Renal papillary necrosis

Kidney anatomy

The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and stimulating red blood cell production.

Also known as: Necrosis - renal papillae and Renal medullary necrosis

Definition

Renal papillary necrosis is a disorder of the kidneys in which all or part renal papillae die. The renal papillae is the area where the openings of the collecting ducts enter the kidney.

Causes, incidence, and risk factors

Renal papillary necrosis is most commonly associated with analgesic nephropathy. However, a number of conditions can cause this condition, including:

Sickle cell anemia is a common cause of renal papillary necrosis in children.

Symptoms

Necrosis (tissue death) of the renal papillae may make the kidney unable to concentrate the urine. Symptoms may include:

Additional symptoms that may be associated with this disease:

Signs and tests

An examination may reveal tenderness when touching the body over the affected kidney. There may be a history of chronic or recurrent urinary tract infections. There may be signs of obstructive uropathy or renal failure.

A urinalysis may show dead tissue in the urine.

An IVP may show obstruction or tissue in the renal pelvis or ureter.

Treatment

There is no specific treatment for renal papillary necrosis. Treatment depends on the underlying cause. For example, if analgesic nephropathy is suspected as the cause, your doctor will recommend that you stop using the suspected medications. This may allow healing over time.

Expectations (prognosis)

How well a person does depends on the underlying condition. If the underlying disorder can be controlled, the condition may go away on its own. In some cases, persons with this condition develop kidney failure.

Complications

Calling your health care provider

Call for an appointment with your health care provider if you have bloody urine. Also call if other symptoms of renal papillary necrosis develop, especially after taking over-the-counter pain medications.

Prevention

Control of diabetes or sickle cell anemia may reduce risk. Prevention of renal papillary necrosis from analgesic nephropathy includes careful moderation in the use of medications, including over-the-counter analgesics.

See also:

  • Disease

    Urinary tract infection - adults

    Bladder catheterization, female

    A urinary tract infection, or UTI, is an infection that can happen anywhere along the urinary tract. Urinary tract infections have different names, depending on what part of the urinary tract is infected. Bladder — an infection in the bladder is also called cystitis or a bladder ...

  • Disease

    Acute kidney failure

    Kidney anatomy

    Acute (sudden) kidney failure is the sudden loss of the ability of the kidneys to remove waste and concentrate urine without losing .

  • Disease

    Hypovolemic shock

    Hypovolemic is an emergency condition in which severe blood and fluid loss makes the heart unable to pump enough blood to the body. This type of shock can cause many organs to stop working.

  • Disease

    Hyperkalemia

    Circulatory system

    Hyperkalemia is higher-than-normal levels of potassium in the blood.

  • Disease

    Metabolic acidosis

    Insulin production and diabetes

    Metabolic acidosis is a condition in which there is too much acid in the body fluids.

  • Special Topic

    Necrosis

    Necrosis of the toes

    Necrosis is death of body tissue. It occurs when there is not enough blood flowing to the tissue, whether from injury, radiation, or chemicals. Necrosis is not reversible. When substantial areas of tissue die due to a lack of blood supply, the condition is called .

  • Disease

    Acute bilateral obstructive uropathy

    Bladder catheterization, female

    Acute bilateral obstructive uropathy is a sudden blockage of the flow of urine from both kidneys. The kidneys continue to produce urine in the normal manner, but because urine does not drain properly, the kidneys start to swell. See also:

  • Disease

    Sickle cell anemia

    Red blood cells, sickle cell

    Sickle cell anemia is a disease passed down through families in which red blood cells form an abnormal crescent shape. (Red blood cells are normally shaped like a disc.)

  • Disease

    Chronic kidney disease

    Kidney anatomy

    Chronic kidney disease is the slow loss of kidney function over time. The main function of the kidneys is to remove wastes and excess water from the body.

  • Disease

    Analgesic nephropathy

    Male urinary system

    Analgesic nephropathy involves damage to one or both kidneys caused by overexposure to mixtures of medications, especially over-the-counter pain remedies (analgesics).

  • Disease

    Urinary tract infection - children

    Voiding cystourethrogram

    A urinary tract infection (UTI) is a bacterial infection of the urinary tract. This article discusses UTIs in children. The urinary tract includes the: Bladder Kidneys Ureters — the tubes that take urine from each kidney to the bladder Urethra — the tube that empties urine from the ...

  • Disease

    Chronic unilateral obstructive uropathy

    Kidney anatomy

    Chronic unilateral obstructive uropathy is a condition in which there is long-term blockage of one of the tubes (ureters) that drains urine from the kidneys. See also:

  • Special Topic

    Renal

    Kidney anatomy

    The term “renal” refers to the kidney. For example, renal failure means kidney failure. Related topics:

  • Disease

    Acute unilateral obstructive uropathy

    Kidney anatomy

    Acute unilateral is a sudden blockage in one of the tubes (ureters) that drain urine from the kidneys. See also:

  • Disease

    Diabetic nephropathy

    Male urinary system

    Diabetic nephropathy is kidney disease or damage that results as a complication of . See also:

  • Disease

    Chronic bilateral obstructive uropathy

    Bladder catheterization, female

    Chronic bilateral obstructive uropathy is a long-term blockage of urine flow from both kidneys. It is a slow blockage that gets worse over time. Bilateral means “both sides.” See also:

Review date:
August 17, 2009
Reviewed by:
Parul Patel, MD, Private Practice specializing in Nephrology and Kidney and Pancreas Transplantation, Affiliated with California Pacific Medical Center, Department of Transplantation, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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