Autonephrectomy

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

There are two types described in literature :

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 .

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

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