RE: Emphysematous pyelonephritis: is nephrectomy warranted?

We read with great interest the article “Emphysematous pyelonephritis: Is nephrectomy warranted?” by Alsharif M. et al .[1] This article highlights interesting updated in managing emphysematous pyelonephritis (EPN) from radical surgery to medical management. Similar finding was published earlier by...

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Main Authors: Kamarulzaman, Mohd Nazli, Che Mohamed, Siti Kamariah
Format: Article
Language:English
Published: Wolters Kluwer - Medknow Publications, Wolters Kluwer India Pvt. Ltd. 2016
Subjects:
Online Access:http://irep.iium.edu.my/50152/
http://irep.iium.edu.my/50152/2/letter_to_editor_urolann_2016.pdf
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author Kamarulzaman, Mohd Nazli
Che Mohamed, Siti Kamariah
author_facet Kamarulzaman, Mohd Nazli
Che Mohamed, Siti Kamariah
author_sort Kamarulzaman, Mohd Nazli
building IIUM Repository
collection Online Access
description We read with great interest the article “Emphysematous pyelonephritis: Is nephrectomy warranted?” by Alsharif M. et al .[1] This article highlights interesting updated in managing emphysematous pyelonephritis (EPN) from radical surgery to medical management. Similar finding was published earlier by Ubee SS et al. in their literature review. [2] They noted the trend towards medical management was begun since late 1980s. This change in management trend was associated with improve in mortality from 40-50% in 1970s to 13.5% recently. [2] It was similar in this paper which had the rate of 30% and 100% for overall mortality and radical nephrectomy rate respectively. This trend of management seems to be widely accepted all over the world. In our opinion, early nephrectomy had its own rule in managing EPN, especially in case where the renographic clearance is <10%.[3] The percentage of EPN patients undergone surgery will be markedly reduced with early detection and aggressive medical management. However, the comparison between medical management and early nephrectomy in term of mortality cannot be ascertained except similar group of EPN patient being subjected for each arm of treatment options. Patients with multiple co-morbidities and in sepsis certainly had higher mortality rate regardless of whatever treatment given.
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institution International Islamic University Malaysia
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language English
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publishDate 2016
publisher Wolters Kluwer - Medknow Publications, Wolters Kluwer India Pvt. Ltd.
recordtype eprints
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spelling iium-501522016-07-31T01:59:55Z http://irep.iium.edu.my/50152/ RE: Emphysematous pyelonephritis: is nephrectomy warranted? Kamarulzaman, Mohd Nazli Che Mohamed, Siti Kamariah RD Surgery We read with great interest the article “Emphysematous pyelonephritis: Is nephrectomy warranted?” by Alsharif M. et al .[1] This article highlights interesting updated in managing emphysematous pyelonephritis (EPN) from radical surgery to medical management. Similar finding was published earlier by Ubee SS et al. in their literature review. [2] They noted the trend towards medical management was begun since late 1980s. This change in management trend was associated with improve in mortality from 40-50% in 1970s to 13.5% recently. [2] It was similar in this paper which had the rate of 30% and 100% for overall mortality and radical nephrectomy rate respectively. This trend of management seems to be widely accepted all over the world. In our opinion, early nephrectomy had its own rule in managing EPN, especially in case where the renographic clearance is <10%.[3] The percentage of EPN patients undergone surgery will be markedly reduced with early detection and aggressive medical management. However, the comparison between medical management and early nephrectomy in term of mortality cannot be ascertained except similar group of EPN patient being subjected for each arm of treatment options. Patients with multiple co-morbidities and in sepsis certainly had higher mortality rate regardless of whatever treatment given. Wolters Kluwer - Medknow Publications, Wolters Kluwer India Pvt. Ltd. 2016-04 Article PeerReviewed application/pdf en http://irep.iium.edu.my/50152/2/letter_to_editor_urolann_2016.pdf Kamarulzaman, Mohd Nazli and Che Mohamed, Siti Kamariah (2016) RE: Emphysematous pyelonephritis: is nephrectomy warranted? Urology Annals, 8 (2). pp. 258-259. ISSN 0974-7796 E-ISSN 0974-7834 http://www.urologyannals.com/temp/UrolAnn82258-8062254_222342.pdf 10.4103/0974-7796.179236
spellingShingle RD Surgery
Kamarulzaman, Mohd Nazli
Che Mohamed, Siti Kamariah
RE: Emphysematous pyelonephritis: is nephrectomy warranted?
title RE: Emphysematous pyelonephritis: is nephrectomy warranted?
title_full RE: Emphysematous pyelonephritis: is nephrectomy warranted?
title_fullStr RE: Emphysematous pyelonephritis: is nephrectomy warranted?
title_full_unstemmed RE: Emphysematous pyelonephritis: is nephrectomy warranted?
title_short RE: Emphysematous pyelonephritis: is nephrectomy warranted?
title_sort re: emphysematous pyelonephritis: is nephrectomy warranted?
topic RD Surgery
url http://irep.iium.edu.my/50152/
http://irep.iium.edu.my/50152/
http://irep.iium.edu.my/50152/
http://irep.iium.edu.my/50152/2/letter_to_editor_urolann_2016.pdf