Autonephrectomy

Last revised by Dr Rohit Sharma on 31 May 2021

Autonephrectomy refers to the end stage of renal tuberculosis where chronic tuberculous infection causes caseous necrosis and progressive renal cavitation, rendering the kidney non-functioning 1.

It is a rare occurrence in non-endemic populations today but can be misdiagnosed if not suspected 2.

There are two types described in literature 3,4:

  1. caseous-cavernous: conversion of the kidney into an enlarged, debris-filled caseated sac resulting in substantial parenchymal loss, calcification may be present
  2. fibrous-sclerotic: extensive parenchymal fibrosis and scarring results in shrinkage of the kidney, often with dystrophic calcification in a lobar distribution that is characteristic of end stage disease 5,6

A secondary nephrectomy is not usually required except in specific cases (e.g. intractable hypertension, tuberculous reactivation) 1.

Autonephrectomy is distinct from putty kidney, which can also result from chronic tuberculous infection.

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Cases and figures

  • Case 1
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  • Case 2
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