Renal papillary necrosis
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Renal papillary necrosis
Pathology
Congenital disorders
Fluid, electrolyte, and acid-base balance disorders
Infectious, immunologic, and inflammatory disorders
Alport syndrome
Goodpasture syndrome
IgA nephropathy (NORD)
Lupus nephritis
Poststreptococcal glomerulonephritis
Rapidly progressive glomerulonephritis
Amyloidosis
Diabetic nephropathy
Focal segmental glomerulosclerosis (NORD)
Lupus nephritis
Membranoproliferative glomerulonephritis
Membranous nephropathy
Minimal change disease
Acute tubular necrosis
Renal papillary necrosis
Acute pyelonephritis
Chronic pyelonephritis
Lower urinary tract infection
Metabolic and regulatory disorders
Neoplasms
Traumatic and mechanical disorders
Vascular disorders
Renal and urinary system pathology review
Congenital renal disorders: Pathology review
Acid-base disturbances: Pathology review
Electrolyte disturbances: Pathology review
Nephritic syndromes: Pathology review
Nephrotic syndromes: Pathology review
Urinary tract infections: Pathology review
Kidney stones: Pathology review
Renal failure: Pathology review
Renal tubular acidosis: Pathology review
Renal tubular defects: Pathology review
Renal and urinary tract masses: Pathology review
Urinary incontinence: Pathology review
Flashcards
Renal papillary necrosis
0 of 6 complete
Questions
USMLE® Step 1 style questions USMLE
0 of 2 complete
A 50-year-old man comes to his primary care PA’s office for routine follow-up. He was recently diagnosed with osteoarthritis of the knees four weeks ago and was initiated on analgesic medications. Past medical history is significant for diabetes mellitus. Current medications include metformin, naproxen and acetaminophen. His vitals and physical exam are within normal limits. Laboratory results are as follows.
Changes to which of the following anatomic regions is most likely accountable for this patient’s rise in creatinine?
| Laboratory value | Results | Reference range | |
| 4 weeks ago | Today | ||
| Serum chemistry | |||
| Sodium | 138 mEq/L | 137 mEq/L | 136-146 mEq/L |
| Potassium | 4 mEq/L | 4.1 mEq/L | 3.5-5 mEq/L |
| Bicarbonate | 24 mEq/L | 25 mEq/L | 22-28 mEq/L |
| Chloride | 96 mEq/L | 94 mEq/L | 95-105 mEq/L |
| Creatinine | 1.1 mg/dL | 1.6 mg/dL | 0.6-1.2 mg/dL |
| Urinalysis | |||
| Protein | 100 mg/day | 102 mg/day | <150 mg/day |
| Cast | None | None | None |
| Blood | None | None | None |
Changes to which of the following anatomic regions is most likely accountable for this patient’s rise in creatinine?
Key Takeaways
Renal papillary necrosis is a condition in which impaired blood supply to the kidneys leads to diffuse ischemia and subsequent necrosis of the renal papilla. Risk factors for renal papillary necrosis include diabetes, sickle cell anemia, and certain medications such as non-steroidal anti-inflammatory drugs (NSAIDs). Symptoms may include fever, flank pain, and blood in the urine. Treatment may include antibiotics, pain management, and in severe cases, surgery.