Xanthogranulomatous pyelonephritis: a systematic review of treatment and mortality in more than 1000 cases

The present systematic review of the demographics, treatment, and mortality rate associated with xanthogranulomatous pyelonephritis (XGP). The study identified 40 eligible studies representing 1139 patients with XGP, with a weighted pooled peri‐operative mortality rate of 1436 per 100,000 patients. The mean age was 49 years, 70% of patients were female, and 28% had diabetes mellitus. The left kidney was more commonly affected (60%). Renal or ureteric stones were present in 69% of patients, including 48% with staghorn calculi. Open radical nephrectomy remains the most common treatment method, but laparoscopic and partial nephrectomy are feasible in well-selected patients. The study concludes that XGP has a lower mortality rate than historically reported.