Infected obstructed kidney: drainage is the treatment
Educational use only. Not clinically reviewed58-year-old woman for calm source-control recognition, escalation, bounded decompression intent, reassessment, and handoff practice. About 8 simulated minutes.
What you will practise
- Reconcile the fever, perfusion, kidney function, and supplied imaging.
- Recognize an undrained source rather than a more severe infection.
- Activate urology, interventional radiology, and culture ownership.
- Review the timing, modality, and evidence boundary.
- Record bounded decompression intent and defer definitive stone treatment.
- Hand off unresolved infection, kidney function, and active risk.
Review and sources
Not clinically reviewed. No clinician has signed this scenario.
- American Urological Association. Surgical Management of Kidney and Ureteral Stones: AUA Guideline (2026). Approved November 2025. Statement 38 (urgent renal drainage; Strong Recommendation, Evidence Level Grade C) and its nephrostomy-or-stent sub-statement (Conditional Recommendation, Evidence Level Grade A).
- European Association of Urology. Guidelines on Urolithiasis, limited text update March 2026. Management of sepsis and anuria in the obstructed kidney: urgent decompression and deferral of definitive stone treatment, both Strong.
- National Institute for Health and Care Excellence. Suspected sepsis in people aged 16 or over. NICE guideline NG253. Published 2025-11-19, replacing NG51. Recommendations 1.6.2, 1.6.4, 1.6.5, 1.11.1 to 1.11.4.
Open Sim Lab is an educational simulator, not for clinical use. It is not a clinical decision-support tool, not a dosing calculator, and is not validated for any decision affecting a real patient.