Graftectomy for pyonephrosis in a dialysis patient with deteriorated graft function: A case report

Abstract

A 47-year-old woman, with a past history of renal transplantation about 7 years previously, returned to hemodialysis due to failed renal function in January 2012. The patient was referred to our hospital from a clinic. Her complaints included a 38-degree fever and vomiting. The symptoms were temporarily improved with antibiotics, but immediately returned upon stopping antibiotic treatment. After a diagnosis of pyonephritis in the grafted kidney, a graftectomy was performed. Pathological examination showed chronic rejection and pyonephrosis. This can be difficult to explain during hemodialysis due to deteriorated renal function following renal transplantation. Graft nephrectomy was ultimately performed in this case because pyonephrosis in the grafted kidney was the origin of the fever and was resistant to conservative therapy with antibiotics.