The clinical and imaging presentation of acute

BMC Nephrology

Francesco Porpiglia⁴  Andrea Veltri³  Mauro Felice Frascisco²  Agostino De Pascale³  Alberto Biglino⁶  Francesca Ragni⁴  Marilisa Biolcati⁵  Melania Serra²  Maria Chiara Deagostini¹  Valentina Consiglio¹  Giorgina Barbara Piccoli¹ 

[1] Nephrology; Department of Clinical and Biological Sciences ASOU san Luigi Gonzaga Regione Gonzole 10, Orbassano, University of Torino, Italy;Emergency Medicine; Department of Clinical and Biological Sciences ASOU san Luigi Gonzaga Regione Gonzole 10, Orbassano, University of Torino, Italy;Radiology; Department of Clinical and Biological Sciences ASOU san Luigi Gonzaga Regione Gonzole 10, Orbassano, University of Torino, Italy;Urology; Department of Clinical and Biological Sciences ASOU san Luigi Gonzaga Regione Gonzole 10, Orbassano, University of Torino, Italy;Materno Foetal Unit, sant'Anna Hospital, University of Torino, Italy;Infectious Diseases Department of Clinical and Biological Sciences, Ospedale di Asti, University of Torino, Italy

关键词: epidemiology;    kidney scars;    nuclear magnetic resonance;    computed tomography;    upper urinary tract infections;    Acute pyelonephritis;   

Others  :  1083215
DOI  :  10.1186/1471-2369-12-68

 received in 2011-04-11, accepted in 2011-12-15,  发布年份 2011

【 摘 要 】

Background

Acute pyelonephritis (APN) is differently defined according to imaging or clinical criteria. In adults information on the relationship between imaging and clinical data is lacking.

Our study was aimed at analysing the relationship between the clinical and imaging presentation of APN, defined according to imaging criteria (parenchymal involvement at MR or CT scan).

Methods

All consecutive patients hospitalized for "non-complicated" APN were considered (June 2005-December 2009). Clinical, biochemical and imaging data at hospitalization were analyzed by univariate and logistic regression analysis.

Results

There were 119 patients, all females, median age 32 years (15-72). At hospitalization, inflammatory markers were elevated (CRP median: 12.1 mg/dL, normal < 0.8). Incomplete presentations were frequent: fever was absent in 6.7%, pain in 17.8%, lower urinary tract symptoms in 52.9%. At CT or MR scan the lesions were bilateral in 12.6%, multiple in 79.8%; abscesses were present in 39.5%. Renal scars were found in 15.1%. Positive cultures were correlated with multiple foci (multivariate OR 4.2; CI 1.139-15.515). No other sign/symptom discriminated between small lesions, abscesses or multifocal involvement.

Conclusions

APN is a protean disease. In the absence of strict correlation with clinical or biochemical markers, imaging studies are required to assess the severity of kidney involvement.

【 授权许可】

   
2011 Piccoli et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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