A Case of Acute Renal Failure due to Bilateral Acute Pyelonephritis

Kim, Kyoung Soo; Lee, Kyu Beck; Lee, Hee Moo; Choi, Kwon; Kim, Bum Soo; Kim, Hyang; Lee, Sang Jong; Park, Chan Pil; Park, Moon Hyang

Abstract

Although urinary tract infections are common in adults, pyelonephritis is rarely considered in the differential diagnosis of acute renal failure. Acute pyelonephritis without urinary tract obstruction, previous renal diseases or septic shock is a rare cause of acute renal failure. Despite appropriate antibiotic therapy, recovery of renal function could be slow and incomplete. We experienced a 45 year-old woman with diabetes who developed bilateral acute pyelonephritis followed by acute renal failure. The renal biopsy revealed diffuse edematous and focal fibrotic inters- titium with infiltration of lymphocytes compatible with interstitial nephritis. Although her renal function improved gradually with antimicrobial treatment, the process was incomplete and renal dysfunction persisted at about 10-month follow-up, suggesting permanent renal damage. Therefore, we report this case with brief review of related literature.