What is renal papillary necrosis?
It is an alteration in the kidneys in which part or all of the renal papillae die. These renal papillae are located in the area where the openings of the collecting ducts enter the kidney and where urine flows into the ureters.
Prognosis of the disease
The prognosis will vary depending on the severity. In some cases the condition may disappear on its own, but in other cases it may be accompanied by kidney failure and a kidney transplant or dialysis may be necessary.
Renal papillary necrosis is a disorder of the kidneys.
Symptoms of renal papillary necrosis
Necrosis of the renal papillae may result in the kidney being unable to concentrate urine. There are several symptoms that can be:
- Back or flank pain
- Blood in the urine
- Cloudy, dark or reddish urine
- Tissue fragments in the urine
Other symptoms could be:
- Fevers and chills
- Incontinence
- Increased frequency of urination
- Painful urination
Medical tests for renal papillary necrosis
The affected area of the kidney may appear tender during an examination. A history of urinary tract infections or signs of blockage of urine flow, as well as kidney failure, will also be evaluated.
Some of the tests to be performed may include:
- Urinalysis and blood tests.
- An ultrasound, CT scan or other studies of the kidneys.
What are the causes of renal papillary necrosis?
It often presents with analgesic nephropathy. This is damage to one or both kidneys caused by excessive analgesic exposure. However, there are other conditions that can also cause renal papillary necrosis, for example:
- Diabetic nephropathy
- Kidney transplant rejection
- Kidney infection
- Sickle cell anemia, common origin in children
- Urinary tract blockage
Can it be prevented?
It is important to follow a control of diabetes or sickle cell anemia, as it may decrease the risk. As for renal papillary necrosis due to analgesic neuropathy, one has to be careful and moderate with the use of medications, including over-the-counter analgesics.
Treatments for renal papillary necrosis
There is no specific treatment for papillary necrosis. The cure depends on the cause; if it can be controlled, the condition may go away on its own. In other cases, sufferers will develop kidney failure and require dialysis or a kidney transplant.
Finally, if the physician suspects that analgesic nephropathy is the cause, he or she will recommend discontinuation of the suspected medications, which may allow for cure over time.
Which specialist treats it?
The specialist who treats renal papillary necrosis is a nephrologist.