
Main Methods:
- Retrospective review of medical records for patients diagnosed with EPN via computed tomography.
- Classification of management into conservative (medical, percutaneous drainage, nephrostomy) and surgical (nephrectomy).
- Outcomes measured included kidney function preservation and patient survival.
Main Results:
- A cohort of 10 EPN patients (9 female, 1 male, median age 55) was analyzed; 63% were diabetic.
- Common presentations included flank pain (100%), fever (75%), and vomiting (63%). Escherichia coli was the most frequent pathogen.
- Nephrectomy did not improve survival rates, whereas conservative management resulted in good outcomes and reduced morbidity, avoiding dialysis dependence.
Conclusions:
- Nephrectomy is not associated with improved survival in emphysematous pyelonephritis.
- Conservative management strategies lead to better patient outcomes and enhanced survival.
- Findings support the increasing trend towards conservative management for EPN.
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