Emphysematous pyelonephritis: a 5-year experience with 13 patients

Area of Science:

• Nephrology
• Infectious Diseases
• Diabetology

Background:

• Emphysematous pyelonephritis is a rare, life-threatening necrotizing infection of the kidney characterized by gas production.
• This condition is often associated with diabetes mellitus.
• Prompt diagnosis and aggressive management are crucial for patient survival.

Purpose of the Study:

• To identify cases of emphysematous pyelonephritis within a large diabetic patient cohort.
• To analyze the management strategies and outcomes for patients with this severe renal infection.

Main Methods:

• Retrospective review of 8,105 admissions to a diabetes service over 5 years.
• Identification of 13 cases of emphysematous pyelonephritis.
• Analysis of patient management including fluids, antibiotics, and surgical intervention (nephrectomy).

Main Results:

• Thirteen cases of emphysematous pyelonephritis were identified in 8,105 diabetic admissions.
• Patients were treated aggressively with intravenous fluids, antibiotics, and immediate nephrectomy.
• A high mortality rate of 40-50% was observed, primarily due to sudden septic complications.

Conclusions:

• Emphysematous pyelonephritis is a severe complication in diabetic patients requiring aggressive management.
• Despite intensive treatment, the mortality rate remains high, emphasizing the critical nature of this infection.
• Sudden septic complications are the main driver of mortality in these patients.