Renal Papillary Necrosis Case Study

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NAME: NOR HANIM BINTI YASMAN ID NUMBER: 0318648 BATCH: 8 SUPERVISOR: COURSE COORDINATOR: Table of Contents 1.0 INTRODUCTION 1.1 Definition 1.2 Epidemiology 1.3 Local statistics 2.0 CLINICAL FEATURES 2.1 Risk factors 2.2 Causes 2.3 Morphology 2.4 How it represents 2.5 Complications 3.0 PATHOLOGY AND PATHOGENESIS 3.1 Investigations 3.2 Findings 3.3 Diagnosis 3.4 Summary 4.0 MANAGEMENT 4.1 Intervention procedures 5.0 PROGNOSIS 6.0 REFERENCES 1.0 INTRODUCTION 1.1 DEFINITION Renal papillary necrosis (RPN) is defined as coagulative necrosis of the renal medullary pyramids and papillae caused by several associated conditions and toxins that promote ischemia.1 G. W. Smith and T. F. GODWIN explains renal papillary necrosis as an ischemic…show more content…
Common age of RPN patients are of 53 year-old , about fifty percent of cases takes place in patients older than 60, and more than ninety percent occurs in people aged more than 40 years. Individuals aged less than 40 years are unlikely to have RPN unless with other conditions such as hemoglobinopathies, hypoxia, dehydration and septicemia. Generally, women have higher incidence than men for RPN.1 Incidence of RPN is higher in the northen, warmer parts of australia. Raised incidence of RPN during summer months suggests dehydration role in…show more content…
Headaches and upper gastrointestinal disorder may be initial signs of RPN. Subsequently, patients with RPN may suffer from nocturia, dysuria, bacteriuria, pyuria, microscopic hematuria , ureteral colic , and lower back pain. Examination on clinical pathology may show reduced glomerular filtration rate, raised blood urea nitrogen and acidosis of renal tubule. RPN has a hallmark of pyelonephritis . Patients with acute RPN are at risk of mortality as a result of kidney failure and septicemia.7 If necrosis of papilla is in situ, radiology may not the best diagnostic measures of RPN. However, computerized tomography (CT Scan) and ultrasound have higher sensitivity in diagnosing papillary necrosis in situ. Magnetic resonance microscopy has also been used for experiments yet it is difficult technically.7 3.4 SUMMARY 4.0 MANAGEMENT 4.1 INTERVENTION PROCEDURES 5.0

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