Clinical Profile And Outcomes Of Patients With Emphysematous Pyelonephritis In A Tertiary Care Center
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2025
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| _version_ | 1866901185000112128 |
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| author | Dr Vivek Mahadeo Barekar |
| author_facet | Dr Vivek Mahadeo Barekar |
| contents | <div> <div> <p><strong>Background:</strong> Emphysematous pyelonephritis (EPN) is a life-threatening necrotizing infection of the kidney, predominantly affecting diabetic and obstructed urinary tracts. Despite advances in imaging and minimally invasive management, outcome predictors remain variably defined. This study evaluated the clinical profile, microbiological spectrum, management strategies, and outcomes of patients with EPN treated at a tertiary-care centre in western India.</p> <p><strong>Methods:</strong> This retrospective observational study included 30 consecutive patients with CT-confirmed EPN admitted between January 2022 and June 2025 at BJGMC and SGH, Pune. Demographic, clinical, laboratory, and microbiological data were analyzed. Radiologic severity was graded using the Huang and Tseng classification and correlated with outcomes. Statistical analysis employed chi-square, Kruskal–Wallis, and logistic regression tests, with p < 0.05 considered significant.</p> <p><strong>Results:</strong> The mean age was 58 ± 12 years; 70% were male. Diabetes mellitus (56.7%) and urinary obstruction or calculi (noted in 40%) were common risk factors. On CT, Class II–III disease accounted for 63.3%. <em>E. coli</em> (46.7%) and <em>Klebsiella pneumoniae</em> (26.7%) were the main isolates. PCD was performed in 36.7%, DJ stenting in 33.3%, and nephrectomy in 6.7%. The mean hospital stay was 14.2 ± 5.8 days. ICU admission and dialysis were required in 36.7% each.<br>Overall mortality was 6.7%, and renal recovery occurred in 83.3% of survivors. Increasing CT class correlated with greater clinical severity but was not statistically significant (p > 0.05). Logistic regression identified no independent mortality predictors, though age, shock on admission, and renal dysfunction showed adverse trends.</p> <p><strong>Conclusion:</strong> EPN in this cohort predominantly affected diabetic patients and was most often caused by <em>E. coli</em> and <em>Klebsiella</em>. Early diagnosis, glycemic control, and minimally invasive drainage achieved low mortality and high renal salvage. Radiologic severity correlated clinically but did not independently predict outcomes. Prompt multidisciplinary management remains key to improving prognosis.</p> </div> </div> <div></div> |
| format | Recurso digital |
| id | zenodo_https___doi_org_10_5281_zenodo_17577533 |
| institution | Zenodo |
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| publishDate | 2025 |
| publisher | Zenodo |
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| spellingShingle | Clinical Profile And Outcomes Of Patients With Emphysematous Pyelonephritis In A Tertiary Care Center Dr Vivek Mahadeo Barekar <div> <div> <p><strong>Background:</strong> Emphysematous pyelonephritis (EPN) is a life-threatening necrotizing infection of the kidney, predominantly affecting diabetic and obstructed urinary tracts. Despite advances in imaging and minimally invasive management, outcome predictors remain variably defined. This study evaluated the clinical profile, microbiological spectrum, management strategies, and outcomes of patients with EPN treated at a tertiary-care centre in western India.</p> <p><strong>Methods:</strong> This retrospective observational study included 30 consecutive patients with CT-confirmed EPN admitted between January 2022 and June 2025 at BJGMC and SGH, Pune. Demographic, clinical, laboratory, and microbiological data were analyzed. Radiologic severity was graded using the Huang and Tseng classification and correlated with outcomes. Statistical analysis employed chi-square, Kruskal–Wallis, and logistic regression tests, with p < 0.05 considered significant.</p> <p><strong>Results:</strong> The mean age was 58 ± 12 years; 70% were male. Diabetes mellitus (56.7%) and urinary obstruction or calculi (noted in 40%) were common risk factors. On CT, Class II–III disease accounted for 63.3%. <em>E. coli</em> (46.7%) and <em>Klebsiella pneumoniae</em> (26.7%) were the main isolates. PCD was performed in 36.7%, DJ stenting in 33.3%, and nephrectomy in 6.7%. The mean hospital stay was 14.2 ± 5.8 days. ICU admission and dialysis were required in 36.7% each.<br>Overall mortality was 6.7%, and renal recovery occurred in 83.3% of survivors. Increasing CT class correlated with greater clinical severity but was not statistically significant (p > 0.05). Logistic regression identified no independent mortality predictors, though age, shock on admission, and renal dysfunction showed adverse trends.</p> <p><strong>Conclusion:</strong> EPN in this cohort predominantly affected diabetic patients and was most often caused by <em>E. coli</em> and <em>Klebsiella</em>. Early diagnosis, glycemic control, and minimally invasive drainage achieved low mortality and high renal salvage. Radiologic severity correlated clinically but did not independently predict outcomes. Prompt multidisciplinary management remains key to improving prognosis.</p> </div> </div> <div></div> |
| title | Clinical Profile And Outcomes Of Patients With Emphysematous Pyelonephritis In A Tertiary Care Center |
| url | https://doi.org/10.5281/zenodo.17577533 |