Abstract

OBJECTIVE

We aimed to evaluate the childhood infection related nephrectomy reasons and to determine the frequency of xanthogranulomatous pyelonephritis (XGP).

METHODS

We retrospectively reviewed 56 pediatric patients who underwent nephrectomy secondary to chronic pyelonephritis between 1991 and 2010 at Izmir Dr.Behcet Uz children’s Hospital. Size and weight of kidneys, findings of radiological and scintigraphic investigations, presence of urinary infection at operation time, age and sex of patients and the relationship of these parameters were assessed.

RESULTS

This series consisted of 35 boys (62.5%) and 21 girls (37.5%) with mean age of 3.05 years (6 months- 10 years). All patients present the loss of renal function more than 90- 95 percent detected by the radiological and scintigraphic evaluation. XGP was found in 9 cases (16.1%). Specific etiologic agents were not isolated in none of them. There are congenital predispositions such as ureteropelvic reflux or obstruction in 14 cases (25%). While kidney was large in 77.8% of XGP, was normal or small in 70.2% of other cases. Urinary infection was determined in 26 cases (46.4%). Hipertrophy of kidney was associated with the presence of XGP by both Chi-square test (p=0,021) and Spearman correlation analyses (p=0.019).

CONCLUSION

In the present study, a realistic comprehensive picture of the nephrectomy secondary to infection has been provided. Then it was discussed if prevention nephrectomy in these disorders with early diagnosis and adequate medical treatment could be possible. In addition it was conclude the reason of higher XGP percentage in our series.