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Neonatal renal papillary and cortical necrosis
American Journal of Diseases of Children (1960)
|July 1, 1977
Summary
Neonatal renal papillary and cortical necrosis (RPCN) is often fatal, but this study reports three survivors. Follow-up revealed decreased urine concentrating ability and characteristic renal abnormalities in these infants.
Area of Science:
- Pediatric Nephrology
- Neonatal Medicine
- Renal Pathology
Background:
- Neonatal renal papillary and cortical necrosis (RPCN) is a severe condition with a historically high mortality rate.
- Understanding the long-term outcomes and sequelae of RPCN is crucial for affected infants.
Observation:
- This report details the follow-up of three infants who survived neonatal RPCN.
- Causes included hemorrhage with asphyxia neonatorum (2 cases) and hemorrhage with shock (1 case).
- Diagnosis was confirmed via excretory urogram or renal biopsy in two infants; the third was diagnosed retrospectively.
Findings:
- Creatinine clearance was normal in one survivor, slightly reduced in another, and moderately reduced in the third.
- All survivors exhibited a decreased maximum ability to concentrate urine.
- Follow-up excretory urograms showed dilated, bizarre calices and renal cortical atrophy, resembling segmental hypoplasia or chronic pyelonephritis.
Implications:
- Neonatal RPCN survivors can experience significant long-term renal dysfunction.
- The characteristic radiological findings in survivors may inform differential diagnoses in pediatric renal imaging.
- Further research is warranted to elucidate the full spectrum of long-term complications and management strategies for neonatal RPCN.