ArticleWorld journal of urology2025
Emergency nephrectomy in surgical pyelonephritis: outcomes and predictors of conservative management failure.
Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSurgical pyelonephritis (SP) encompasses severe upper urinary tract infections, including pyonephrosis, renal and perinephric abscesses, and emphysematous pyelonephritis. The 2024 EAU Guidelines classify these as complicated UTIs requiring early antibiotic therapy, hemodynamic stabilization, and prompt source control. This study aimed to reassess the role of emergency nephrectomy (EN) in SP management and to identify predictors of conservative management (CM) failure.
methodsWe conducted a retrospective, single-center study including patients treated for SP at Caen University Hospital, France, between January 2011 and December 2022.
resultsEighty-eight patients were included: 10 underwent primary EN, and 78 received CM, of whom 9 (11.5%) later required secondary nephrectomy (SN) due to CM failure. Renal abscesses (RA) were the most frequent indication for EN, followed by emphysematous pyelonephritis. Diabetes was significantly more prevalent in EN patients (p < 0.001). Urinary tract obstruction was observed in 30.0% of EN patients versus 82.1% of those initially treated conservatively (p = 0.001). Initial EN patients had higher severe morbidity rates than CM patients (50.0% vs. 29.5%, p = 0.04), although similar to SN patients (66.7% vs. 50.0%, p = 0.07). A high ASA score, chronic kidney disease (CKD), and smoking were associated with an increased risk of CM failure.
conclusionsSurgical pyelonephritis should be managed stepwise, favoring conservative approaches when possible. Early identification of patients at risk of failure is crucial, and timely escalation to nephrectomy may improve outcomes. Biomarkers and standardized reassessment protocols may support better risk stratification.
Indexed as
Identifiers
40968182What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.