Renal papillary necrosis is a disorder of the kidneys in which all or part of the renal papillae die. The renal papillae are the areas where the openings of the collecting ducts enter the kidney and where urine flows into the ureters.
Necrosis - renal papillae; Renal medullary necrosis
Renal papillary necrosis often occurs with analgesic nephropathy. This is damage to one or both kidneys caused by overexposure to pain medicines. But, other conditions can also cause renal papillary necrosis, including:
Symptoms of renal papillary necrosis may include:
Other symptoms that may occur with this disease:
There is no specific treatment for renal papillary necrosis. Treatment depends on the cause. For example, if analgesic nephropathy is the cause, your doctor will recommend that you stop using the medicine that is causing it. This may allow the kidney to heal over time.
How well a person does, depends on what is causing the condition. If the cause can be controlled, the condition may go away on its own. Sometimes, people with this condition develop kidney failure and will need dialysis or a kidney transplant.
Health problems that may result from renal papillary necrosis include:
Call for an appointment with your health care provider if:
Controlling diabetes or sickle cell anemia may reduce your risk. To prevent renal papillary necrosis from analgesic nephropathy, follow your provider's instructions when using medicines, including over-the-counter pain relievers. Do not take more than the recommended dose without asking your provider.
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Landry DW, Bazari H. Approach to the patient with renal disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 106.
Schaeffer AJ, Matulewicz RS, Klumpp DJ. Infections of the urinary tract. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 12.
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