renal papillary necrosis

Last reviewed 10/2023

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