Xanthogranulomatous pyelonephritis: critical analysis of 18 cases from a rural tertiary care centre of India.

Xanthogranulomatous pyelonephritis is an uncommon disorder of the kidney that is characterised by chronic inflammation and extensive destruction of the involved kidney usually associated with renal calculus and obstruction. It commonly involves the middle aged people with an increased incidence among females and diabetic population. Confirmed diagnosis can be done only after histopathological examination of the diseased nephrectomy specimen. So early suspicion and timely intervention is important to reduce the morbidity. In this retrospective study, we analysed the case records of all patients diagnosed with xanthogranulomatous pyelonephritis in our institute over a period of 11 years. A total 18 patients were treated and diagnosed with xanthogranulomatous pyelonephritis from January 2002 to December 2012. Among them 13 were female and 5 male. Most common clinical presentation was flank pain, fever, dysuria and weight loss. Left kidney was affected in 15 cases and right kidney in 3 cases. All patients were having urinary calculus causing obstruction to the pelvicalyceal system of the kidney. Only 2 patients were diabetic. Urine culture was sterile in all patients. All patients were treated with antibiotics, other supportive measures pre-operatively and ultimate nephrectomy having good recovery. Early suspicion and prompt treatment is necessary in minimising morbidity and mortality from the condition.