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Xanthogranulomatous pyelonephritis: experience in 36 cases.

C K Chuang1, M K Lai, P L Chang

  • 1Department of Surgery, Chang-Gung Memorial Hospital, Taipei, Taiwan, Republic of China.

The Journal of Urology
|February 1, 1992
PubMed
Summary

Xanthogranulomatous pyelonephritis (XGP) most often affects middle-aged women with prior urinary issues. This retrospective study highlights common symptoms, causative bacteria like Escherichia coli, and treatment approaches for this kidney condition.

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Area of Science:

  • Nephrology
  • Urology
  • Pathology

Background:

  • Xanthogranulomatous pyelonephritis (XGP) is a rare, chronic destructive kidney inflammation.
  • It is often associated with recurrent urinary tract infections and obstruction.

Purpose of the Study:

  • To review the clinical characteristics, management, and outcomes of patients with XGP.
  • To identify common pathogens and predisposing factors in XGP cases.

Main Methods:

  • Retrospective analysis of 36 patients who underwent nephrectomy for XGP.
  • Review of patient demographics, clinical presentations, laboratory data, and surgical findings.

Main Results:

  • The condition predominantly affected middle-aged women with a history of recurrent urinary tract disorders.

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  • Common presenting symptoms included flank pain and fever.
  • Escherichia coli (67%) and Proteus mirabilis (26%) were the most frequently isolated organisms.
  • Complications included focal XGP, emphysematous pyelonephritis, fistula formation, and septic arthritis.
  • Conclusions:

    • XGP requires nephrectomy, often in patients with a history of urinary tract issues.
    • Prompt diagnosis and appropriate antibiotic therapy (e.g., cephalothin with gentamicin/tobramycin) are crucial before surgery.