The Usefulness of the Interpretation of Initial Plain CT Scan in Hospitalized Patients with Acute Pyelonephritis without Obstructive Uropathy

Takehiro Sejima; Shuichi Morizane; Katsuya Hikita; Masashi Honda; Atsushi Takenaka

doi:doi:10.11648/j.ijidt.20190401.12

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The Usefulness of the Interpretation of Initial Plain CT Scan in Hospitalized Patients with Acute Pyelonephritis without Obstructive Uropathy

Takehiro Sejima, Shuichi Morizane, Katsuya Hikita, Masashi Honda, Atsushi Takenaka

Published in International Journal of Infectious Diseases and Therapy (Volume 4, Issue 1)

Received: 8 February 2019 Accepted: 9 April 2019 Published: 15 May 2019

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Abstract

To investigate the association between plain computed tomography (CT) findings and clinical characteristics and to characterize the potential factors affecting the disease outcome in hospitalized patients with acute pyelonephritis (APN) without obstructive uropathy, we reviewed our clinical database retrospectively. Five plain CT scan abnormal kidney findings of perirenal fat stranding, thickening of perirenal fasciae, kidney enlargement, dilation of renal pelvis, and abnormal density of renal parenchyma were elucidated in 70 patients with APN without obstructive uropathy who were hospitalized. The association between CT scan findings and clinical characteristics were analyzed. Logistic regression analysis was performed to characterize the potential factors that affect the period until the patient was afebrile using various clinical factors and five defined CT scan findings. Perirenal fat stranding and dilation of renal pelvis were significantly frequent in females and patients with diabetes mellitus. Serum inflammation markers were significantly deteriorated in patients with perirenal fat stranding, thickening of perirenal fasciae and kidney enlargement compared to patients with normal findings. An age-adjusted Charlson comorbidity index ≥ 5 and low serum albumin values were significantly associated with a prolonged febrile period. In conclusion, although abnormal plain CT scan findings at diagnosis are associated with some clinical characteristics, the patient’s intrinsic factors are more useful for predicting the disease outcome in hospitalized patients with APN without obstructive uropathy.

Published in	International Journal of Infectious Diseases and Therapy (Volume 4, Issue 1)
DOI	10.11648/j.ijidt.20190401.12
Page(s)	7-12
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Computed Tomography, Hospitalized Patient, Kidney, Pyelonephritis

References

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[2]	Lim SK, Ng FC. Acute pyelonephritis and renal abscesses in adults—correlating clinical parameters with radiological (computer tomography) severity. Ann Acad Med Singapore. 2011; 40: 407-413.
[3]	Expert Panel on Urologic Imaging (2012) ACR Appropriateness Criteria Acute Pyelonephritis. Available at: https://acsearch.acr.org/docs/69489/Narrative/
[4]	Oh SJ, Je BK, Lee SH, et al. Comparison of computed tomography findings between bacteremic and non-bacteremic acute pyelonephritis due to Escherichia coli. World J Radiol. 2016; 8: 403-409.
[5]	Yuh BI, Cohan RH, Francis IR, et al. Comparison of nephrographic with excretory phase helical computed tomography for detecting and characterizing renal masses. Can Assoc Radiol J. 2000; 51: 170-176.
[6]	Taniguchi LS, Torres US, Souza SM, et al. Are the unenhanced and excretory CT phases necessary for the evaluation of acute pyelonephritis? Acta Radiol. 2017; 58: 634-640.
[7]	Kim JS, Lee S, Lee KW, et al. Relationship between uncommon computed tomography findings and clinical aspects in patients with acute pyelonephritis. Korean J Urol. 2014; 55: 482-486.
[8]	Ramakrishnan K, Scheid DC. Diagnosis and management of acute pyelonephritis in adults. Am Fam Physician. 2005; 71: 933-942.
[9]	Tseng CC, Wu JJ, Wang MC, et al. Host and bacterial virulence factors predisposing to emphysematous pyelonephritis. Am J Kidney Dis. 2005; 46: 432-439.
[10]	Scholes D, Hooton TM, Roberts PL, et al. Risk factors associated with acute pyelonephritis in healthy women. Ann Intern Med. 2005; 142: 20-27.
[11]	Kim SH, Kim YW, Lee HJ. Serious acute pyelonephritis: a predictive score for evaluation of deterioration of treatment based on clinical and radiologic findings using CT. Acta Radiol. 2012; 53: 233-238.
[12]	Pertel PE, Haverstock D. Risk factors for a poor outcome after therapy for acute pyelonephritis. BJU Int. 2006; 98: 141-147.
[13]	Efstathiou SP, Pefanis AV, Tsioulos DI, et al. Acute pyelonephritis in adults: prediction of mortality and failure of treatment. Arch Intern Med. 2003; 163: 1206-1212.

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APA Style

Takehiro Sejima, Shuichi Morizane, Katsuya Hikita, Masashi Honda, Atsushi Takenaka. (2019). The Usefulness of the Interpretation of Initial Plain CT Scan in Hospitalized Patients with Acute Pyelonephritis without Obstructive Uropathy. International Journal of Infectious Diseases and Therapy, 4(1), 7-12. https://doi.org/10.11648/j.ijidt.20190401.12

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ACS Style

Takehiro Sejima; Shuichi Morizane; Katsuya Hikita; Masashi Honda; Atsushi Takenaka. The Usefulness of the Interpretation of Initial Plain CT Scan in Hospitalized Patients with Acute Pyelonephritis without Obstructive Uropathy. Int. J. Infect. Dis. Ther. 2019, 4(1), 7-12. doi: 10.11648/j.ijidt.20190401.12

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AMA Style

Takehiro Sejima, Shuichi Morizane, Katsuya Hikita, Masashi Honda, Atsushi Takenaka. The Usefulness of the Interpretation of Initial Plain CT Scan in Hospitalized Patients with Acute Pyelonephritis without Obstructive Uropathy. Int J Infect Dis Ther. 2019;4(1):7-12. doi: 10.11648/j.ijidt.20190401.12

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@article{10.11648/j.ijidt.20190401.12,
  author = {Takehiro Sejima and Shuichi Morizane and Katsuya Hikita and Masashi Honda and Atsushi Takenaka},
  title = {The Usefulness of the Interpretation of Initial Plain CT Scan in Hospitalized Patients with Acute Pyelonephritis without Obstructive Uropathy},
  journal = {International Journal of Infectious Diseases and Therapy},
  volume = {4},
  number = {1},
  pages = {7-12},
  doi = {10.11648/j.ijidt.20190401.12},
  url = {https://doi.org/10.11648/j.ijidt.20190401.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20190401.12},
  abstract = {To investigate the association between plain computed tomography (CT) findings and clinical characteristics and to characterize the potential factors affecting the disease outcome in hospitalized patients with acute pyelonephritis (APN) without obstructive uropathy, we reviewed our clinical database retrospectively. Five plain CT scan abnormal kidney findings of perirenal fat stranding, thickening of perirenal fasciae, kidney enlargement, dilation of renal pelvis, and abnormal density of renal parenchyma were elucidated in 70 patients with APN without obstructive uropathy who were hospitalized. The association between CT scan findings and clinical characteristics were analyzed. Logistic regression analysis was performed to characterize the potential factors that affect the period until the patient was afebrile using various clinical factors and five defined CT scan findings. Perirenal fat stranding and dilation of renal pelvis were significantly frequent in females and patients with diabetes mellitus. Serum inflammation markers were significantly deteriorated in patients with perirenal fat stranding, thickening of perirenal fasciae and kidney enlargement compared to patients with normal findings. An age-adjusted Charlson comorbidity index ≥ 5 and low serum albumin values were significantly associated with a prolonged febrile period. In conclusion, although abnormal plain CT scan findings at diagnosis are associated with some clinical characteristics, the patient’s intrinsic factors are more useful for predicting the disease outcome in hospitalized patients with APN without obstructive uropathy.},
 year = {2019}
}

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TY  - JOUR
T1  - The Usefulness of the Interpretation of Initial Plain CT Scan in Hospitalized Patients with Acute Pyelonephritis without Obstructive Uropathy
AU  - Takehiro Sejima
AU  - Shuichi Morizane
AU  - Katsuya Hikita
AU  - Masashi Honda
AU  - Atsushi Takenaka
Y1  - 2019/05/15
PY  - 2019
N1  - https://doi.org/10.11648/j.ijidt.20190401.12
DO  - 10.11648/j.ijidt.20190401.12
T2  - International Journal of Infectious Diseases and Therapy
JF  - International Journal of Infectious Diseases and Therapy
JO  - International Journal of Infectious Diseases and Therapy
SP  - 7
EP  - 12
PB  - Science Publishing Group
SN  - 2578-966X
UR  - https://doi.org/10.11648/j.ijidt.20190401.12
AB  - To investigate the association between plain computed tomography (CT) findings and clinical characteristics and to characterize the potential factors affecting the disease outcome in hospitalized patients with acute pyelonephritis (APN) without obstructive uropathy, we reviewed our clinical database retrospectively. Five plain CT scan abnormal kidney findings of perirenal fat stranding, thickening of perirenal fasciae, kidney enlargement, dilation of renal pelvis, and abnormal density of renal parenchyma were elucidated in 70 patients with APN without obstructive uropathy who were hospitalized. The association between CT scan findings and clinical characteristics were analyzed. Logistic regression analysis was performed to characterize the potential factors that affect the period until the patient was afebrile using various clinical factors and five defined CT scan findings. Perirenal fat stranding and dilation of renal pelvis were significantly frequent in females and patients with diabetes mellitus. Serum inflammation markers were significantly deteriorated in patients with perirenal fat stranding, thickening of perirenal fasciae and kidney enlargement compared to patients with normal findings. An age-adjusted Charlson comorbidity index ≥ 5 and low serum albumin values were significantly associated with a prolonged febrile period. In conclusion, although abnormal plain CT scan findings at diagnosis are associated with some clinical characteristics, the patient’s intrinsic factors are more useful for predicting the disease outcome in hospitalized patients with APN without obstructive uropathy.
VL  - 4
IS  - 1
ER  -

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Author Information

Takehiro Sejima

Department of Urology, Matsue City Hospital, Matsue, Japan
Shuichi Morizane

Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan
Katsuya Hikita

Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan
Masashi Honda

Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan
Atsushi Takenaka

Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan

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APA Style

Takehiro Sejima, Shuichi Morizane, Katsuya Hikita, Masashi Honda, Atsushi Takenaka. (2019). The Usefulness of the Interpretation of Initial Plain CT Scan in Hospitalized Patients with Acute Pyelonephritis without Obstructive Uropathy. International Journal of Infectious Diseases and Therapy, 4(1), 7-12. https://doi.org/10.11648/j.ijidt.20190401.12

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ACS Style

Takehiro Sejima; Shuichi Morizane; Katsuya Hikita; Masashi Honda; Atsushi Takenaka. The Usefulness of the Interpretation of Initial Plain CT Scan in Hospitalized Patients with Acute Pyelonephritis without Obstructive Uropathy. Int. J. Infect. Dis. Ther. 2019, 4(1), 7-12. doi: 10.11648/j.ijidt.20190401.12

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AMA Style

Takehiro Sejima, Shuichi Morizane, Katsuya Hikita, Masashi Honda, Atsushi Takenaka. The Usefulness of the Interpretation of Initial Plain CT Scan in Hospitalized Patients with Acute Pyelonephritis without Obstructive Uropathy. Int J Infect Dis Ther. 2019;4(1):7-12. doi: 10.11648/j.ijidt.20190401.12

Copy | Download

@article{10.11648/j.ijidt.20190401.12,
  author = {Takehiro Sejima and Shuichi Morizane and Katsuya Hikita and Masashi Honda and Atsushi Takenaka},
  title = {The Usefulness of the Interpretation of Initial Plain CT Scan in Hospitalized Patients with Acute Pyelonephritis without Obstructive Uropathy},
  journal = {International Journal of Infectious Diseases and Therapy},
  volume = {4},
  number = {1},
  pages = {7-12},
  doi = {10.11648/j.ijidt.20190401.12},
  url = {https://doi.org/10.11648/j.ijidt.20190401.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20190401.12},
  abstract = {To investigate the association between plain computed tomography (CT) findings and clinical characteristics and to characterize the potential factors affecting the disease outcome in hospitalized patients with acute pyelonephritis (APN) without obstructive uropathy, we reviewed our clinical database retrospectively. Five plain CT scan abnormal kidney findings of perirenal fat stranding, thickening of perirenal fasciae, kidney enlargement, dilation of renal pelvis, and abnormal density of renal parenchyma were elucidated in 70 patients with APN without obstructive uropathy who were hospitalized. The association between CT scan findings and clinical characteristics were analyzed. Logistic regression analysis was performed to characterize the potential factors that affect the period until the patient was afebrile using various clinical factors and five defined CT scan findings. Perirenal fat stranding and dilation of renal pelvis were significantly frequent in females and patients with diabetes mellitus. Serum inflammation markers were significantly deteriorated in patients with perirenal fat stranding, thickening of perirenal fasciae and kidney enlargement compared to patients with normal findings. An age-adjusted Charlson comorbidity index ≥ 5 and low serum albumin values were significantly associated with a prolonged febrile period. In conclusion, although abnormal plain CT scan findings at diagnosis are associated with some clinical characteristics, the patient’s intrinsic factors are more useful for predicting the disease outcome in hospitalized patients with APN without obstructive uropathy.},
 year = {2019}
}

Copy | Download

TY  - JOUR
T1  - The Usefulness of the Interpretation of Initial Plain CT Scan in Hospitalized Patients with Acute Pyelonephritis without Obstructive Uropathy
AU  - Takehiro Sejima
AU  - Shuichi Morizane
AU  - Katsuya Hikita
AU  - Masashi Honda
AU  - Atsushi Takenaka
Y1  - 2019/05/15
PY  - 2019
N1  - https://doi.org/10.11648/j.ijidt.20190401.12
DO  - 10.11648/j.ijidt.20190401.12
T2  - International Journal of Infectious Diseases and Therapy
JF  - International Journal of Infectious Diseases and Therapy
JO  - International Journal of Infectious Diseases and Therapy
SP  - 7
EP  - 12
PB  - Science Publishing Group
SN  - 2578-966X
UR  - https://doi.org/10.11648/j.ijidt.20190401.12
AB  - To investigate the association between plain computed tomography (CT) findings and clinical characteristics and to characterize the potential factors affecting the disease outcome in hospitalized patients with acute pyelonephritis (APN) without obstructive uropathy, we reviewed our clinical database retrospectively. Five plain CT scan abnormal kidney findings of perirenal fat stranding, thickening of perirenal fasciae, kidney enlargement, dilation of renal pelvis, and abnormal density of renal parenchyma were elucidated in 70 patients with APN without obstructive uropathy who were hospitalized. The association between CT scan findings and clinical characteristics were analyzed. Logistic regression analysis was performed to characterize the potential factors that affect the period until the patient was afebrile using various clinical factors and five defined CT scan findings. Perirenal fat stranding and dilation of renal pelvis were significantly frequent in females and patients with diabetes mellitus. Serum inflammation markers were significantly deteriorated in patients with perirenal fat stranding, thickening of perirenal fasciae and kidney enlargement compared to patients with normal findings. An age-adjusted Charlson comorbidity index ≥ 5 and low serum albumin values were significantly associated with a prolonged febrile period. In conclusion, although abnormal plain CT scan findings at diagnosis are associated with some clinical characteristics, the patient’s intrinsic factors are more useful for predicting the disease outcome in hospitalized patients with APN without obstructive uropathy.
VL  - 4
IS  - 1
ER  -

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