The importance of renal ultrasound in detecting chronic pielonephritis in the elderly

• Published in: Ultraschall in der Medizin - European Journal of Ultrasound
• Main Authors: Pacurari, A, Banciu, C, Gorun, C, Romosan, I
• Format: Conference Proceeding
• Language: English
• Published: 15.05.2008
• ISSN: 0172-4614; 1438-8782
• DOI: 10.1055/s-2008-1079779

Aim: Urinary tract infection (UTI) is a common problem in the elderly. Diagnosis, prevention, and treatment can be complex because clinical manifestations can be atypical and host defenses diminish with age. The aim of this study is to establish the role of renal ultrasound in diagnosing chronic pielonephritis in elderly patients. Methods: The study was carried out on a group of 245 elderly patients diagnosed with active or inactive chronic pielonephritis, admitted in the IVth Medical Clinic in a 3 years period. The mean age of the patients was 78.5±13.5 years. Of them 219 were women and 26 men. We performed in all patients a renal ultrasound using an Aloka ProSound 4400 ultrasound system with a 3.5MHz transceiver. Results: In 92.2% of patients the right kidney had less then 10cm, and in 93.06% of patients the left kidney was smaller then 10cm. The exterior contour of the right kidney was unequal in 90.6% of patients and of the left kidney in 91.8% of patients. The parenchyma index was less then 1.5 in the right kidney of 92.3% patients and in the left kidney of 91.8% patients. Conclusion: Because in the elderly the clinical manifestations of UTI are atypical, the patient's pathology is complex and the investigations are limited (intravenous urography can not be made in all elderly), the renal ultrasound exam is the simplest investigation for elderly patients. In the majority of our patients, the diagnosis of a chronic pielonephritis was possible without other investigations that are more risky and expensive.