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.