MRCEM Notes

Renal papillary necrosis

Renal papillary necrosis describes the coagulative necrosis of the renal papillae due to a variety of causes.

Features
  • visible haematuria
  • loin pain
  • proteinuria

Causes
  • severe acute pyelonephritis
  • diabetic nephropathy
  • obstructive nephropathy
  • analgesic nephropathy: phenacetin was the classic cause but this has now been withdrawn
  • sickle cell anaemia

© Image used on license from PathoPic
Renal papillary necrosis secondary to acute pyelonephritis. Note the pale areas highlighted by the blue arrows

Full-size image