{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T13:45:56Z","timestamp":1762004756460,"version":"3.40.4"},"reference-count":24,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2015,12,11]]},"abstract":"<jats:p>We present a case of a man in his late 50s with a history of metastatic prostate carcinoma requiring bilateral ureteric stenting. He was admitted with increasing confusion and lethargy. He was diagnosed with sepsis and an acute kidney injury (AKI). Clinical suspicions of an obstructive component to his AKI were not confirmed by an ultrasound scan, which showed a unilateral hydronephrosis unchanged from a scan 1\u2005month previously. A nephrostomy was performed, and frank pus aspirated. The patient's clinical state improved steadily thereafter. Patients who are dehydrated, or who have suffered from malignant or fibrotic processes affecting the retroperitoneum, may present with urinary obstruction without a corresponding increase in urinary tract dilation. Additionally, there must be a suspicion of pyonephrosis in a symptomatic patient with known hydronephrosis. Clinicians should be aware that clinical suspicions of urinary obstruction not demonstrated on ultrasound scanning require further investigation.<\/jats:p>","DOI":"10.1136\/bcr-2015-212028","type":"journal-article","created":{"date-parts":[[2016,1,5]],"date-time":"2016-01-05T16:02:42Z","timestamp":1452009762000},"page":"bcr2015212028","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Pyelonephritis and obstructive uropathy: a case of acute kidney injury"],"prefix":"10.1136","volume":"2016","author":[{"given":"Adam Edward","family":"Ashmore","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher James","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,1,5]]},"reference":[{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61454-2"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.2","doi-asserted-by":"publisher","DOI":"10.1038\/kisup.2012.1"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.3","doi-asserted-by":"publisher","DOI":"10.1186\/cc2872"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.4","doi-asserted-by":"publisher","DOI":"10.1186\/cc5713"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.5","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2006070756"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.6","doi-asserted-by":"publisher","DOI":"10.1186\/cc6863"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2009.04.001"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.8","doi-asserted-by":"publisher","DOI":"10.5812\/numonthly.12721"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.9","unstructured":"National Institute for Health and Care Excellence. Acute kidney injury\u2014prevention, detection and management of acute kidney injury up to the point of renal replacement therapy\u2014NICE clinical guideline 169. London: National Institute for Health and Care Excellence, 2013."},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.10","unstructured":"National Confidential Enquiry into Patient Outcome and Death. Adding insult to injury\u2014a review of the care of patients who died in hospital with a primary diagnosis of acute kidney injury (acute renal failure). London: National Confidential Enquiry into Patient Outcome and Death, 2009."},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.11","doi-asserted-by":"crossref","first-page":"25","DOI":"10.37549\/AR1678","article-title":"Renal infections: an update","volume":"38","author":"Akbar","year":"2009","journal-title":"Appl Radiol"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.12","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1002\/j.2040-4603.2012.tb00431.x","article-title":"Pathophysiology of acute kidney injury","volume":"2","author":"Basile","year":"2012","journal-title":"Compr Physiol"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.13","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-003-1662-x"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.14","doi-asserted-by":"publisher","DOI":"10.1111\/iju.12200"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.15","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-013-0383-y"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.16","doi-asserted-by":"publisher","DOI":"10.4103\/0974-777X.52984"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.17","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-110-2-138"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.18","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.163.2.8037031"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.19","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.296.6635.1517"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.20","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/13.1.203"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.21","doi-asserted-by":"publisher","DOI":"10.3109\/0886022X.2010.517343"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2004.03001.x"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.23","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.160.3.3526405"},{"key":"2025042702132641000_2016.jan05_1.bcr2015212028.24","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0085214"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2015-212028","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T09:13:35Z","timestamp":1745745215000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2015-212028"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1,5]]},"references-count":24,"alternative-id":["10.1136\/bcr-2015-212028"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2015-212028","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2016,1,5]]}}}