title: [A case of pyonephrosis caused by a protein calculus in a patient on hemodialysis].
abstract: We report a case of pyonephrosis caused by a protein calculus in a patient on hemodialysis. A 56-year-old man had been treated with dialysis for five years because of end-stage renal failure. The patient complained of right lumbar back pain and fever. Computed tomography and an ultrasonography revealed right hydronephrosis. Pyonephrosis was strongly suspected. A single-J catheter was indwelt, cloudy pus with a terrible smell was discharged. After reducing inflammation, a right nephrectomy was performed. The analysis of stone component revealed mostly a protein calculus, which was a black and turf-like substance in the calices. Patients undergoing dialysis often develop urinary calculi. Some calculi are composed of beta2-microglobulin-origin amyloid, which is very difficult to find with diagnostic imaging.
authors.affiliation: Department of Urology, Toyooka Public Hospital.
authors.forename: Noboru
authors.initials: N
authors.lastname: Shibasaki
authors.forename: Toru
authors.initials: T
authors.lastname: Kanno
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tsuji
authors.forename: Yoji
authors.initials: Y
authors.lastname: Taki
authors.forename: Hideo
authors.initials: H
authors.lastname: Takeuchi
mesh_terms: D000682:Amyloid / Q000032:analysis; D006801:Humans; D006869:Hydronephrosis / Q000150:complications; D007669:Kidney Calculi / Q000737:chemistry / Q000150:complications*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D009392:Nephrectomy; D011704:Pyelonephritis / Q000209:etiology*; D006435:Renal Dialysis; D001613:beta 2-Microglobulin / Q000032:analysis*
chemical_list: D000682:Amyloid; D001613:beta 2-Microglobulin