Nine elderly patients who presented with features suggestive of acute pyelonephritis were studied with the help of laboratory and imaging investigations. All patients had acute kidney injury of variable severity at presentation. Renal imaging helped us in revealing bilateral involvement and the findings are discussed. The infection was treated with appropriate antibiotics. Because of severe renal failure, five patients were supported with hemodialysis, of them, three became dialysis independent. The remaining two patients were dialysis dependent at discharge. However, none of them came to us for follow-up.
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