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 the urine flows into the ureters.
Necrosis – renal papillae; Renal medullary necrosis
Renal papillary necrosis usually occurs with
Kidney infection (pyelonephritis)
Kidney transplant rejection
Sickle cell anemia
Urinary tract blockage
Sickle cell anemia is a common cause of renal papillary necrosis in children.
Tissue death (
- Back pain or
flank pain Bloody urine Cloudy urine Dark, rust-colored, or brown urine
Tissue pieces in the urine
Other symptoms that may ocur with this disease:
- Urinary frequency or urgency
Urinary hesitancy Urinary incontinence
- Urinating large amounts
- Urinating often at night
Exams and Tests
The area over the affected kidney (in the flank) may feel tender during an exam. There may be a history of urinary tract infections. There may be signs of
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. In some cases, persons with this condition develop kidney failure and will need dialysis or a kidney transplant.
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.
Acute kidney failure
- Acute bilateral obstructive uropathy
- Acute unilateral obstructive uropathy
- Chronic bilateral obstructive uropathy
Chronic kidney disease Chronic or recurrent urinary tract infection(UTI)
- Chronic unilateral obstructive uropathy
Hyperkalemia Hypovolemia Metabolic acidosis
When to Contact a Medical Professional
Call for an appointment with your health care provider if:
You develop other symptoms of renal papillary necrosis, especially after taking over-the-counter pain medications
Controlling diabetes or sickle cell anemia may reduce your risk. To prevent renal papillary necrosis from analgesic nephropathy, be careful when using medications, including over-the-counter pain relievers.