The Role of Double J Stenting in Nonobstructive Acute Pyelonephritis With Acute Kidney Injury

Background and objective There has been a paradigm shift in the clinical manifestations and renal outcomes of patients with nonobstructive acute pyelonephritis (NO-APN), with acute kidney injury (AKI) being a common complication. While the standard of care remains parenteral antibiotics, minimally invasive urologic procedures is still uncertain. This study aimed to assess the effectiveness of double J (DJ) stenting in patients with NO-APN with AKI in promoting renal recovery, assessed by improvements in creatinine and inflammatory markers. Methods This retrospective study examined the renal outcomes of patients with NO-APN and AKI admitted to a tertiary care hospital in Chennai, India. Patients were divided into two cohorts according to the treatment received: conservative management (Group A) and DJ stenting (Group B). Treatment outcomes were assessed in terms of renal recovery, sepsis resolution, and length of hospital stay. Additionally, a pre-specified subgroup analysis was conducted comparing Kidney Disease: Improving Global Outcomes (KDIGO) Stage III AKI patients between Group A and Group B. Results There was no statistically significant difference between the conservative (Group A) and intervention (Group B) patients in terms of overall renal outcomes. However, in the subgroup analysis of Stage III AKI patients, those who underwent DJ stenting (Group B) demonstrated better treatment outcomes than the conservative group. There was a statistically significant reduction in mean total leukocyte count (TLC) (from 14,937.9 ± 5,275.5 cells/mm³ at admission to 11,656.3 ± 4,936.1 cells/mm³ at discharge, <i>p</i> = 0.03) and serum creatinine (from 3.46 ± 2.50 mg/dL at admission to 2.19 ± 1.93 mg/dL at discharge, <i>p</i> = 0.05) in Group B, while the duration of hospitalization was similar between groups. Conclusions DJ stenting can be considered a minimally invasive adjunct to intravenous antibiotics in cases of NO-APN with Stage III AKI.