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논문분류	춘계학술대회 초록집
제목	Clinical usefulness of contrast-enhanced computed tomography in patients with nonobstructive acute pyelonephritis-associated acute kidney injury
저자	AYOUNG CHO, KWANG YOUNG LEE, IN O SUN, MI-SUK LEE
출판정보	2019; 2019(1):
키워드	acute kidney injury \| acute pyelonephritis \| computed tomography
초록	The aim of this study is to investigate the clinical utility of contrast-enhanced computed tomography (CE-CT) in patient with nonobstructive acute pyelonephritis (APN). From 2007 to 2013, 540 APN patients who underwent a CE-CT scan within 24 hours after hospital admission were enrolled. We divided these patients ingo greater (50% or greater involvement, n=141) and lesser (less than 50% involvement, n=399) groups based on renal parenchymal involvement in CE-CT examination. We compared clinical characteristics between two groups and analyzed the clinical value of CE-CT scan as a prognostic factor for predicting acute kidney injury (AKI) in patient with nonobstructive APN. The mean age of these patients was 55.2 ± 17.8 years and 93.7% were women. The mean estimated glomerular filtration rate was 70.3 ± 4.7 mL/min/1.73m2. Compared with patients in lesser group, the patients in greater goup had lower serum albumin levels (3.51 ± 0.50 vs 3.88 ± 0.63, p<0.01) and longer hospital stay (10.19 ± 4.73 vs 8.90 ± 4.48, p=0.004). In addition, AKI (22.0% vs 12.3%, p<0.005) and bacteremia (35.5% vs 27.1%, p=0.039) were frequently developed in greater group, respectively. The overall incidence of AKI was 14.2%, of which 8.7%, 4.9% and 0.6% were classified as risk, injury and failure, respectively, according to RIFLE criteria. In a mulivariate logistic regression analysis for predicting AKI, age, serum albumin, leukocyte and the presence of renal parenchymal involvement of greater than 50% were significant predictors of AKI. The CE-CT scan could be useful to predict the clinical severity and course including AKI in patients with nonobstructive APN.
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