Abstract:
PURPOSE:To analyse the incidence and management of emphysematous pyelonephritis (EPN) in North West London and examine factors that influence immediate and 6-month outcomes with the aim of guiding future management. METHODS:This work analyses EPN cases from the London North West Healthcare NHS Trust from October 2006 to July 2015 (population ≈ 850,000). Diagnosis and stage were confirmed by computed tomography (CT). Demographic, clinical, biochemical and microbiological characteristics were assessed. Treatment modalities were medical management, minimally invasive management (MIM) and surgical. Immediate and 6-month outcomes were analysed. RESULTS:Thirteen cases were identified (f = 8, m = 5) from 5525 CT scans. EPN occurred in patients with diabetes mellitus (n = 11, 84.6%), hypertension (n = 10, 76.9%) or urinary tract calculi (n = 7, 53.85%). Unilateral EPN occurred predominantly (n = 11, 84.6%); 46.1% (n = 6) were class 1 or 2 and 53.8% (n = 7) class 3 or 4. Escherichia coli was most commonly cultured (n = 5, 38.46%). All patients received antibiotics, and ten cases required MIM. Two patients had a delayed nephrectomy, both survived. Mortality was 15.4% (n = 2, grade 1 and 3a), both died acutely post-MIM, neither underwent emergency nephrectomy. At 6 months, eight patients had ongoing renal impairment. No specific poor prognostic factors were identifiable. CONCLUSIONS:Patients with low-grade EPN may also have a high mortality rate. In the two cases who died, earlier consideration for nephrectomy may have been prudent. It may be beneficial to have a low threshold for prompt emergency nephrectomy in severe cases and where MIM treatment has failed. We suggest a management algorithm to guide clinicians and minimise mortality.
journal_name
Int Urol Nephroljournal_title
International urology and nephrologyauthors
Boakes E,Batura Ddoi
10.1007/s11255-017-1706-8subject
Has Abstractpub_date
2017-12-01 00:00:00pages
2127-2136issue
12eissn
0301-1623issn
1573-2584pii
10.1007/s11255-017-1706-8journal_volume
49pub_type
杂志文章abstract:OBJECTIVE:To evaluate all possible risk factors that can cause impairment of overall renal function in patients with unilateral ureteral calculus and a normal contralateral kidney. METHODS:This is a prospective study of 90 patients who presented to our institute complaining of renal colic secondary to unilateral urete...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-015-0986-0
更新日期:2015-07-01 00:00:00
abstract::Biomedical informatics in Health (BIH) is the discipline in charge of capturing, handling and using information in health and biomedicine in order to improve the processes involved with assistance and management. Informatic nephrology has appeared as a product of the combination between conventional nephrology with BI...
journal_title:International urology and nephrology
pub_type: 杂志文章,评审
doi:10.1007/s11255-012-0282-1
更新日期:2013-08-01 00:00:00
abstract::It is well known that some antibiotics are particularly nephrotoxic. In the present study we investigated kidney function and AAP excretion (as an index of nephrotoxicity) in patients with urinary tract infection treated with CAZ or CTX plus TOB. The main cause of infection was E. coli in both treated groups. After 10...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02550604
更新日期:1988-01-01 00:00:00
abstract::Administration of intravenous iron to supplement erythropoiesis stimulating agents (ESAs) has become a common practice in the management of anemia in patients with end-stage renal disease. Randomized clinical trials of anemia correction in this population have shown more adverse outcomes in CKD and ESRD patients assig...
journal_title:International urology and nephrology
pub_type: 杂志文章,评审
doi:10.1007/s11255-011-0028-5
更新日期:2012-04-01 00:00:00
abstract::Measuring calcium (Ca) absorption, Ca balance and Ca level in serum,feces and urine during HK (hypokinesia) with and without Ca loading, the aim of this study was to disclose if prolonged HK could reduce Ca deposition more with or without Ca load contributing to greater Ca imbalance. Studies were conducted during 30-d...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-004-0929-7
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:The purpose was to evaluate the efficacy of the addition of short-term desmopressin to enuretic alarm in patients with primary monosymptomatic nocturnal enuresis (PMNE). MATERIALS AND METHODS:A total of 58 [corrected] children with PMNE were included in this study. The patients were randomized into two group...
journal_title:International urology and nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11255-008-9355-6
更新日期:2008-01-01 00:00:00
abstract::We report a 40-year-old lady who presented with severe headaches, persistent microscopic haematuria and hypertension requiring anti-hypertensive medication. Investigations for secondary hypertension were all normal except for a CT scan. This indicated a complex cystic lesion, measuring 2.4 x 5 x 10 cms , arising from ...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-006-9085-6
更新日期:2007-01-01 00:00:00
abstract::Immunoglobulin A nephropathy (IgAN) is an immune-complex-mediated glomerulonephritis characterized by the presence of IgA deposits in mesangial and paramesangial regions. However, the exact mechanism involved in IgA deposition is still unknown. TGF-β(1) that mediates the progression of IgAN is well established as a cr...
journal_title:International urology and nephrology
pub_type: 杂志文章,评审
doi:10.1007/s11255-009-9682-2
更新日期:2010-09-01 00:00:00
abstract:PURPOSE:We have recently reported lipopolysaccharide (LPS) pretreatment attenuated renal ischemia/reperfusion injury (IRI), but the exact mechanism remains to be well elucidated. It was reported that heat shock protein (Hsp) 27 was up-regulated after administration of LPS, but whether a direct link existed between Hsp2...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-017-1735-3
更新日期:2018-03-01 00:00:00
abstract::To remove multiple calyceal stones percutaneously is not a simple task. During the act of dilating the pierced channel the stones are apt to drift away towards other parts of the renal cavitary system. For avoidance we recommend the use of Pyeloform, a bicomponent synthetic compound in which chemical reaction between ...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:Some studies have found that prostate cancer (PCa) screening provides little or no change in PCa-related mortality during the 7-10 years following diagnoses. However, most men are diagnosed with PCa at low-stage disease and die of unrelated causes during this period. Men diagnosed at stage IV are at much high...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-010-9799-3
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:The adequate control of phosphataemia is of major importance in end-stage renal disease patients on maintenance dialysis. Recently, lanthanum carbonate (LC) has been added to the phosphate binder armamentarium. To our knowledge, no studies have yet evaluated the usefulness of this drug in uncontrolled hyperp...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-010-9860-2
更新日期:2012-02-01 00:00:00
abstract::In 21 men suffering from acute or chronic epididymitis who underwent scrotal surgical exploration, diagnostic microbiological studies consisting in cultures of the epididymal tissues and mid-stream urine specimens, as well as examination of the urethral swabs--before and after prostatic massage--were performed. Labora...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02549519
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the relationship between the expression of E-cadherin (E-CD) and tumor recurrence and progression in patients with high-grade stage T1 urothelial carcinoma of bladder. METHODS:Fifty-two patients who had primary high-grade stage T1 urothelial carcinoma were enrolled to the study. The pathologic sp...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-006-9159-5
更新日期:2007-01-01 00:00:00
abstract::A modified method of retropubic radical prostatectomy was devised. The root of the penis was compressed and the bilateral internal iliac arteries were clamped before the dissection of the prostate. The urethra was divided at the junction of the prostate and bladder so that the bladder stump thus created has the size o...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02549537
更新日期:1992-01-01 00:00:00
abstract::Considering the aging dialysis population of today, increasing our knowledge about the nature, diagnosis and the treatment of bone mineral density (BMD) problems in end-stage renal disease (ESRD) patients deserves more attention. Osteoporosis is basicly defined as a decrease in bone mass. Large epidemiological studies...
journal_title:International urology and nephrology
pub_type: 杂志文章,评审
doi:10.1007/s11255-006-9109-2
更新日期:2007-01-01 00:00:00
abstract:PURPOSE:To compare the performance of prostate-specific antigen (PSA) density in the diagnosis of prostate cancer in obese and non-obese Chinese men. METHODS:The results of transrectal ultrasound-guided (TRUS) prostate biopsies of Chinese men with PSA <20 ng/mL were reviewed. Parameters including age, body mass index ...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-014-0826-7
更新日期:2014-12-01 00:00:00
abstract:PURPOSE:Pulmonary embolism with viable tumor cells developed after surgery for renal cell carcinoma may metastasize to lung. We investigated the incidence and fate of newly developed pulmonary embolism after surgery for renal cell carcinoma with vena cava thrombus. METHODS:Among 4549 renal cell carcinoma patients trea...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-017-1583-1
更新日期:2017-07-01 00:00:00
abstract:PURPOSE:The venous thromboembolic events (VTE) incidence is high in nephrotic syndrome (NS). We aimed to assess prospectively the risk of VTE in a large cohort of NS patients and to identify predictive factors for VTE, especially haemostasis-related parameters. METHODS:This is the prospective, observational study cond...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-013-0574-0
更新日期:2014-04-01 00:00:00
abstract::Accurate knowledge about the morphology and degree of infiltration of a bladder tumor is an essential prerequisite to correctly plan, and forecast the results of, the treatment of these tumors. Among the radiological investigations double contrast cystography is superior to excretory cystogram or conventional cystogra...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02082014
更新日期:1977-01-01 00:00:00
abstract::The hemodynamic response to ephedrine sulphate were studied in a patient on maintenance hemodialysis therapy with chronic renal failure due to renal amyloidosis. The evaluation (including cardiac catheterization studies) and estimation of responses to Valsalva maneuvers before and after ephedrine administration docume...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02082096
更新日期:1976-01-01 00:00:00
abstract:OBJECTIVES:To examine symptomatology and microbiology of infected lymphocele (LC) post-robotic-assisted radical prostatectomy and pelvic lymph node dissection (PLND) and to assess for potential predictors for LC fluid culture positivity. Secondly, to provide general recommendations about use of select antimicrobial the...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-017-1599-6
更新日期:2017-07-01 00:00:00
abstract:PURPOSE:To evaluate the efficacy and safety of the calcineurin inhibitors (CNIs) cyclosporine (CyA) and tacrolimus (TAC) in the induction and maintenance treatment of lupus nephritis (LN). METHODS:The Cochrane library, PubMed, Embase, and CENTRAL databases were searched and reviewed up to February 2015. Randomized con...
journal_title:International urology and nephrology
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s11255-015-1201-z
更新日期:2016-05-01 00:00:00
abstract::Twenty patients on home peritoneal dialysis were studied during two years. The patients dialysed 4--5 times a week, using an average of 78 l dialysis fluid. The dialysis equipment used was either a simplified delivery system or a fully automatic dialysis machine. Despite clinical improvement, serum urea and serum crea...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02081965
更新日期:1979-01-01 00:00:00
abstract::Posttransplant lymphoproliferative disorders (PTLD) are commonly caused by Ebstein-Barr Virus infection. The role of hepatitis C virus (HCV) in the genesis of lymphomas has been recognized recently. We report a HCV infected renal transplant recipient who developed PTLD 11 months after transplantation. Reduction of imm...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-006-0050-1
更新日期:2006-01-01 00:00:00
abstract::The aim of this study was to investigate the hormonal and hemodynamic changes during percutaneous nephrolithotomy (PCNL) procedure. Twenty-one patients between 15-65 years of age were included in the study. Invasive blood pressure and heart rate were monitored during PCNL. Serum sodium, potassium, BUN and creatinine l...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1023/a:1017527126481
更新日期:2001-01-01 00:00:00
abstract:PURPOSE:Hypovitaminosis D is common in chronic kidney disease (CKD) and is associated with endothelial dysfunction and cardiovascular events. This study aimed to investigate the effects of vitamin D supplementation on endothelial dysfunction in non-dialysis CKD patients. MATERIALS AND METHODS:Seventy-one non-dialysis ...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-018-1829-6
更新日期:2018-05-01 00:00:00
abstract::Ganglioneuroblastoma is a common type of tumor in children, but is rarely seen in adults. We present here a case of adrenal ganglioneuroblastoma in a 59-year old man. ...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-004-0851-z
更新日期:2004-01-01 00:00:00
abstract:PURPOSE:A region of chromosome 22 which includes APOL1 and MYH9 genes was recently identified as a risk locus for non-diabetic forms of kidney disease, including idiopathic and HIV-associated focal segmental glomerular sclerosis and kidney disease clinically attributed to hypertension among African Americans. The purpo...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-012-0263-4
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVES:Progression of the cell cycle is regulated by the interactions of cyclins, cyclin dependent kinases (CDKs) and CDK inhibitors (CDKIs). p27 is a member of the universal cyclin-dependent kinase inhibitor family. The level of p27 protein expression decreases during tumor development and progression in some epit...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1023/b:urol.0000020301.39181.03
更新日期:2003-01-01 00:00:00