We evaluated the degree of kidney damage in 175 patients treated by nephrectomy for recurrent renal stones. Renal histopathological lesions of the removed kidneys were graded and correlated to clinical and operative findings. Nonexcreting kidneys on intravenous pyelography or small atrophic kidneys with poor contrast excretion showing advanced hydronephrosis and pyelonephritic scarring intraoperatively corresponding to kidneys with advanced parenchymatous destruction histopathologically. In 91% of the cases severe renal damage was correctly predicted, and a decision to remove the affected kidney was justified.
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