[Nephrectomy without hemostasis of the pedicle]

Area of Science:

• Nephrology
• Urology
• Cardiovascular Medicine

Background:

• Renal pelvis lithiasis, or kidney stones, can lead to complex complications if left untreated over extended periods.
• Inflammatory conditions such as perinephritis and peripyelitis can arise secondary to chronic renal lithiasis.
• Complications involving the renal pedicle can compromise major blood vessels supplying the kidney.

Observation:

• A long-standing case of renal pelvis lithiasis presented with severe perinephritis and peripyelitis.
• The inflammation extended to the renal pedicle, causing significant constriction of the renal artery.
• This arterial obstruction led to diminished renal blood supply and secondary hypertension.

Findings:

• The case highlights a rare instance where chronic kidney stones triggered severe perirenal inflammation.
• Renal artery stenosis secondary to inflammatory processes can lead to renovascular hypertension.
• Severe compromise of renal blood flow necessitated a nephrectomy without pedicle hemostasis due to the kidney's non-viability.

Implications:

• This case underscores the importance of timely management of renal lithiasis to prevent severe secondary complications.
• Understanding the inflammatory cascade is crucial for managing rare urological and cardiovascular comorbidities.
• The report contributes to the literature on rare causes of renal artery obstruction and associated hypertension.