Fate of Emphysematous Pyelonephritis: A Single Center Study

Abstract

Background: Emphysematous Pyelonephritis (EPN) is a Urological emergency. It is a gas forming infection of the renalparenchyma and also involves the perirenal fat. It affects persons having Diabetes Mellitusspecifically females.Objectives: To present clinical features, and compare abnormal laboratory investigations among poor and good outcome inpatients affected by emphysematous pyelonephritis.Materials and methods: This retrospective study was conducted in Institute of Kidney Diseases Hayatabad Peshawar on recordsof 50 patients affected by EPN. Patients having age from 35 to 85 years, clinical feature of upper urinary tract infections, and gasaccumulation in renal parenchyma seen on computed tomography (CT) scan were included in the study. Age, sex, control ofglucose status and abnormal laboratory investigations were recorded. Outcome was measured as poor or good. Data analysiswas done in SPSS version 22.Results: The mean age was 63.1±11.48 years and 62% were females. The clinical features in patients with EPN was fever (n=37,74%) Flank, abdomen, or back pain (n=34, 68%). Urine analysis showed that pyuria was common (n=35, 70%) followed by severeproteinuria (n=31, 62%). Macrohematuria was found in 19(38%), thrombocytopenia in 24(48%) and leukocytosis in 28(56%)patients. In 35(70%) patients HbA1C was > 8% of which 6(12%) died (P=.021). In 32(64%) the outcome was good.Conclusion: Emphysematous Pyelonephritis affects females more than males. Most common abnormal laboratory findings areleukocytosis, thrombocytopenia and HbAIC > 8%. EPN is a fatal disease so quick management is required.Keywords: Emphysematous Pyelonephritis, Diabetes Mellitus, Pyuria, Proteinuria, Macrohematuria.