{
  "abstract": "Acute focal bacterial nephritis (AFBN) is often characterized as a complicated form of upper urinary tract infection. Its relationship with acute kidney injury (AKI) is not well established, and most reported cases have preserved renal function because most patients respond well to antibiotic treatment. We report a 74-year-old woman with type 2 diabetes mellitus who presented with fever, diarrhea, oliguria, and severe AKI requiring hemodialysis. Blood and urine next-generation sequencing identified Escherichia coli. Imaging showed bilateral renal enlargement and cortical swelling suggestive of presumed AFBN. Despite 4 weeks of antibiotic therapy, renal function failed to recover. Empirical corticosteroid therapy transiently increased urine output but did not improve serum creatinine. Renal biopsy revealed IgA-dominant infection-related glomerulonephritis (IgA-IRGN) with tubulointerstitial injury. She remained dialysis-dependent 1 year later. This case illustrates the complexity of AKI in a patient with sepsis, presumed AFBN, and IgA-IRGN. We highlight the importance of considering multiple etiologies and the role of renal biopsy when renal function fails to recover after infection control.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Nephrology, Peking University Third Hospital, Beijing, China",
    "Department of Pathology, Peking University Third Hospital, Beijing, China"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Qi Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Daorina Bao"
    },
    {
      "affs": [
        0
      ],
      "name": "Haidong Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhuan Cui"
    },
    {
      "affs": [
        1
      ],
      "name": "Yao Yao"
    },
    {
      "affs": [
        1
      ],
      "name": "Min Lu"
    },
    {
      "affs": [
        0
      ],
      "name": "Danxia Zheng"
    },
    {
      "affs": [
        0
      ],
      "name": "Yue Wang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/edp99e1xrc0nz.bib",
  "cited_by": 0,
  "doi": "10.3389/fmed.2026.1948946",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13735621/",
  "id": "edp99e1xrc0nz",
  "issns": [
    "2296-858X"
  ],
  "landing_url": "https://doi.org/10.3389/fmed.2026.1948946",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
    [
      "openalex",
      "2727|Acute Kidney Injury Research"
    ]
  ],
  "openalex": "W7223187711",
  "pdf_url": "https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1948946/pdf",
  "pmcid": "PMC13735621",
  "pmid": "42990889",
  "published": "2026-10-22",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/edp99e1xrc0nz.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:21:16Z",
      "native_id": "PMC13735621",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fmed.2026.1948946"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2727|Acute Kidney Injury Research",
      "subfield": "general"
    }
  ],
  "title": "Acute kidney injury in an elderly patient with presumed acute focal bacterial nephritis: a case report highlighting diagnostic challenges",
  "title_text": "Acute kidney injury in an elderly patient with presumed acute focal bacterial nephritis: a case report highlighting diagnostic challenges",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:21:16Z",
  "url": "https://research.draconitic.com/paper/edp99e1xrc0nz",
  "venue": "Frontiers in Medicine",
  "versions": []
}