| Autor: |
Parrill AM; Department of Family Medicine, University of South Carolina School of Medicine, Seneca, South Carolina, USA. allisonmparrill@gmail.com., Tsiyer A; Department of Internal Medicine, Universal Health Services Southern California Medical Education Consortium, Temecula Valley Hospital, Temecula, California, USA., Fogel J; Department of Management, Marketing, and Entrepreneurship, Brooklyn College, Brooklyn, New York, USA., Gala D; American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten, Netherland Antilles., Politi K; Department of Emergency Medicine, Good Samaritan University Hospital, West Islip, New York, USA., Patel H; American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten, Netherland Antilles., Bhatt H; American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten, Netherland Antilles., Alvarez-Betancourt A; Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, USA., Smith A; Department of Urology, Northwell Health, New Hyde Park, New York, USA., Kim Z; Department of Nephrology, Nassau University Medical Center, East Meadow, New York, USA., Cadet B; Department of Nephrology, Nassau University Medical Center, East Meadow, New York, USA., Nalesnik J; Department of Urology, Kern Medical Center, Bakersfield, California, USA., Mahoney J; Department of Urology, University of the Ottawa, Ottawa Hospital, Ottawa, Ontario, Canada. |
| Abstrakt: |
Xanthogranulomatous Pyelonephritis (XGP) is a serious and rare inflammatory disease of unknown etiology. This systematic review analyzes XGP cases. We performed a literature search for "Pyelonephritis, Xanthogranulomatous." The primary composite outcome was recovery with post-surgery complications, partial recovery, death, or chronic kidney disease. The secondary outcome was any presentation or treatment complication. Predictor variables consisted of demographics, history, symptoms, and diagnosis/management. Among the 251 patients, the mean age was 36.1 years, and 57.4% were female. The most common symptom and finding were fever (55.0%) and renal stones (53.8%), respectively. There were 15.5% with the composite outcome. There were 51.0% with any presentation or treatment complication. Multivariate logistic regression analysis for the composite outcome showed that kidney of both/horseshoe (OR:3.86, 95% CI:1.01, 14.73, p = 0.048), dialysis required (OR:8.64, 95% CI:2.27, 32.94, p = 0.002), and operative treatment of nephrostomy or nephrostomy followed by nephrectomy (OR:4.57, 95% CI:1.58, 13.17, p = 0.01) were each significantly associated with increased odds. Fever (OR:3.04, 95% CI:1.63, 5.67, p <0.001) and renal stones (OR:2.55, 95% CI:1.35, 4.81, p = 0.004) were each significantly associated with increased odds for any presentation/treatment complication. In conclusion, XGP patients with involvement of both or horseshoe kidneys, dialysis requirements, or treatment of nephrostomy or nephrostomy followed by nephrectomy may require aggressive treatment to mitigate poor patient outcomes. |
