Korean J Urogenit Tract Infect Inflamm.  2015 Apr;10(1):41-48. 10.14777/kjutii.2015.10.1.41.

Effects of Diabetes Mellitus and HbA1c on Treatment Prognosis in Uncomplicated Acute Pyelonephritis

Affiliations
  • 1Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. tigerhj@dreamwiz.com

Abstract

PURPOSE
We investigated potential difference in the clinical features of hospitalized female acute pyelonephritis (APN) patients with and without diabetes mellitus (DM). The additional purpose of the study was to determine whether HbA1c has a role in predicting clinical outcome in terms of morbidity compared with those considered to have normal glycemic control in female APN patients with DM.
MATERIALS AND METHODS
Among the female patients who received inpatients care due to APN from January 2011 to December 2013, 282 patients (86 with DM and 196 without DM) were selected and their medical records were analyzed. Laboratory results (white blood cell, blood urea nitrogen, serum creatinine, fasting plasma glucose, HbA1c) were dichotomized. Primary outcomes for comparison between the groups of patients with or without DM were early clinical response rate and length of in-hospital stay. Subgroup analysis was also performed in DM patients according to HbA1c status (<6.5%, > or =6.5%).
RESULTS
In multivariate logistic regression analysis, DM was not found to show independent association with poor early clinical response or longer hospital stay. HbA1c was the common risk factor of poor early clinical response (odds ratio [OR] 4.88, 95% confidence interval [CI] 1.61-14.8) and longer hospital stay (OR 4.20 95% CI 1.52-11.60) in APN patients with DM.
CONCLUSIONS
Strict glucose control may be more important prognostic factor than presence or absence of DM in APN patients. As a marker of prolonged hospitalization and poor early clinical response, HbA1c can complement the present clinical and laboratory parameters used as guide in the proper treatment of DM patients with APN.

Keyword

Pyelonephritis; Diabetes mellitus; Hemoglobin A, glycosylated; Prognosis

MeSH Terms

Blood Cells
Blood Glucose
Blood Urea Nitrogen
Complement System Proteins
Creatinine
Diabetes Mellitus*
Fasting
Female
Glucose
Hemoglobin A, Glycosylated
Hospitalization
Humans
Inpatients
Length of Stay
Logistic Models
Medical Records
Prognosis*
Pyelonephritis*
Risk Factors
Complement System Proteins
Creatinine
Glucose
Hemoglobin A, Glycosylated

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