ABSTRACT
Introduction: Emphysematous pyelonephritis (EPN) is thenecrotizing infection of renal parenchyma with the presence ofgas in the renal parenchyma, collecting system or perinephrictissue. EPN is an uncommon life-threatening conditionprecipitated mainly by poorly controlled blood sugars andurinary tract obstruction. Current research aimed to study theclinical and biochemical factors determining the prognosis ofpatients with acute pyelonephritis.Material and Methods: The study was conducted from June2016 to June 2017 in Tirunelveli Medical college among 50patients of pyelonephritis with classical clinical features. Allbasic blood investigations were done and radiological imaginglike USG, KUB and CT abdomen was done for more detailingand followed up.Results: Females above 50 years of age were more frequentlyaffected by pyelonephritis. Altered sensorium, hypotension,HbA1c values > .5 and thrombocytopenia were noticed ina significant number of cases. Prognosis of cases with thesecomorbid conditions was found to be low. 6 patients died inthis study due to poor glycaemic control, thrombocytopeniaand renal dysfunction.Conclusion: Long-standing and uncontrolled type II diabetesmellitus, hypotension, renal dysfunction, thrombocytopeniaand radiological features of the high-risk disease are allassociated with a poor prognosis.
ABSTRACT
Introduction: Diabetic kidney disease (DKD) is one of the primary causes of end-stage renal disease. Early diagnosis is veryimportant in preventing the development of DKD. Urinary albumin excretion rate and glomerular filtration rate (GFR) are widelyaccepted as criteria for the diagnosis and clinical grading of DKD, and microalbuminuria has been recommended as the firstclinical sign of DKD.Aim: The aim of the study was to study the existence of normoalbuminuric diabetic nephropathy in type 1 diabeticsMaterials and Methods: This prospective study was conducted in type 1 diabetic by documenting low c-peptide level. Fastinglipid profile was done in these patients. Serum electrolytes such as potassium, sodium, magnesium, and uric acid were measured.The characteristic profile of patients with duration of diabetes and low GFR was analyzed with respect to the duration of diabetes,serum magnesium level, hypertension, retinopathy, and renal biopsy features.Results: In 95 patients, of 17 patients with renal biopsy-proven normoalbuminuric diabetic nephropathy, 11 patients (65%) hadserum magnesium of <2 mg/dl, and only six patients had serum magnesium of >2 mg/dl. Among the 17 patients, five patients(29%) had hypertension and eight patients (47%) had diabetic retinopathy changes.Conclusion: There exists an entity – normoalbuminuric diabetic nephropathy in type 1 diabetic patients. The incidence ofnormoalbuminuric diabetic nephropathy increases with duration of diabetes.