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Bilateral acute non-obstructive pyelonephritis presenting as acute kidney injury requiring haemodialysis
  1. Suvarna L Guvvala1,
  2. Sailaja Sakam2,
  3. Michael B Stokes3 and
  4. Kalpana Uday4
  1. 1 Department of Internal Medicine, Paul L Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas, USA
  2. 2 Department of Internal Medicine, Bronx-Lebanon Hospital Center, Bronx, New York, USA
  3. 3 Department of Pathology, Columbia University Medical Center, New York, New York, USA
  4. 4 Division of Nephrology, Department of Internal Medicine, Bronx-Lebanon Hospital Center, Bronx, New York, USA
  1. Correspondence to Dr Suvarna L Guvvala, suvarna.guvvala{at}


A 54-year-old female patient with hypothyroidism and diabetes mellitus type 2 was brought to emergency room by the family members for acute change in mental status. The laboratory evaluation demonstrated findings consistent with acute renal failure (normal renal function 3 months prior to presentation). She was initiated on hemodialysis due to lack of improvement in renal function. Urine culture done prior to initiation of antibiotics was positive for Escherichia coli, which was later confirmed by renal biopsy. Extensive workup for the cause of renal failure including for connective tissue disease, plasmacytoma, obstruction was negative. She was treated with 6 week course of antibiotics with eventual recovery of her renal function in 4 months.

  • urinary tract infections
  • acute renal failure
  • dialysis

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  • Patient consent for publication Obtained.

  • Contributors SLG has drafted the initial manuscript and approved the final version as submitted. SS has reviewed and revised the final version as submitted. MBS and KU have critically reviewed and approved the final version as submitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.