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Kidney Week

Abstract: FR-PO057

Clinical Usefulness of Contrast-Enhanced Computed Tomography in Patients with Nonobstructive Acute Pyelonephritis-Associated AKI

Session Information

  • AKI: Clinical Outcomes, Trials
    November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Sun, In O, Presbyterian Medical Center, Jeonju, Korea, Jeonju, Korea (the Republic of)
  • Oh, Ju hwan, Presbyterian Medical Center, Jeonju, Korea, Jeonju, Korea (the Republic of)
Background

The aim of this study is to investigate the clinical utility of contrast-enhanced computed tomography (CE-CT) in patient with
non-obstrcutive acute pyelonephritis (APN).

Methods

From 2007 to 2013, 537 APN patients who underwent a CE-CT scan within 24 hours after hospital admission were enrolled. We divided these patients into greater (50% or greater involvment, n=143) and lesser (less than 50% involvement, n=394) groupsbased on renal parenchymal involvement in CE-CT examination.We compared clinical characteristics between two groups and analyzed the clinical value of CE-CT scan asa reliable marker for predicting clinical severity and disease course in patient with non-obstructive APN.

Results

The mean age of these patients was 55.2±17.9 years and 93.9% were women.The mean estimated glomerular filtration rate was 70.6±25.5 mL/min/1.73m2. Compared with patients in lesser group, the patients in greater group had lower serum albumin levels (3.5 ± 0.5 vs 3.8± 0.6, p<0.01) and longer hosptal stay (10.1± 4.7 vs 8.8± 4.5, p<0.05). In addition, AKI (23.1% vs 11.4%, p<0.005) and bacteremia (36.4% vs 26.8%, p=0.02) were frequently developed in greater group, respectively. The overall incidence of AKI was 14.8%; of which 9.3%, 4.9% and 0.6% were classified as risk, injury and failure, respectively, according to RIFLE criteria.In a multivariate logistic regression analysis for predciting AKI, age, presence of diabetes mellitusand the presence of renal parenchymal involvement of greater than 50% in CE-CT were significant predictors of AKI.

Conclusion

The CE-CT scancould be useful to predict the clinical severity and course including AKI in non-obstructive APN patients with preserved renal function.