Bilateral metachronous xanthogranulomatous pyelonephritis in end-stage renal failure

We report a case of bilateral metachronous xanthogranulomatous pyelonephritis (XGP) in a hemodialyzed patient with end-stage renal failure due to bilateral nephrolithiasis. The XGP was initially diagnosed by computed tomographic (CT) scan, and right nephrectomy was performed. The patient remained clinically stable for the next year. Involvement of the contralateral kidney was again confirmed by CT examination. Both kidneys showed histologic changes compatible with XGP. A coexisting nephrogenic adenoma of the bladder has been attributed to chronic urinary tract infection.