Renal papillary necrosis

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Summary of Renal papillary necrosis

Renal papillary necrosis is a nephropathy resulting from impaired blood supply leading to diffuse necrosis of the renal papilla. Lesions that characterize renal papillary necrosis come from an impairment of the blood supply and from subsequent ischemic necrosis that is diffuse. The pathophysiology of this condition can be due to analgesic nephropathy, which in turn is a result of long-term use of aspirin.

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Renal papillary necrosis

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Renal papillary necrosis

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A 56-year-old woman comes to the office because of a 1-week history of left flank pain. Her medical history is relevant for fibromyalgia and osteoarthritis. She currently takes low-dose aspirin, acetaminophen, and ibuprofen. Upon further interrogation, the patient claims no relief of her symptoms despite taking more pain medication than usual. She also noticed an increased urinary frequency and "cloudy and pink" urine. Physical exam shows dry skin and conjunctivae. Her temperature is 36.5°C (97.7°F), pulse is 91/min, respirations are 16/min, blood pressure is 140/90 mmHg. An abdominal CT scan reveals an atrophic and small left kidney with papillary calcifications. This patient most likely has which of the following conditions?

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