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Related Concept Videos

Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such as Proteus,...
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations01:26

Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations

Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
Urinary Tract Calculi V: Nursing Management01:28

Urinary Tract Calculi V: Nursing Management

AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...

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Related Experiment Video

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Standardized Colon Ascendens Stent Peritonitis in Rats - a Simple, Feasible Animal Model to Induce Septic Acute Kidney Injury
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Development of a Predictive Nomogram for Sepsis in Patients with Urolithiasis-Related Obstructive Pyelonephritis.

Yi-Chun Tsai1, Yu-Hsuan Huang2, Kuang-Yu Niu2

  • 1Department of Nursing, Chang Gung University of Science and Technology, Taoyuan 333, Taiwan.

Medicina (Kaunas, Lithuania)
|July 27, 2024
PubMed
Summary

Patients with urolithiasis-related obstructive pyelonephritis (UROP) and diabetes mellitus (DM), higher shock index (SI), elevated C-reactive protein (CRP), and increased neutrophil-to-lymphocyte ratio (NLR) face higher sepsis risk.

Keywords:
nomogramsepsisuolithiasis-related obstructive pyelonephritis

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Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis
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Area of Science:

  • Urology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Urolithiasis-related obstructive pyelonephritis (UROP) poses a significant risk of sepsis, a life-threatening complication.
  • Early identification of sepsis risk factors in UROP patients is crucial for improving outcomes.

Purpose of the Study:

  • To identify independent risk factors for sepsis development in patients with UROP.
  • To develop and validate a predictive nomogram model for sepsis in UROP patients.

Main Methods:

  • Retrospective analysis of 148 UROP patients admitted between 2016 and 2021.
  • Sepsis defined by Sepsis-3 criteria; risk factors identified using LASSO and multivariable logistic regression.
  • A predictive nomogram was constructed and validated using the area under the receiver operating characteristic curve (AUC).

Main Results:

  • Sepsis occurred in 46 patients (31.1%).
  • Independent risk factors for sepsis included a history of diabetes mellitus (DM) (OR=4.24), elevated shock index (SI) (OR=1.55), C-reactive protein (CRP) (OR=1.08), and neutrophil-to-lymphocyte ratio (NLR) (OR=1.58).
  • The nomogram achieved an AUC of 0.890, indicating good predictive accuracy.

Conclusions:

  • DM, higher SI, elevated CRP, and increased NLR are significant predictors of sepsis in UROP patients.
  • The developed nomogram can aid clinicians in stratifying sepsis risk among UROP patients.
  • Prompt initiation of treatment for high-risk individuals is essential.