Journal Article

Long-Term Follow-Up of Women Hospitalized for Acute Pyelonephritis

Raul Raz, Waheeb Sakran, Bibiana Chazan, Raul Colodner and Calvin Kunin

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 37, issue 8, pages 1014-1020
Published in print October 2003 | ISSN: 1058-4838
Published online October 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/377737
Long-Term Follow-Up of Women Hospitalized for Acute Pyelonephritis

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Long-term outcome of acute pyelonephritis (AP) in adults is unknown. We evaluated the frequency of renal damage 10–20 years after hospitalization for AP in adult women and the utility of technetium Tc 99m–labeled dimercaptosuccinic acid (Tc 99m–DMSA) scanning for detection of renal scars; 63 of 203 women hospitalized with AP during 1982–1992 were included in the study. Tc 99m–DMSA scanning detected renal scarring in 29 women (46%). Multivariate analysis showed that pregnancy and hypoalbuminemia (albumin level, <3.2 g/dL) at hospitalization were independent risk factors for subsequent development of renal scars. At follow-up, hypertension was observed in approximately one-fifth of patients, regardless of renal scarring status. Four women with scars had a glomerular filtration rate of ⩽75 mL/min; none of them developed severe renal impairment. In conclusion, the risk of developing renal scarring after AP in adult women is high. However, clinically relevant renal damage is rare 10–20 years after AP. Tc 99m–DMSA scanning is useful for detecting renal scars in adults but is not routinely needed in practice.

Journal Article.  3815 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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