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Renal papillary necrosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The renal papillae are the tips of renal medulla which protrude into each calyx of the renal pelvis.

Gross necrosis of the renal papillae is usually seen in two conditions:

  • the nephropathy associated with diabetes mellitus
  • analgesic abuse nephropathy

It may also occur in:

  • severe infection
  • vascular obstruction
  • ureteric obstruction
  • radiotherapy

Papillary necrosis is associated with:

  • pyuria, often sterile
  • haematuria, often gross
  • renal colic, if the necrotic papilla is excreted

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