{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:50:08Z","timestamp":1776905408738,"version":"3.51.2"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T00:00:00Z","timestamp":1774137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T00:00:00Z","timestamp":1774137600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Emphysematous pyelonephritis (EPN) is a rare but severe infection with a high mortality rate characterised by gas formation within the renal parenchyma. Although primarily affecting native kidneys, EPN may exceptionally develop in nonfunctioning renal allografts. We report two cases of EPN occurring after therapeutic embolization of nonfunctioning kidney grafts because of graft intolerance syndrome (GIS). The first case involved a 50\u2010year\u2010old KT woman with a history of post\u2010transplant diabetes and recurrent urinary tract infections, who developed EPN 3 months after embolization. Despite initial improvement with antibiotics, her condition worsened, requiring urgent transplant nephrectomy, which led to full recovery. The second case involved a 54\u2010year\u2010old woman with two failed KT and a previous nephrectomy due to infectious complications. Failure of the third graft due to acute rejection and GIS required embolization. She presented with septic shock 1 month after embolization. Due to clinical deterioration, urgent transplant nephrectomy was performed, resulting in a favourable outcome. These cases underscore that EPN in nonfunctioning renal allografts is an extremely rare clinical entity but should be considered in the differential diagnosis of sepsis following embolization. In severe cases, prompt surgical intervention with transplant nephrectomy, alongside broad\u2010spectrum antibiotics and intensive supportive care, may be necessary for optimal management.<\/jats:p>","DOI":"10.1111\/nep.70194","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T01:19:27Z","timestamp":1774228767000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Emphysematous Pyelonephritis After Embolization of\u00a0a Nonfunctioning Kidney Graft"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8589-8010","authenticated-orcid":false,"given":"Marina","family":"Arnaiz","sequence":"first","affiliation":[{"name":"Department of Nephrology Hospital Universitario Puerta del Mar  C\u00e1diz Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8270-9037","authenticated-orcid":false,"given":"Marta","family":"Alonso","sequence":"additional","affiliation":[{"name":"Department of Nephrology Hospital Universitario Puerta del Mar  C\u00e1diz Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Narv\u00e1ez","sequence":"additional","affiliation":[{"name":"Department of Nephrology Hospital Universitario Puerta del Mar  C\u00e1diz Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7828-9479","authenticated-orcid":false,"given":"Florentino","family":"Villanego","sequence":"additional","affiliation":[{"name":"Department of Nephrology Hospital Universitario Puerta del Mar  C\u00e1diz Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6568-6160","authenticated-orcid":false,"given":"Luis Alberto","family":"Vigara","sequence":"additional","affiliation":[{"name":"Department of Nephrology Hospital Universitario Puerta del Mar  C\u00e1diz Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9888-9674","authenticated-orcid":false,"given":"Rodrigo","family":"Garc\u00eda\u2010Baquero","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital Universitario Puerta del Mar  C\u00e1diz Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2491-3221","authenticated-orcid":false,"given":"Teresa","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Department of Nephrology Hospital Universitario Puerta del Mar  C\u00e1diz Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Luis","family":"\u00c1lvarez\u2010Ossorio","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital Universitario Puerta del Mar 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