Obstructive pyelonephritis in intensive care units: A retrospective multicenter study
Authors' conclusion
Obstructive pyelonephritis is a severe condition leading to organ failure and significant in-hospital mortality.
Study context
- Population
- Patients admitted to intensive care unit (ICU) (8 ICUs) for obstructive pyelonephritis over a 10-year period
- Participants
- 483 patients
- Outcome
- In-hospital mortality
Main finding
As reported in the abstract
Factors associated with in-hospital mortality (multivariate analysis)
Odds ratio (95 % CI)P value
Need for vasopressors
3.27(1.33–8.06)
P = 0.01Mechanical ventilation
2.49(1.35–4.59)
P = 0.004Lactate levels (per 1 mmol/l increase)
1.18(1.06–1.31)
P = 0.004Tumor-related obstruction
4.78(2.24–10.17)
P < 0.001Stent obstruction
3.38(1.44–7.93)
P = 0.005Per 1 mmol/l increase, as printed
Observational data: associations, not effects.
Further findings
Delayed urinary drainage (>12 h)
- Associated with mortality only in patients receiving vasopressors
Disease severity at admission
%
- Norepinephrine infusion
- 70
- Invasive mechanical ventilation
- 23
Microbiology
- Escherichia coli in urine
- 63 %
- Positive blood cultures
- two-thirds
- Extended-spectrum beta-lactamase-producing bacteria, n (%)
- 53 (11 %)
Timing of urinary drainage
%
- Before ICU admission
- 43
- < 6 h
- 28
- > 6 h
- 29
- Double-J stenting
- 71
Original publication
Obstructive pyelonephritis in intensive care units: A retrospective multicenter study. J Crit Care. Published 12 November 2025. doi:10.
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