Binaut R, Glowacki F, Bridoux F, Mougenot B, Gobert P,
Vanhille P
Acute renal failure due toacute pyelonephritis: a reppraisal
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1369 1996
This report is a retrospective collection of cases of acute bacterial
pyelonephritis that resulted in acute renal failure. 46 such patients were
identified over a 15 year period. Their average age was 60 and 26% had
diabetes, half were alcoholics, 23% had a history of urinary tract
infection, and five patients had preexistent chronic renal failure (creat
2.0). Renal biopsy revealed acute tubular necrosis in 32%. 18 (39%)
patients required hemodialysis. Four patients remained on chronic
hemodialysis and 16 had a creatinine clearance <30 mL/min at follow up 18
months later. The only predictor of poor outcome identified in this study
was oliguria.
Comment: Over the years there have been several reports of acute
pyelonephritis causing ARF. For example, refer to the report by Jones
(Clinical Infectious Diseases 14:243-246, 1992). I doubt the
condition is
as rare as some have suggested, having seen an unequivocal case in a renal
transplant recipient last month and in an elderly woman last year (both
diagnoses made/confirmed by renal biopsy). (Mark S. Paller, M.D.,
University of Minnesota, Minneapolis)
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Am Soc Nephrol
ARF etiology :
Pyelonephritis