Renal Cortical Scarring in Acute Pyelonephritis

Tsugaya, Masayuki; Hirao, Noriaki; Sakagami, Hiroshi; Ohtaguro, Kazuo; Washida, Hiroto

doi:10.1111/j.1464-410x.1992.tb15521.x

Cited by 12 publications

(7 citation statements)

References 9 publications

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“…The most common radiologic CT finding of APN is a striated or wedge-shaped area of hypoperfusion or mass-like lesion after contrast injection [7,8]. Other uncommon radiologic findings such as perirenal fat infiltration, ureteral wall edema, renal abscess formation, pelvic ascites, portal edema, and renal scarring are also observed on CT scans [9,10]. …”

Section: Introductionmentioning

confidence: 99%

Relationship Between Uncommon Computed Tomography Findings and Clinical Aspects in Patients With Acute Pyelonephritis

Kim

Lee

et al. 2014

Korean J Urol

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PurposeComputed tomography (CT) has become popular in the diagnosis of acute pyelonephritis (APN) and its related complications in adults. The aim of this study was to investigate the relationship between uncommon CT findings and clinical and laboratory data in patients with APN.Materials and MethodsFrom July 2009 to July 2012, CT findings and clinical data were collected from 125 female patients with APN. The six uncommon CT findings (excluding a wedge-shaped area of hypoperfusion in the renal parenchyma) studied were perirenal fat infiltration, ureteral wall edema, renal abscess formation, pelvic ascites, periportal edema, and renal scarring. The clinical parameters analyzed were the age and body mass index of the patients as well as the degree and duration of fever. Laboratory parameters related to inflammation and infection included white blood cell count, C-reactive protein (CRP) level, erythrocyte sedimentation rate, pyuria, and bacteriuria.ResultsThe most common CT finding was perirenal fat infiltration (69 cases, 55%). A longer duration of fever, higher CRP level, and grade of pyuria were related with perirenal fat infiltration (p=0.010, p=0.003, and p=0.049, respectively). The CRP level was significantly higher in patients with renal abscess and ureteral wall edema (p=0.005 and p=0.015, respectively).ConclusionsThe uncommon CT findings that were related to aggravated clinical and laboratory parameters of APN patients were perirenal fat infiltration, ureteral wall edema, and renal abscess formation. The inflammatory reaction and tissue destruction may be more aggressive in patients with these CT findings.

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Section: Introductionmentioning

confidence: 99%

Relationship Between Uncommon Computed Tomography Findings and Clinical Aspects in Patients With Acute Pyelonephritis

Kim

Lee

et al. 2014

Korean J Urol

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“…The abnormal pattern of parenchymal enhancement may persist for several months [20,22]. Follow-up studies on some of these patients show that they develop scars -in up to 37-50 % of the cases described [16,22,23]. It is at present unclear what the frequency of scarring is following pyelonephritis and what its long-term significance for the patient is.…”

Section: Imaging When Acute Urinary Tract Infection Fails To Respond mentioning

confidence: 84%

“…Non-enhancing fluid collections within the abnormal areas of parenchyma indicate the development of microabscesses. The abnormal pattern of parenchymal enhancement may persist for several months [20,22]. Follow-up studies on some of these patients show that they develop scars -in up to 37-50 % of the cases described [16,22,23].…”

Section: Imaging When Acute Urinary Tract Infection Fails To Respond mentioning

confidence: 90%

The role of imaging in adult acute urinary tract infection

Webb

1997

Eur Radiol

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Imaging is required in only a minority of patients with urinary tract infection. Some patients who present with severe loin pain are imaged because ureteric colic is suspected. If urinary tract infection does not respond normally to antibiotics, imaging is undertaken to check for evidence of renal obstruction or sepsis. Finally, after the acute infection has been treated, imaging is required in some patients to check for factors pre-disposing to renal damage or to relapsing or recurrent infection. This review discusses the appropriate choice of imaging technique to use in each clinical situation and summarises the expected findings.

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“…Interest in the demonstration of parenchymal involvement is due to the postulate that renal scars could have a detrimental effect on renal function and play a role in the pathogenesis of secondary hypertension [5][6][7][8][9]. However, because pyelonephritis is typically a disease of the young, long-term data on the pathogenetic effect of pyelonephritic scars are lacking.…”

Section: Introductionmentioning

confidence: 97%