TREATMENT OF ACUTE PURULENT PYELONEPHRITI S IN DIABETES-MELLITUS PATIENTS

The analysis of clinical, diagnostic and treatment efficacy data has b een made for 160 diabetes mellitus patients (50 cases of insulin-depen dent and 110 of noninsulin-dependent) with acute purulent pyelonephrit is (APP). A diffuse form of the disease was detected in 100 patients ( 62.5%), purulent-destructive one in 60 patients (37.5%). Intoxication, resistant to insulin decompensation of diabetes mellitus, sepsis may be resultant from latent APP. Nondestructive forms of APP were respons ive to antibacterial and detoxication therapy combined with catheteriz ation of the urinary tracts. On demand, conservative therapy was reinf orced with renal drainage by nephrostomy. Primary nephrectomy was reco mmended in purulent-destructive forms and purulent paranephritis. Radi cal surgery in intensive and advanced purulent-destructive pyelonephri tis produced a decrease in postoperative lethality by 26.8 %. Adequate therapeutic policy provided positive results in 80 % of the patients. Lethal outcomes (20 %) were due to grave diabetes mellitus and APP.