Complex, Crusty Calculi: A Case Study Report of Renal Transplant Lithiasis and Encrustation.

Ureteric encrustation and lithiasis after renal transplantation are rare but not without risk of obstruction and graft loss. Patients are usually asymptomatic, and a majority present with graft dysfunction with imaging demonstrating hydronephrosis and rarely with acute graft pyelonephritis. We compare a case of transplant lithiasis with encrusted pyelitis and highlight key differences in their presentation and workup. A key focus for transplant physicians is to recognize when dealing with transplant hydronephrosis that the presence of a high urine pH and pyuria should be a key indicator to suspect ureteric encrustation to look for a urease-producing organism, recognizing that such organisms require prolonged incubation with urine culturing for up to 72 h.

'A disease of disparity': chronic kidney disease of unknown aetiology in endemic immigrant communities.

Chronic kidney disease (CKD) of unknown aetiology is a form of tubulointerstitial CKD in the absence of traditional and known predisposing risk factors. Since the early 2000s, there is an emerging trend in marginalised agricultural communities among workers exposed to occupational and environmental hazards. CKD of unknown aetiology has received significant attention in recent years and is becoming increasingly relevant to the Australian medical community with the growing migrant population, which this case-based communication illustrates.