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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Emphysematous pyelonephritis (EPN) is a rare, life-threatening necrotizing infection of the renal parenchyma and perinephric tissues characterized by gas formation. Despite advances in diagnostic imaging and therapeutic interventions, EPN remains associated with significant morbidity and mortality. This study aimed to evaluate the risk factors, clinical profile, and outcomes in a large cohort of patients with EPN over an 8-year period.
A retrospective analysis was conducted on 369 patients diagnosed with EPN between 2017 and 2025. Data were collected regarding demographic characteristics, predisposing risk factors, clinical presentation, laboratory investigations, microbiological findings, radiological classification according to the Huang-Tseng system, treatment modalities, and clinical outcomes. Statistical analysis was performed to identify prognostic factors associated with mortality and treatment failure.
The cohort comprised 369 patients with a mean age of 57.3 years and a female-to-male ratio of 2.5:1. Diabetes mellitus was the most common predisposing factor, present in 85-95% of cases, followed by urinary tract obstruction in 60-75% of patients, predominantly due to urolithiasis. The clinical triad of fever (79-100%), flank pain (50-71%), and nausea/vomiting (17-50%) constituted the most common presenting symptoms. Laboratory findings revealed leukocytosis in 83% of patients, thrombocytopenia in 26-33%, and acute kidney injury in 59-75% of cases.
Escherichia coli was isolated in 69-80% of urine or pus cultures, followed by Klebsiella pneumoniae (11-20%), Proteus mirabilis (5-11%), and other pathogens. According to the Huang-Tseng classification system, 60-75% presented with Class 1 or 2 disease, 15-25% with Class 3A or 3B, and 10-13% with Class 4 bilateral EPN.
Treatment consisted of broad-spectrum antibiotics combined with percutaneous drainage or DJ stenting in 70-80% of cases. Nephrectomy was required in 6-22% of patients who failed conservative management. The overall mortality rate was 10.6-19%. Independent predictors of mortality included Huang-Tseng Class 3B or 4 disease, thrombocytopenia, acute kidney injury requiring hemodialysis, septic shock, and presence of two or more risk factors (platelet count <150,000/μL, altered consciousness, acute renal failure, and shock).
EPN remains a challenging urological emergency with substantial mortality despite contemporary management strategies. Early recognition, aggressive resuscitation, appropriate antibiotic therapy, and timely drainage procedures constitute the cornerstone of management. The Huang-Tseng classification system effectively stratifies disease severity and guides therapeutic decisions. Conservative management with percutaneous drainage achieves renal preservation in the majority of cases, reserving nephrectomy for patients with extensive disease or those failing minimally invasive interventions. Diabetes mellitus and urinary obstruction remain the primary modifiable risk factors, emphasizing the importance of glycemic control and prompt relief of urinary tract obstruction in prevention and management.
