title: Evaluation of acute renal failure in bacterial allograft pyelonephritis using abdominal CT and graft biopsy.
abstract: The causes of acute renal failure in bacterial allograft pyelonephritis were evaluated using abdominal CT and graft biopsy. Twenty-one recipients, who showed a poor response to antibiotic therapy, comprised this study group. The diagnostic approach taken with this poor responder group was first to perform abdominal CT. If a focal lesion was identified on abdominal CT, a diagnosis of acute focal bacterial nephritis or renal abscess was made. If no focal lesion was found, a graft biopsy was performed for diagnosis. Abdominal CT revealed focal lesions in 9 of the 21 recipients, and renal biopsy showed superimposed acute rejection in 8 of the 12 recipients biopsied. In conclusion, acute renal failure in allograft pyelonephritis is associated with not only severe infection but also a superimposed acute rejection process. Therefore, imaging study and graft biopsy are recommended in the poor responder group.
authors.affiliation: Department of Internal Medicine, Catholic University Medical College, Seoul, Korea.
authors.forename: C W
authors.initials: CW
authors.lastname: Yang
authors.forename: S H
authors.initials: SH
authors.lastname: Lee
authors.forename: Y J
authors.initials: YJ
authors.lastname: Choi
authors.forename: Y S
authors.initials: YS
authors.lastname: Kim
authors.forename: S Y
authors.initials: SY
authors.lastname: Kim
authors.forename: E J
authors.initials: EJ
authors.lastname: Choi
authors.forename: Y S
authors.initials: YS
authors.lastname: Chang
authors.forename: B K
authors.initials: BK
authors.lastname: Bang
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000209:etiology; D000328:Adult; D001706:Biopsy; D004927:Escherichia coli Infections / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000473:pathology; D008297:Male; D011704:Pyelonephritis / Q000175:diagnosis* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000150:complications / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed