Renal papillary necrosis

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Kidney anatomy

Kidney - blood and urine flow

Necrosis - renal papillae; Renal medullary necrosis

• Tissue in the urine
• Cloudy urine
• Dark, rust-colored, or brown urine
• Bloody urine
• Back pain or flank pain
  • May be on only one side
  • May be acute
  • May be colicky or spasm-like pain

• Painful urination
• Urinary hesitancy
• Increased urinary frequency or urgency
• Polyuria (large urine volumes)
• Nocturia (urinating frequently at night)
• Incontinence
• Chills

An examination may reveal tenderness when touching the body over the affected kidney. There may be a history of chronic or recurrent urinary tract infections. There may be signs of obstructive uropathy or renal failure.

• A urinalysis may show sediment, casts, tissue, or blood in the urine. Examination of tissue in the urine may show a necrotic renal papilla.
• An IVP may show obstruction or tissue in the renal pelvis or ureter.

Review Date: 09/13/2005
Reviewed By: Robert Mushnick, M.D., Clinical Assistant Professor, SUNY Downstate Health Center, Brooklyn, NY. Review provided by VeriMed Healthcare Network.