Pyonephrosis natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Harsh Vardhan Chawla, M.B.B.S.[2]
Overview
Pyonephrosis is a urological emergency. If left untreated, it can rapidly lead to septic shock and death. Upon early treatment, the prognosis of pyonephrosis is good. There is a significant improvement in the condition within 24-48 hours after drainage of the pus. Structural changes like scarring, fistulas, and abscess formations may occur if the treatment of the cause of obstruction is delayed.
Natural history
- Pyonephrosis is a urological emergency. If left untreated, it can rapidly lead to septic shock and death.[1]
- Abscess formation in or around the renal tissue is also possible.
Complications
- Long-term complications of pyonephrosis are rare if prompt medical care is received.
- If not diagnosed and treated promptly, pyonephrosis can lead to septic shock causing rapid deterioration of the patient's condition.
- Structural changes like scarring, fistulas, and abscess formations may occur if the treatment of the cause of obstruction is delayed. Additionally, permanent damage to the kidneys can develop which may require nephrectomy.[2]
Prognosis
Upon early treatment, the prognosis of pyonephrosis is good. There is a significant improvement in the condition within 24-48 hours after drainage of the pus.[3][4]
References
- ↑ Florido C, Herren JL, Pandhi MB, Niemeyer MM (2020). "Emergent Percutaneous Nephrostomy for Pyonephrosis: A Primer for the On-Call Interventional Radiologist". Semin Intervent Radiol. 37 (1): 74–84. doi:10.1055/s-0039-3401842. PMC 7056339 Check
|pmc=value (help). PMID 32139973 Check|pmid=value (help). - ↑ Colemen BG, Arger PH, Mulhern CB, Pollack HM, Banner MP (1981). "Pyonephrosis: sonography in the diagnosis and management". AJR Am J Roentgenol. 137 (5): 939–43. doi:10.2214/ajr.137.5.939. PMID 6975018.
- ↑ Wagenlehner FME, Bjerklund Johansen TE, Cai T, Koves B, Kranz J, Pilatz A; et al. (2020). "Epidemiology, definition and treatment of complicated urinary tract infections". Nat Rev Urol. 17 (10): 586–600. doi:10.1038/s41585-020-0362-4. PMID 32843751 Check
|pmid=value (help). - ↑ Thornton RH, Covey AM (2016). "Urinary Drainage Procedures in Interventional Radiology". Tech Vasc Interv Radiol. 19 (3): 170–81. doi:10.1053/j.tvir.2016.06.002. PMID 27641451.