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신 및 신주위 농양: 지난 10년간의 단일기관 경험

Renal and Perinephric Abscesses: Ten Years Experience at a Single Center

대한비뇨기과학회지 2008년 49권 10호 p.923 ~ 930
성병주 ( Sung Byung-Ju ) - 고신대학교 의과대학 비뇨기과학교실

이상돈 ( Lee Sang-Don ) - 부산대학교 의과대학 비뇨기과학교실
정재민 ( Chung Jae-Min ) - 고신대학교 의과대학 비뇨기과학교실
최성 ( Choi Seong ) - 고신대학교 의과대학 비뇨기과학교실
류현열 ( Rhew Hyun-Yul ) - 고신대학교 의과대학 비뇨기과학교실

Abstract


Purpose: We analyzed the clinical experiences of patients with renal, perinephric, and mixed abscesses during the last 10 years in a single center.

Materials and Methods: We reviewed the medical records of 33 patients with renal, perinephric, and mixed abscesses treated at our hospital between January 1998 and March 2008. The medical records, including predisposing conditions, clinical manifestations, physical examination, laboratory and radiologic findings, duration of hospitalization, types of uropathogens, time to clinical improvement, time to laboratory improvement, treatment, and clinical outcomes, were retrospectively analyzed.

Results: Renal, perinephric and mixed abscesses occurred in 22(66.7%), 4(12.1%), and 7(21.2%) patients. The most common predisposing conditions were diabetes mellitus(39.4%) and liver disease(27.3%). Flank pain (57.6%) and fever(54.5%) were the most common symptoms. Urine and blood cultures were positive in 23.3 and 19.2% of patients, respectively. The most common isolated uropathogen in the urine, blood, and purulent cultures was E. coli. The time to clinical and laboratory improvement was not significantly different between the patients with renal, perinephric, and mixed abscesses. Patients with renal, perinephric, and mixed abscesses received antibiotic therapy only in 59.1, 50.0, and 42.9% of cases, respectively. Similarly, patients with renal, perinephric, and mixed abscesses underwent percutaneous or surgical drainage in 22.7, 50.0, and 14.3% of cases, respectively. Patients required a nephrectomy in 18.2 and 42.9% of renal and mixed abscess cases, respectively. Most patients were cured(54.5%) or improved(42.4%) at the time of discharge from the hospital.

Conclusions: We suggest that renal, perinephric, and mixed abscesses are successfully managed by proper medical or interventional treatment. However, the cases suspicious for renal cancer or with non-functioning kidneys must be evaluated carefully for nephrectomy.

키워드

Abscess;Kidney;Treatment
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