Clinical outcomes of patients with emphysematous pyelonephritis according to type of treatment and classification of severity by Huang-Tseng.

Abstract

Background: Emphysematous pyelonephritis (EP) is an acute, necrotizing infection of the renal parenchyma and surrounding tissues, characterized by the presence of gas in the renal parenchyma and adjacent structures.

Objective: To analyze the outcomes of patients with EP, treated at the General Hospital of Mexico.

Material and methods: An observational, analytical study was carried out, between January 2018 and December 2023. Clinical data, urine cultures and tomographic findings (severity classification by Huang-Tseng) were collected.

Results: 51 clinical records were included, 64.7% women, and average age 52 years. 70% lived with diabetes type 2 and 60% had uro-renal lithiasis, about 30% had severe EP. 80% of cases were resolved with treatment based on antibiotics and drainage by interventional radiology. There was an average of 10 days of hospitalization and fatality of 5.9%; the severity of the acute kidney injury showed an association with mortality (p ≤ 0.05).

Conclusions: The combined use of antibiotics with drainage of the abscess through interventional radiology was associated with a decrease in morbidity and mortality in these cases.