Acute renal cortical necrosis. Variable course and changing prognosis.

Area of Science:

• Nephrology
• Pathology

Background:

• Acute bilateral renal cortical necrosis is a rare and severe kidney injury.
• Clinical presentations and outcomes vary significantly among affected individuals.

Purpose of the Study:

• To report three distinct cases of acute bilateral renal cortical necrosis.
• To discuss the influence of pathogenesis theories and dialysis availability on prognostic assessment.

Main Methods:

• Case report analysis of three patients with acute bilateral renal cortical necrosis.
• Review of clinical courses, renal function recovery, and treatment outcomes.
• Pathological examination to assess the extent of cortical necrosis.

Main Results:

• Case 1: Spontaneous recovery of renal function after prolonged oliguria.
• Case 2: Temporary renal function recovery, followed by need for chronic hemodialysis and transplantation, with evidence of progressive necrosis.
• Case 3: Complete loss of renal function, managed with dialysis and transplantation.

Conclusions:

• Outcomes for acute bilateral renal cortical necrosis range from full recovery to end-stage renal disease requiring transplantation.
• Modern understanding of pathogenesis and advances in dialysis impact the initial prognostic evaluation.
• This condition necessitates careful monitoring and individualized management strategies.