Xanthogranulomatous pyelonephritis in a patient treated by hemodialysis for 21 years

Xanthogranulomatous pyelonephritis is a form of chronic infection of the re nal parenchyma in the presence of urolithiasis; it is often misdiagnosed as a renal tumour. A definitive diagnosis can be made only by histology. Flan k pain and, fever are the most frequent symptoms, in patients with urolithi asis. Xanthogranulomatous pyelonephritis is rare in patients with chronic r enal failure, those on dialysis and transplant recipients. We report a patient who developed xanthogranulomatous pyelonephritis after 21 years of renal replacement treatment by hemodialysis and cadaveric renal transplant The rare occurrence of this disease in a patient on dialysis mu st be distinguished from two commoner complications of renal replacement, a cquired renal cystic disease and its most serious complication, renal cell carcinoma.