Abstract: A 46yearold female presented with chills,fever,lumbago,urinary frequency,urinary urgency,dysuria,resolve brown urine,and elevated serum creatinine,Laboratory tests found positive for urinary white blood cells,and urine culture was positive for Escherichia coli.Symptoms were significantly relieved after antiinfective treatment,but proteinuria and microscopic hematuria were still present.Renal biopsy revealed IgA nephropathy,with tubulointerstitial nephritis.The final diagnosis was IgA nephropathy comply with tubulointerstitial nephritis associated with pyelonephritis.