EVALUATION OF ACUTE-RENAL-FAILURE IN BACTERIAL ALLOGRAFT PYELONEPHRITIS USING ABDOMINAL CT AND GRAFT BIOPSY

The causes of acute renal failure in bacterial allograft pyelonephriti s were evaluated using abdominal CT and graft biopsy. Twenty-one recip ients, who showed a poor response to antibiotic therapy, comprised thi s study group. The diagnostic approach taken with this poor responder group was first to perform abdominal CT. Ifa focal lesion was identifi ed on abdominal CT, a diagnosis of acute focal bacterial nephritis or renal abscess was made. If no focal lesion was found, a graft biopsy w as performed for diagnosis. Abdominal CT revealed focal lesions in 9 o f the 21 recipients, and renal biopsy showed superimposed acute reject ion in 8 of the 12 recipients biopsied. In conclusion, acute renal fai lure in allograft pyelonephritis is associated with not only severe in fection but also a superimposed acute rejection process. Therefore, im aging study and graft biopsy are recommended in the poor responder gro up.