Alkaline-encrusting pyelitis - A rare disastrous complication postPCNL leading to chronic renal failure

Abstract

Alkaline-encrusting pyelitis (AEP) is a severe form of infectious disease characterized by encrustation along the lining of the urinary tract leading to loss of renal function. Common predisposing factors are chronic infection, immunosuppression, and endourology procedures. Urea-producing organisms arefrequently associated, and urine alkalization leads to calcific deposition in the pelvicalyceal system. We present a 23-year male with AEP in a solitary kidney leading to chronic renal failure postpercutaneous nephrolithotomy for renal stones.

Figure 1

(a) X-ray kidney, ureter, and bladder showing left radiopaque dense shadows at L2–L3 level on the left side (white solid arrow). (b) Intravenous pyelogram showing left solitary functioning kidney with presence of multiple renal stones (white solid arrow)

Figure 2

(a) Computed tomography abdomen images (axial) showing renal parenchymal enhancement with site of urine leak and double-J stentin situ(white solid arrow). (b) Noncontrast computed tomography images (coronal) showing dense calcific encrustation along the whole lining of the pelvicalyceal system and ureter (white solid arrow)