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Renal papillary necrosis: an update

G Eknoyan, W Y Qunibi, R T Grissom

    Medicine
    |March 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

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    Renal papillary necrosis (RPN) often results from multiple coexisting conditions, most commonly diabetes mellitus. Understanding these multifactorial causes is key to recognizing RPN, a condition frequently linked to infections and other underlying diseases.

    Area of Science:

    • Nephrology
    • Pathology
    • Epidemiology

    Background:

    • Renal papillary necrosis (RPN) is a serious kidney condition affecting renal papillae.
    • Identifying associated risk factors and clinical presentations is crucial for diagnosis and management.

    Observation:

    • A study of 27 patients revealed diabetes mellitus as the most frequent associated condition (56%).
    • Other common factors included urinary tract infections (UTI), analgesic abuse, sickle hemoglobinopathy, and urinary tract obstruction.
    • Multifactorial causation was observed in 55% of cases, with 22% having two coexisting RPN-implicated diseases (excluding infection).

    Findings:

    • The average age at diagnosis was 53 for women and 56 for men.
    • Bilateral RPN occurred in three-fourths of cases.

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  • Clinical presentations commonly included chills and fever (67%), flank pain, and dysuria (41%); oliguria and uremia were rare.

    • Implications:

    • The multifactorial nature of RPN suggests that its occurrence may be less frequent in individual primary diseases than expected.
    • This highlights the importance of considering multiple contributing factors in patients presenting with RPN symptoms.
    • Diagnostic methods included X-ray, histological examination, and autopsy findings.