Kidney preservation protocol for management of emphysematous pyelonephritis: Treatment modalities and follow-up

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dc.contributor.authorEl-Nahas, A.
dc.contributor.authorShokeir, A.A
dc.contributor.authorEziyi, A.K
dc.contributor.authorBarakat, A.
dc.contributor.authorTijani, K.H.
dc.date.accessioned2019-11-27T09:09:13Z
dc.date.available2019-11-27T09:09:13Z
dc.date.issued2011
dc.descriptionStaff publicationsen_US
dc.description.abstractObjectives: To present treatments for kidney preservation in the management of emphysematous pyelonephritis (EPN), and to evaluate the functional outcome of preserved kidneys during the follow-up. Patients and methods: The computerized files of patients with EPN from 2000 to 2010 were reviewed. After initial resuscitation, ultrasonography-guided percutaneous tubes were placed for drainage of infected fluid and gas. A radio-isotopic renal scan was done after stabilization of the patients’ condition. Preservation of the affected kidney was attempted when the differential function was >10%. A renal isotopic scan was taken during the follow-up to evaluate renographic changes in preserved kidneys. Results: The study included 33 kidneys in 30 consecutive patients (mean age 51.7 years, SD 10.9). Kidney preservation was applicable for 23 kidneys (20 patients). Preservation methods included percutaneous nephrostomy for 12, percutaneous tube drain for two and conservative treatment for nine kidneys (six patients). Nephrectomy was performed for 10 kidneys (emergency in three and delayed in seven). The frequency of post-treatment septic shock after kidney preservation (10%) was significantly lower than after nephrectomy (20%, P = 0.005). The overall mortality rate was 7% (two patients). The follow-up was completed for 13 patients with 15 preserved kidneys for a mean duration of 21 months. During the follow-up, differential renographic clearance of the affected kidney was stable in 13 of 15 while two kidneys showed improvement. Conclusions: Kidney preservation should be the primary goal in the treatment of EPN when the differential renal clearance is >10%. It was associated with fewer complications than nephrectomy and the follow-up showed a favourable functional outcome of the preserved kidneys.en_US
dc.identifier.citationEl-Nahas A, Shokeir AA, Aziyi AK, Barakat A, Tijani KH. Kidney preservation protocol for management of emphysematous pyelonephritis: Treatment modalities and follow-up. Arab J Urol 2011;9:181-85en_US
dc.identifier.issn2090-598X
dc.identifier.otherdoi:10.1016/j.aju.2011.09.002
dc.identifier.urihttps://ir.unilag.edu.ng/handle/123456789/6995
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.ispartofseriesArab J Urol;Vol.9
dc.subjectemphysematous pyelonephritisen_US
dc.subjectobstructionen_US
dc.subjectinfectionen_US
dc.subjectdiabetes mellitusen_US
dc.subjectResearch Subject Categories::MEDICINE::Surgeryen_US
dc.titleKidney preservation protocol for management of emphysematous pyelonephritis: Treatment modalities and follow-upen_US
dc.typeArticleen_US
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