Case Of Renal Cortical Necrosis Research Articles

Extensive renal cortical necrosis in a postpartum patient after COVID-19 infection

It has been more than two years since the COVID-19 pandemic affects the world. COVID-19 affects other organs in addition to the respiratory system. Renal cortical necrosis is a severe kidney injury due to decreased renal arterial perfusion induced by vascular spasm, microvascular injury and endovascular thrombosis. Acute kidney injury is a common finding in COVID-19; however, renal cortical necrosis is rare. To the best of our knowledge, only one case of renal cortical necrosis has been reported in the literature.

A Case of Renal Cortical Necrosis in a 15-year-old Boy with Acute Kidney Injury

A Case of Renal Cortical Necrosis in a 15-year-old Boy with Acute Kidney Injury

Acute renal cortical necrosis in pregnancy: Clinical course and changing prognosis

Obstetric cortical renal necrosis is a serious complication that can lead to chronic renal failure and the need for chronic dialysis. The aim of renal cortical necrosis therapy is to restore hemodynamic stability, institute early dialytic therapy, and treat the underlying cause of the disease. Most cases of renal cortical necrosis do not recover a normal renal function despite intensive care. We describe the course of a patient who was diagnosed with acute renal cortical necrosis in pregnancy treated with hemodialysis for three years but then she recovered her renal function.

Changing picture of renal cortical necrosis in acute kidney injury in developing country.

Renal cortical necrosis (RCN) is characterized by patchy or diffuse ischemic destruction of all the elements of renal cortex resulting from significantly diminished renal arterial perfusion due to vascular spasm and microvascular injury. In addition, direct endothelial injury particularly in setting of sepsis, eclampsia, haemolytic uremic syndrome (HUS) and snake bite may lead to endovascular thrombosis with subsequent renal ischemia. Progression to end stage renal disease is a rule in diffuse cortical necrosis. It is a rare cause of acute kidney injury (AKI) in developed countries with frequency of 1.9%-2% of all patients with AKI. In contrast, RCN incidence is higher in developing countries ranging between 6%-7% of all causes of AKI. Obstetric complications (septic abortion, puerperal sepsis, abruptio placentae, postpartum haemorrhage and eclampsia) are the main (60%-70%) causes of RCN in developing countries. The remaining 30%-40% cases of RCN are caused by non-obstetrical causes, mostly due to sepsis and HUS. The incidence of RCN ranges from 10% to 30% of all cases of obstetric AKI compared with only 5% in non-gravid patients. In the developed countries, RCN accounts for 2% of all cases of AKI in adults and more than 20% of AKI during the third trimester of pregnancy. The reported incidence of RCN in obstetrical AKI varies between 18%-42.8% in different Indian studies. However, the overall incidence of RCN in pregnancy related AKI has decreased from 20%-30% to 5% in the past two decades in India. Currently RCN accounts for 3% of all causes of AKI. The incidence of RCN in obstetrical AKI was 1.44% in our recent study. HUS is most common cause of RCN in non-obstetrical group, while puerperal sepsis is leading cause of RCN in obstetric group. Because of the catastrophic sequelae of RCN, its prevention and aggressive management should always be important for the better renal outcome and prognosis of the patients.

Renal cortical necrosis in tropics

The aim of this study is to review cases of renal cortical necrosis (RCN) that were seen on renal biopsy at our center over a period of seven years. All renal biopsy records over seven years at the Osmania General Hospital were reviewed to identify patients with histologically proven RCN. The demographic, clinical, laboratory investigations and follow-up data were noted. There were a total of 105 patients with RCN. The mean age was 28.13 ± 12.40 years. Forty-one cases (39.04%) resulted from obstetric complications. The most common histology type of RCN was patchy cortical necrosis in 65 patients (62%). All patients required dialysis, and the mean duration of dialysis was 3 ± 1 weeks. Thirty-three (31.42%) patients progressed to end-stage kidney disease while three patients underwent renal transplantation. Ten (9.5%) patients succumbed to acute kidney injury. The remaining patients recovered sufficient renal function and were dialysis-independent till the last follow-up. RCN is an important cause of chronic kidney disease. Obstetric complications are the leading cause of RCN in our setting. An early renal biopsy, especially in cases of anuric renal failure, helps in establishing the diagnosis.

Type III Cryoglobulinemia Complicated by Renal Cortical Necrosis

Renal involvement is rare in patients with type III cryoglobulinemia. We report a case of renal cortical necrosis in a patient with type III cryoglobulinemia. Renal function improved partially after treatment with plasma exchange, steroids, and cyclophosphamide. Renal magnetic resonance imaging was a valuable tool in the evaluation of the extent of renal cortical necrosis and improvement in renal vascularization after treatment.

RENAL CORTICAL NECROSIS

In the course of thirteen years, 5994 postmortem examinations were done, among which six cases of renal cortical necrosis were found. These are classified according to microscopical changes. Only three were registered as complications to obstetric diseases. The manifestation of microfibrin thrombosis is found to bee an essentiel factor in the pathogenesis of the condition. According to the similar findings in the generalized Shwartzman reaction, the pathogenesis of renal cortical necrosis is discussed and it is presumed that this condition is confined to a common mechanism, through a varying clinical picture and apparently different pathogenesis.

A Case of Renal Cortical Necrosis with Dystrophic Calcification

A Case of Renal Cortical Necrosis with Dystrophic Calcification

A case of renal cortical necrosis probably caused by a human equivalent of the Shwartzman reaction.

A case of renal cortical necrosis probably caused by a human equivalent of the Shwartzman reaction.

BILATERAL CORTICAL NECROSIS OF THE KIDNEYS FOLLOWING TREATMENT OF AN UNUSUAL CASE OF HEART BLOCK

Case Reports1 June 1951BILATERAL CORTICAL NECROSIS OF THE KIDNEYS FOLLOWING TREATMENT OF AN UNUSUAL CASE OF HEART BLOCKDAVID E. HAFT, M.D., JOHN T. PRIOR, M.D.DAVID E. HAFT, M.D.Search for more papers by this author, JOHN T. PRIOR, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-34-6-1483 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptBilateral necrosis of the renal cortex, which presents such a distinct clinical and striking pathologic picture, was first recognized by Juhel-Renoy1 in 1886 in a young female with scarlet fever. Of the approximately 100 cases that have been reported to date, one-half have occurred in association with pregnancy, the rest in a variety of situations, including acute infections and alcoholism.2 It is not within the scope of this paper to discuss the symptomatology, pathology and clinical course of bilateral cortical necrosis. These considerations have been excellently reviewed by Ash3 and more recently by Duff and More.2A short time ago...Bibliography1. Juhel-Renoy E: De l'anurie precoce scarlatineuse, Arch. gén. de méd. 17: 385-410, 1886. Google Scholar2. DuffMore GR: Bilateral cortical necrosis of the kidneys, Am. J. M. Sc. 201: 428-450, 1941. CrossrefGoogle Scholar3. Ash G: Bilateral cortical necrosis of the kidneys (angioneurotic edema), Am. J. M. Sc. 185: 71-86, 1933. CrossrefGoogle Scholar4. TruetaBarclayFranklinDanielPritchard JAHPM: Studies on the renal circulation, 1947, Charles C. Thomas, Springfield, Ill. Google Scholar5. PennerBernheim AA: Acute ischemic necrosis of the kidney, Arch. Path. 30: 465-480, 1940. Google Scholar6. Byrom F: Morbid effects of vasopressin on the organs and vessels of rats, J. Path. and Bact. 45: 1-16, 1937. CrossrefGoogle Scholar7. Black-SchafferHiebertKerby BTG: Experimental study of purpuric meningococcemia in relation to the Schwartzman phenomenon, with discussion of meningococcic purpura, the Waterhouse-Friderichsen syndrome and bilateral renal cortical necrosis, Arch. Path. 43: 28-54, 1947. Google Scholar8. HowkinsMcLaughlinDaniel JCP: Neuronal damage from temporary cardiac arrest, Lancet, 1: 488-492, 1946. CrossrefMedlineGoogle Scholar9. WeinbergerGibbonGibbon LMJ: Temporary arrest of the circulation to the central nervous system, Arch. Neurol. and Psychiat. 43: 615-634, 961-986, 1940. CrossrefGoogle Scholar10. ScarffKeele RC: The effects of temporary occlusion of the renal circulation in the rabbit, Brit. J. Exper. Path. 24: 147-149, 1943. Google Scholar11. Levine S: Clinical heart disease, 1948, W. B. Saunders Co., Philadelphia. Google Scholar12. Gilchrist A: The action of atropine in complete heart block, Quart. J. Med. 2: 483-498, 1933. Google Scholar13. Gilchrist A: The action of adrenalin in complete heart block, Quart. J. Med. 2: 499-519, 1933. Google Scholar14. SpainCathcart DR: Heart block caused by fat infiltration of the interventricular septum (cor adiposum), Am. Heart J. 32: 659-664, 1946. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Syracuse, New York*Received for publication July 16, 1949.From the Departments of Medicine and Pathology, Syracuse University College of Medicine, Syracuse, New York. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByAkutes NierenversagenDie symmetrische Nierenrindennekrose des LaborschweinsA Case of Renal Cortical Necrosis Probably Caused by a Human Equivalent of the Shwartzman ReactionRenal cortical necrosis�ber das Sanarelli-Shwartzman-Ph�nomen (sog. generalisierte Shwartzman-Ph�nomen) des MenschenBilateral renal cortical necrosis 1 June 1951Volume 34, Issue 6Page: 1483-1491KeywordsAlcoholsClinical pathologyElectrocardiographyHeartKidneysNecrosisPhotographyPregnancyScarlet fever Issue Published: 1 June 1951 PDF DownloadLoading ...