Clinical spectrum, outcome and impact of nephrectomy in critically-ill adult patients with emphysematous pyelonephritis: the PYELEMPHY observational retrospective multicenter Study
Authors' conclusion
EPN requiring ICU admission carries substantial mortality. Early nephrectomy may improve survival, without increasing long-term renal complications.
Study context
- Population
- Adults admitted with infectious emphysematous pyelonephritis to 48 French intensive care unit (ICUs), 2001–2021
- Participants
- 109 adults · 48 French ICUs
- Exposure
- Early nephrectomy vs no early nephrectomy
- Early nephrectomyn = 14
- Delayed nephrectomyn = 8
- Outcome
- 90-day mortality
- Follow-up
- Day 90
Methodological detailsnational, multicentre, propensity-weighted model
- National
- Multicentre
- Propensity-weighted model
Main finding
As reported in the abstract
Hazard ratio (95% CI)P value
Early nephrectomymultivariable analysis
0.18(0.04–0.90)
P = 0.037SAPS II (per point)independent predictor of increased 90-day mortality
1.08(1.05–1.12)
P < 0.001Per point, as printed
- Died by day 90 (vital status known for 105)
- 18
Observational data: associations, not effects.
Further findings
Major adverse kidney events (MAKE90) · day 90
| aOR (95% CI) | P value | ||
|---|---|---|---|
| Early nephrectomyTrend, not statistically significant · propensity-weighted model | 0.32 (0.10–1.02) | P = 0.054 | |
| 0.10.31310Adjusted odds ratio (log scale) |
- Major adverse kidney events (MAKE90) — MAKE90 overall
- 40%
ICU mortality
- ICU mortality
- 15% (n = 16)
Septic shock
- Septic shock
- 72%
Initial management with antibiotics and/or minimally invasive drainage
- Antibiotics and/or minimally invasive drainage
- 53%
- Subsequent nephrectomy after ICU discharge without nephrectomy (of 75)
- 4 (4%)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Clinical spectrum, outcome and impact of nephrectomy in critically-ill adult patients with emphysematous pyelonephritis: the PYELEMPHY observational retrospective multicenter Study. Ann Intensive Care. Published 21 May 2026. doi:10.
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