Acute pyelonephritis: a cause of acute renal failure?

Kooman, Jeroen P.; Barendregt, Jos N. M.; Sande, Frank M. van der; Suylen, Robert-Jan van

doi:10.1016/s0300-2977(00)00063-2

Cited by 11 publications

(8 citation statements)

References 11 publications

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“…Only a few studies investigated the risk factors for AKI in UTI patients. Previous studies indicated that hypovolemia, hypotension, sepsis, the use of nephrotoxic drugs, contrast media and urinary obstruction were AKI risk factors in UTI patients [ 23 , 24 ]. Our study showed that UTI patients with DM, upper UTI, afebrile or septic shock during hospitalization and impaired baseline renal function were at higher risk for development of AKI.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Development of Acute Kidney Injury in Patients with Urinary Tract Infection

et al. 2015

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Acute kidney injury (AKI) is associated with high morbidity and mortality. Urinary tract infection (UTI) may be associated with sepsis or septic shock, and cause sudden deterioration of renal function. This study investigated the clinical characteristics and change of renal function to identify the risk factors for development of AKI in UTI patients. This retrospective study was conducted in a tertiary referral center. From January 2006 to January 2013, a total of 790 UTI patients necessitating hospital admission were included for final analysis. Their demographic and clinical characteristics and comorbidities were collected and compared. Multivariate logistic regression analysis was performed to evaluate the risk factors for AKI in UTI patients. There were 97 (12.3%) patients developing AKI during hospitalization. Multivariate logistic regression analysis showed that patients with older age (OR 1.02, 95% CI 1.00–1.04, P = 0.04), diabetes mellitus (DM) (OR 2.23, 95% CI 1.35–3.68, P = 0002), upper UTI (OR 2.63, 95% CI 1.53–4.56, P = 0001), afebrile during hospitalization (OR 1.71, 95% CI 1.04–2.83, P = 0036) and lower baseline eGFR [baseline eGFR 45–59 mL/min/1.73 m2 (OR 2.12, 95% CI 1.12–4.04, P = 0.022), baseline eGFR 30-44 mL/min/1.73 m2 (OR 4.44, 95% CI 2.30–8.60 P < 0.001) baseline eGFR < 30 mL/min/1.73 m2 (OR 4.72, 95% CI 2.13–10.45, P <0.001), respectively] were associated with increased risk for development of AKI. were associated with increased risk for development of AKI. Physicians should pay attention to UTI patients at risk of AKI (advancing age, DM, upper UTI, afebrile, and impaired baseline renal function).

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Development of Acute Kidney Injury in Patients with Urinary Tract Infection

et al. 2015

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“…Acute renal failure in non‐transplant patients due to acute uncomplicated pyelonephritis is an uncommon event (24), although renal dysfunction due to pyelonephritis in compromised patients may be more common. Acute renal failure secondary to pyelonephritis has been reported in the elderly (25), HIV‐infected patients (26) and in patients with a single kidney (27).…”

Section: Introductionmentioning

confidence: 99%

Renal Allograft Injury Is Associated with Urinary Tract Infection Caused by Escherichia coli Bearing Adherence Factors

Rice¹,

Peng²,

Kuo³

et al. 2006

American Journal of Transplantation

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Urinary tract infections are the most common infection in renal transplant patients and Escherichia coli (E. coli) is the most common clinical isolate. Although acute allograft injury (AAI) secondary to urinary tract infection (UTI) has been reported, the incidence of AAI associated with UTI, the virulence factors express by uropathic E. coli and whether virulence factors are associated with renal allograft outcome have not been described. We collected E. coli from our renal transplant patients with UTI, determined O:H serotypes, P and Dr fimbriae expression and the clinical presentation and allograft function during the UTI and post-UTI period. Pyelonephritis occurred in 40% of our patients, 82% of which had AAI (>20% increase in SCr). Sixtytwo percent of E. coli isolates that expressed P fimbriae were associated with AAI, whereas only 29% that did not express P fimbriae had AAI (p = 0.03). The pattern of P fimbriae and O serotypes differed from reported isolates, as the P fimbriae PapG class II and the O25 serotype were the most common. Dr adhesin was expressed on 7 isolates, including 2 of 3 with urosepsis. We propose a unique pattern of uropathogenic serotypes and adherence factors contribute to acute allograft injury in renal transplant patients with UTI.

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“…Prompt diagnosis with antibiotic coverage had a favorable effect on the prognosis of pyelonephritis-induced acute kidney injury in most of the patients. However, three died from pyelonephritis and two required hemodialysis [9][10][11][12][13][14][15][16][17][18][19]. A severe form of pyelonephritis, emphysematous pyelonephritis, is characterized by gas within the renal parenchyma and/or the collecting ducts.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury from pyelonephritis in an elderly man: case report

et al. 2011

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Pyelonephritis is rarely considered in the differential diagnosis of acute kidney injury. Acute non-obstructed bacterial pyelonephritis is an infrequent and rarely considered cause of rapidly progressive acute kidney injury. A diagnostic challenge thus develops as it is difficult to clinically differentiate acute kidney injury secondary to ischemic or toxic acute tubular necrosis or papillary necrosis versus acute interstitial nephritis secondary to drugs or infectious pyelonephritis. We describe a case of acute kidney injury due to suppurative pyelonephritis in an elderly immunocompetent man who presented with dysuria, vomiting, and fever and later found to have histologic and radiologic proven pyelonephritis as the cause of acute kidney injury in the absence of hypotension, nephrotoxic agents, non-steroidal analgesics, immunosuppression, urinary tract obstruction, or other structural anomalies. The patient was managed with antimicrobial therapy, hemodialysis, and a short course of corticosteroids.

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Acute pyelonephritis: a cause of acute renal failure?

Cited by 11 publications

References 11 publications

Risk Factors for Development of Acute Kidney Injury in Patients with Urinary Tract Infection

Risk Factors for Development of Acute Kidney Injury in Patients with Urinary Tract Infection

Renal Allograft Injury Is Associated with Urinary Tract Infection Caused by Escherichia coli Bearing Adherence Factors

Acute kidney injury from pyelonephritis in an elderly man: case report

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