Renal papillary necrosis may occur when certain risk factors are present. Many patients have multiple risk factors.


Risk factors for papillary necrosis:

(1) diabetes mellitus

(2) urinary tract obstruction

(3) pyelonephritis

(4) analgesic nephropathy (associated with prolonged and/or high dose therapy)

(5) sickle cell hemoglobinopathy

(6) renal transplant rejection

(7) infant with dehydration, sepsis, hypoxia and/or jaundice

(8) cirrhosis (with other risk factors)

(9) NSAID therapy (with other risk factors)

(10) vasculitis (systemic lupus erythematosus, Wegener's granulomatosus)

(11) hypercoagulable state (with renal vein thrombosis)

(12) cryoglobulinemia

(13) severe pancreatitis

(14) hypotensive shock

(15) rapidly progressive glomerulonephritis

(16) renal amyloidosis

(17) use of contrast agents

(18) aplastic anemia

(19) severe dehydration and/or hyperviscosity


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