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Related Concept Videos

Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

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Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
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Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Imaging Studies V: Intravenous Urography and Retrograde Pyelography01:22

Imaging Studies V: Intravenous Urography and Retrograde Pyelography

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IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
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Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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Nephrectomy for xanthogranulomatous pyelonephritis-a not-so-simple solution.

Caroline Kelly1, Steven Anderson2, Aisling Looney2

  • 1Urology Department, St. Vincent's University Hospital, Dublin, Ireland. carolineekelly@rcsi.com.

Irish Journal of Medical Science
|August 23, 2023
PubMed
Summary
This summary is machine-generated.

Xanthogranulomatous pyelonephritis (XGP) is a complex kidney condition often requiring surgery. Patients undergoing nephrectomy for XGP experienced high complication rates, emphasizing the need for careful treatment planning.

Keywords:
AdultNephrectomyPyelonephritisUrinary tract infectionXanthogranulomatous pyelonephritis

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Area of Science:

  • Nephrology
  • Urology
  • Infectious Diseases

Background:

  • Xanthogranulomatous pyelonephritis (XGP) is a rare, chronic inflammatory kidney disease.
  • XGP is associated with significant patient morbidity and often necessitates nephrectomy.

Purpose of the Study:

  • To evaluate the outcomes of patients who underwent nephrectomy for XGP.
  • To analyze clinical presentation, treatment, and complications associated with XGP.

Main Methods:

  • Retrospective review of renal tissue samples with XGP features (2010-2022).
  • Collection and analysis of laboratory, imaging, and clinical data.
  • Assessment of patient demographics, presentations, and surgical outcomes.

Main Results:

  • Eleven patients (8 female, 3 male, mean age 58.1) were included.
  • Recurrent urinary tract infection (55%) and collections/abscesses (45%) were common presentations.
  • High rates of bacteriuria (91%), antibiotic resistance (60%), and postoperative complications (73%) were observed, including Clavien-Dindo grade 3+ complications and one mortality.

Conclusions:

  • XGP is challenging to treat, with infection being a common factor.
  • Open nephrectomy is frequently required for complex XGP cases.
  • High postoperative complication rates underscore the importance of meticulous antibiotic and surgical management.