What is the definition of Renal Papillary Necrosis?

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.

What are the alternative names for Renal Papillary Necrosis?

Necrosis - renal papillae; Renal medullary necrosis

What are the causes for Renal Papillary 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:

  • Diabetic nephropathy
  • Kidney infection (pyelonephritis)
  • Kidney transplant rejection
  • Sickle cell anemia, a common cause of renal papillary necrosis in children
  • Urinary tract blockage

What are the symptoms for Renal Papillary Necrosis?

Symptoms of renal papillary necrosis may include:

  • Back pain or flank pain
  • Bloody, cloudy, or dark urine
  • Tissue pieces in the urine

Other symptoms that may occur with this disease:

  • Fever and chills
  • Painful urination
  • Needing to urinate more often than usual (frequent urination) or a sudden, strong urge to urinate (urgency)
  • Difficulty starting or maintaining a urine stream (urinary hesitancy)
  • Urinary incontinence
  • Urinating large amounts
  • Urinating often at night

What are the current treatments for Renal Papillary Necrosis?

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.

What is the outlook (prognosis) for Renal Papillary Necrosis?

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.

What are the possible complications for Renal Papillary Necrosis?

Health problems that may result from renal papillary necrosis include:

  • Kidney infection
  • Kidney stones
  • Kidney cancer, especially in people who take a lot of pain medicines

When should I contact a medical professional for Renal Papillary Necrosis?

Call for an appointment with your health care provider if:

  • You have bloody urine
  • You develop other symptoms of renal papillary necrosis, especially after taking over-the-counter pain medicines

How do I prevent Renal Papillary Necrosis?

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.

Kidney anatomy
Kidney - blood and urine flow

REFERENCES

Chen W, Monk RD, Bushinsky DA. Nephrolithiasis and nephrocalcinosis. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 57.

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.

There is no recent research available for this condition. Please check back because thousands of new papers are published every week and we strive to find and display the most recent relevant research as soon as it is available.

There are no recent clinical trials available for this condition. Please check back because new trials are being conducted frequently.