Syed Sohail Ali, Syed Zulfiqar Hyder Rizvi, Suhail Muzaffar, Aasim Ahmad, Akhtar Ali, Sheema H. Hassan


Background: The purpose of this study is to review cases of renal cortical necrosis (RCN) which we came across during a period of five years, confirmed on needle biopsy specimens, with literature available so far. Methods: All renal biopsy records between January 1996 to December 2001 at the Aga Khan University Hospital, Karachi, Pakistan were reviewed to identify patients with histologically proven renal cortical necrosis. Seven patients were also referred by the department of Nephrology, Lady Reading Hospital, Peshawar, Pakistan. Patients’ medical records were reviewed for demographic, clinical, and follow up data. Results: There were total of nine patients identified with renal cortical necrosis. The mean age was 26.21±13.01 year. Five cases (55.5%) were caused by obstetric complications. The most common histology type of RCN was patchy cortical necrosis in seven patients (77.8%). Three patients were alive at last follow up; remaining patients were lost to follow up. Conclusion: Obstetric complications remain the leading cause of renal cortical necrosis in our setting. The recognition of this entity and value of renal biopsy in cases of acute renal failure needs to be emphasized as this helps in establishing diagnosis, to assess prognosis and to aid in selection of a rational approach to therapy.

KEY WORDS: Renal cortical necrosis, renal biopsy, acute renal failure.

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Prakash J , Tripathi K, Pandey LK, Gadela SR. Renal cortical necrosis in pregnancy-related acute renal failure. J Indian Med Assoc 1996;94:227-9.

Matlin RA, Gay NF. Acute cortical necrosis: Case report and review of literature. Am J Med 1974;56:110-8.

Kleinknecht D, Grunfeld JP, Cia Gomez P, Moreau JF, Garcia-Torres R. Diagnostic procedures and long term progress in bilateral cortical necrosis. Kidney Int 1973;4:390.

Prakash J, Tripathi K, Pandey LK, Sahai S, Usha, Srivastava. Spectrum of renal cortical necrosis in acute renal failure in Eastern India. Postgrad Med J 1995;71:208-10.

Lauler DP, Schreiner GE. Bilateral renal cortical necrosis. Am J Med 1958;24:519.

Deutsch V, Frankl O, Drony Y, Eliahou, Braf ZF. Bilateral renal cortical necrosis with survival through the acute phase with a note on the value of selective nephroangiography. Am J Med 1971;50:828-34.

Schreiner GE. Bilateral cortical necrosis. In: Hamburger J, Crosnier J, Grunfeld JP (Eds): Nephrology. New York, Wiley, 1979, pp 411-30.

Sakhuja V, Chugh KS. Renal cortical necrosis. Int J Artif Organs 1986;9:145-6.

Solez K. Pathology of kidney, 3rd ed. Boston, Little Brown and Co., 1983, pp 1121-33.

Zuelzer WW, Charles S, Kurvetz R. Circulatory diseases of kidneys in infancy and childhood. Am J Dis Child 1951;81:1-46.

Sheehan HL, Moore HC. Renal cortical necrosis and the Kidney of concealed Accidental Haemorrhage. Oxford: Blackwell, 1952.

Tisher CC, Brenner BM (Eds). Renal pathology with clinical and functional correlations. Lippincott Company, Philadelphia 1989, Vol. 1: pp 700-27.

Prakash J, Sen D, Kumar NS, Kumar H, Tripathi LK, Saxena RK. Acute renal failure due to intrinsic renal diseases: review of 1122 cases. Ren Fail 2003;25:225-33.

Chugh KS, Singhal PC, Sharma BK, Pal Y, Mathew MT, Dhall K, et al. Acute renal failure of obstetric origin. Obstet Gynaecol 1976;48:642-6.

Orom S, Ron G, Pell L, Winteler J. Renal cortical calcification after snake bite. Br Med J 1963;1:1647.

Walls J, Schorr WJ, Kerr DNS. Prolonged oliguria with survival in acute bilateral cortical necrosis. Br Med J 1968;4:220-2.

Chris VG, Willem P, Jef A, Jos V, Paul JD. Activation of both coagulation and fibrinolysis in childhood hemolytic uremic syndrome. Kidney Int 1998;54:1324-30.

McFarlane D: Focal renal cortical necrosis in a fatal case of shock. J Path & Bact 1941;52:406-8.

Sandra WM, Nancy EG, Robert PE. Renal cortical necrosis following streptococcal infection. Arch Intern Med 1977;137:1196-7.

Campbell AC, Henderson JL. Symmetrical cortical necrosis of the kidneys in infancy and childhood. Arch Dis Childhood 1949;24:269-85.

Groshong TD, Taylor AA, Knoff DK, Esterly J, Maher JF. Renal function following cortical necrosis in childhood. J Pediat 1971;79:267.

Perry JW. Phosphorus poisoning with cortical necrosis of the kidneys, a report of two fatal cases. Aus Ann Med 1953;2:94.

Palapattu GS, Barbaric Z, Rajfer J. Acute bilateral renal cortical necrosis as a cause of postoperative renal failure. Urology 2001;58:281.

Ober WE, Reid DE, Rommy SL, Merril JP. Renal lesions and acute renal failure in pregnancy. Am J Med 1956;21:781.

Jeong JY, Kim SH, Sim JS, Lee HJ, Do KH, Moon MH, Lee DK, Seong CK. MR findings of renal cortical necrosis. J Comput Assist Tomogr 2002;26:232-6.

Rathod K, Garg A, Chavhan G, Rathod N. Computed tomography as a diagnostic tool in acute renal cortical necrosis. J Assoc Physicians India 2002;50:1451-2.


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