GENDER BASED COMPARISON OF CLINICAL, LABORATORY AND RENAL FUNCTION PARAMETERS IN DIABETIC PATIENTS WITH ACUTE PYELONEPHRITIS

Dr. Shailesh C. Trivedi; Dr. Vijay M. Katekhaye

Volume : V, Issue : X, October - 2016

GENDER BASED COMPARISON OF CLINICAL, LABORATORY AND RENAL FUNCTION PARAMETERS IN DIABETIC PATIENTS WITH ACUTE PYELONEPHRITIS

Dr. Shailesh C. Trivedi, Dr. Vijay M. Katekhaye

Abstract :

Introduction Diabetes mellitus (DM) is important risk factor for poor outcomes in acute pyelonephritis (APN). Gender based differentiation of APN in terms of clinical manifestations and treatment outcomes defined by laboratory and renal function changes remains to be explored. Objective: To compare clinical manifestations and assess treatment efficacy by laboratory and renal function parameters in diabetic males and females with APN Materials and Methods: In a retrospective analysis, data of diabetic patients with APN was analysed. Clinical manifestations were compared in two genders. Treatment efficacy was compared in two genders as assessed by changes in laboratory parameters like pyuria, haematuria, total leucocyte count, C–reactive protein, and renal function with changes in serum creatinine and estimated glomerular filtration rate. Results: In 39 patients, 23 (58.9%) were females and 16 (41.1%) were males. No differences in two genders for clinical presentation were seen except for flank pain being significant in females than males (34.8% Vs 6.3%, p=0.038). Hospital stay (p=0.062) and duration of intravenous antibiotics (p=0.170) did not differ in two genders. Cefaperazone–sulbactam was the most used antibiotic in males (93.8%) and females (100.0%). After a mean follow–up of 15.5�4.63 days, treatment was associated with significant improvement in haematuria (p<0.0001), leucocyte counts (p<0.0001), CRP (p<0.0001), serum creatinine (p=0.002) and eGFR (p=0.035) only in females but not in males. Rise of serum creatinine from baseline was seen in 10 (25.6%) cases (7 males and 3 females) with 4 males having 30% or more rise of creatinine levels. Conclusion: Despite similar clinical presentation, improvements were significant in females than males. Renal function changes in APN may be frequent in males. This gender–based difference in treatment outcome and impact of renal function to treatment response require detailed evaluation in a prospective, long–term, clinical trial.