skip to main content

Xanthogranulomatous Pyelonephritis — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

ModerateAcute Kidney InjuryXanthogranulomatous PyelonephritisESENeph

A 45-year-old woman presents with recurrent episodes of acute pyelonephritis. CT shows a xanthogranulomatous pyelonephritis (XGP) with a staghorn calculus in a non-functioning left kidney. The right kidney is normal. What is the definitive treatment?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Nephrectomy of the affected kidney

Xanthogranulomatous pyelonephritis is a severe chronic destructive infection characterised by replacement of renal parenchyma with lipid-laden macrophages, typically associated with staghorn calculi and obstruction. The affected kidney is usually non-functional. Definitive treatment is nephrectomy, as the destroyed kidney serves only as a source of chronic infection and cannot recover function. Antibiotics alone are insufficient. Surgery can be challenging due to perinephric inflammation and adhesions.

Reference: EAU 2024 – Infections; NICE NG109 – UTI