I have chronic pyelonephritis and four kidney stones in my kidney. it has shrunk immensely in size and is now in early renal failure. should i remove?

Stones or kidney?: If stones are cause of chronic pyelonephritis, then discuss removing stones to reduce risk for repeat infections as a means to improve kidney function. Optimize blood pressure & sugar as these are two main causes of renal failure. We don't usually remove kidneys even in failure.

YES,YES,YES: Urgent urologic consultation is warranted in patients with urosepsis, acute renal failure, anuria, and/or unyielding pain, nausea, or vomiting . Outpatient urology referral is indicated in patients with a stone >10 mm in diameter and in patients who fail to pass the stone after a trial of conservative management, including medical expulsive therapy, particularly if the stone is >4 mm in diameter