Factors Associated To Intensive Care Admission And Mortality In Patients With Emphysematous Pyelonephritis

NCT ID: NCT04326517

Last Updated: 2020-04-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

65 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-04-01

Study Completion Date

2021-04-01

Brief Summary

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Emphysematous pyelonephritis is a lifethreatening necrotizing infection of the kidney characterized by accumulation of gas in the renal parenchyma and within the surrounding tissues. The aim of the study is to report the outcome of the management of this condition at the investigators institution and to determine the microbiological characteristics, antibiotic resistance patterns, and to analyze factors predicting mortality and intensive care unit admission.

Detailed Description

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The investigators are planning to perform a retrospective study analyzing cases of emphysematous pyelonephritis from a single tertiary care institution in the north of Mexico in the period of 2011-2021. The diagnosis of emphysematous pyelonephritis is confirmed by computed tomography. Demographic, clinical, biochemical, therapeutic management, and outcomes will be collected. Variables will be analyzed to determine factors associated with admission to intensive care unit and mortality. Urine cultures will be analyzed and drug resistance profile will be determined using microdilution plate. Clinical and demographic characteristics will be analyzed using Chi square test for categorical variables, and T-test for numerical variables. Statistical significance is set at p\<0.05. Statistical analysis will be performed with the SPSS software version 20.0.

Conditions

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Emphysematous Pyelonephritis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

OTHER

Study Groups

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Emphysematous pyelonephritis

This is a single-group cohort study. A sub-classification will be used in order to differentiate patients that did not require intensive care, the ones who admitted to intensive care and mortality.

Nephrectomy

Intervention Type PROCEDURE

Different therapeutic options are described in literature for emphysematous pyelonephritis. In our center, medical treatment (no invasive procedure), ureteral stent (endourologic procedure), percutaneous drainage (minimally invasive procedure), and nephrectomy are the therapeutic options for this disease.

Interventions

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Nephrectomy

Different therapeutic options are described in literature for emphysematous pyelonephritis. In our center, medical treatment (no invasive procedure), ureteral stent (endourologic procedure), percutaneous drainage (minimally invasive procedure), and nephrectomy are the therapeutic options for this disease.

Intervention Type PROCEDURE

Other Intervention Names

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ureteral stent percutaneous drainage medical treatment

Eligibility Criteria

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Inclusion Criteria

* Emphysematous pyelonephritis confirmed with computed tomography
* Systemic inflammatory response
* Urinary tract infection symptoms
* Complete medical records
* Both genders included
* \>18 years old

Exclusion Criteria

* Other infectious causes
* Asymptomatic bacteriuria
* Incomplete medical records
* Endourologic procedure 3 months before recruitment
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Universitario Dr. Jose E. Gonzalez

OTHER

Sponsor Role lead

Responsible Party

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Adrián Gutiérrez González

Head of Urology Department

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Adrián Gutiérrez-González, PhD

Role: PRINCIPAL_INVESTIGATOR

Universidad Autónoma de Nuevo León

Locations

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Hospital Universitario "Dr. José Eleuterio González"

Monterrey, Outside U.S./Canada, Mexico

Site Status RECRUITING

Countries

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Mexico

Central Contacts

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Jose I Robles-Torres, M.D.

Role: CONTACT

+526531191450

Marco A Ocaña-Munguía, M.D.

Role: CONTACT

+528113112108

Facility Contacts

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Jose I Robles-Torres, M.D.

Role: primary

+526531191450

Marco A Ocaña-Munguía, M.D.

Role: backup

+528113112108

References

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Michaeli J, Mogle P, Perlberg S, Heiman S, Caine M. Emphysematous pyelonephritis. J Urol. 1984 Feb;131(2):203-8. doi: 10.1016/s0022-5347(17)50309-2. No abstract available.

Reference Type RESULT
PMID: 6366247 (View on PubMed)

Pontin AR, Barnes RD, Joffe J, Kahn D. Emphysematous pyelonephritis in diabetic patients. Br J Urol. 1995 Jan;75(1):71-4. doi: 10.1111/j.1464-410x.1995.tb07237.x.

Reference Type RESULT
PMID: 7850302 (View on PubMed)

Ubee SS, McGlynn L, Fordham M. Emphysematous pyelonephritis. BJU Int. 2011 May;107(9):1474-8. doi: 10.1111/j.1464-410X.2010.09660.x. Epub 2010 Sep 14.

Reference Type RESULT
PMID: 20840327 (View on PubMed)

Kumar A, Turney JH, Brownjohn AM, McMahon MJ. Unusual bacterial infections of the urinary tract in diabetic patients--rare but frequently lethal. Nephrol Dial Transplant. 2001 May;16(5):1062-5. doi: 10.1093/ndt/16.5.1062. No abstract available.

Reference Type RESULT
PMID: 11328918 (View on PubMed)

Huang JJ, Tseng CC. Emphysematous pyelonephritis: clinicoradiological classification, management, prognosis, and pathogenesis. Arch Intern Med. 2000 Mar 27;160(6):797-805. doi: 10.1001/archinte.160.6.797.

Reference Type RESULT
PMID: 10737279 (View on PubMed)

Falagas ME, Alexiou VG, Giannopoulou KP, Siempos II. Risk factors for mortality in patients with emphysematous pyelonephritis: a meta-analysis. J Urol. 2007 Sep;178(3 Pt 1):880-5; quiz 1129. doi: 10.1016/j.juro.2007.05.017. Epub 2007 Jul 16.

Reference Type RESULT
PMID: 17631348 (View on PubMed)

Huang JJ, Chen KW, Ruaan MK. Mixed acid fermentation of glucose as a mechanism of emphysematous urinary tract infection. J Urol. 1991 Jul;146(1):148-51. doi: 10.1016/s0022-5347(17)37736-4.

Reference Type RESULT
PMID: 2056576 (View on PubMed)

Somani BK, Nabi G, Thorpe P, Hussey J, Cook J, N'Dow J; ABACUS Research Group. Is percutaneous drainage the new gold standard in the management of emphysematous pyelonephritis? Evidence from a systematic review. J Urol. 2008 May;179(5):1844-9. doi: 10.1016/j.juro.2008.01.019. Epub 2008 Mar 19.

Reference Type RESULT
PMID: 18353396 (View on PubMed)

Other Identifiers

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UR 18-00008

Identifier Type: -

Identifier Source: org_study_id

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