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Emphysematous pyelonephritis in diabetic patients
A R Pontin1, R D Barnes, J Joffe
1Department of Urology, Groote Schuur Hospital, South Africa.
British Journal of Urology
|January 1, 1995
Summary
Emphysematous pyelonephritis (EPN) is a severe kidney infection causing gas production, predominantly affecting diabetic women. Prompt resuscitation and emergency nephrectomy are crucial for managing this life-threatening condition.
Area of Science:
- Nephrology
- Infectious Diseases
- Diabetology
Background:
- Emphysematous pyelonephritis (EPN) is a rare but severe necrotizing infection of the kidney.
- It is characterized by the presence of gas within the renal parenchyma.
- EPN predominantly affects diabetic patients, often associated with urinary tract infections.
Purpose of the Study:
- To elucidate the clinico-pathological characteristics of patients diagnosed with emphysematous pyelonephritis.
- To identify key demographic and clinical features associated with EPN.
- To evaluate the clinical presentation and management outcomes in EPN patients.
Main Methods:
- Retrospective review of medical records for 22 patients diagnosed with EPN.
- Analysis of patient demographics, diabetes status (insulin-dependent vs. non-insulin-dependent), clinical presentation, and diagnostic findings.
- Documentation of treatment strategies, including resuscitation and surgical intervention (nephrectomy).
Main Results:
- EPN was observed predominantly in female diabetic patients, often without ureteric obstruction.
- Patients presented with symptoms of urinary sepsis, severe illness, dehydration, and ketoacidosis.
- Radiological evidence of gas in the kidney confirmed the diagnosis; 18 patients underwent emergency nephrectomy.
Conclusions:
- Emphysematous pyelonephritis is an uncommon, life-threatening renal infection.
- The condition is marked by the formation of intraparenchymal gas.
- Aggressive resuscitation combined with emergency nephrectomy is considered the optimal treatment approach for EPN.