Total renal replacement lipomatosis

Renal replacement lipomatosis can be defined as the proliferation of fibrofatty tissue which subsequently replaces the renal parenchyma. It is usually unilateral and occurs as a result of severe atrophy or destruction of the renal parenchyma, mostly due to a calculus with secondary proliferation of renal sinus, renal hilus, and perirenal fatty tissue to a variable extent. There may be moderate replacement of renal tissue by fat as in renal sinus lipomatosis or in severe cases the whole of the renal parenchyma may be replaced by fat and is referred to as renal replacement lipomatosis. Herein we report a case of total renal replacement lipomatosis. The possible pathogenic mechanisms and the treatment are also discussed.