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Renal cortical necrosis (RCN) is a rare cause of acute kidney failure. The condition is "usually caused by significantly diminished arterial perfusion of the kidneys due to spasms of the feeding arteries, microvascular injury, or disseminated intravascular coagulation " and is the pathological progression of acute tubular necrosis . [ 1 ]
It may cause acute kidney injury. It is now more commonly used to describe diffuse, fine, renal parenchymal calcification in radiology. [2] It is caused by multiple different conditions and is determined by progressive kidney dysfunction. These outlines eventually come together to form a dense mass. [3]
In terms of cause, almost any condition that involves ischemia can lead to renal papillary necrosis. A mnemonic for the causes of renal papillary necrosis is POSTCARDS: pyelonephritis, obstruction of the urogenital tract, sickle cell disease, tuberculosis, cirrhosis of the liver, analgesia/alcohol use disorder, renal vein thrombosis, diabetes mellitus, and systemic vasculitis. [3]
The renal cortex is the outer portion of the kidney between the renal capsule and the renal medulla. [1] In the adult, it forms a continuous smooth outer zone with a number of projections ( cortical columns ) that extend down between the pyramids .
Kidney ischemia [1] is a disease with a high morbidity and mortality rate. [2] Blood vessels shrink and undergo apoptosis which results in poor blood flow in the kidneys. More complications happen when failure of the kidney functions result in toxicity in various parts of the body which may cause septic shock, hypovolemia, and a need for surgery. [3]
Taken as a whole, if the disease is limited to the kidney, only 20–30% develop metastatic disease after nephrectomy. [110] More specific subsets show a five-year survival rate of around 90–95% for tumors less than 4 cm. For larger tumors confined to the kidney without venous invasion, survival is still relatively good at 80–85%.
Fig.1) Schematic diagram of the nephron (yellow), relevant circulation (red/blue), and the four methods of altering the filtrate. The nephron is the functional unit of the kidney. [3] This means that each separate nephron is where the main work of the kidney is performed. A nephron is made of two parts:
CT scan or kidney ultrasonography is useful in the diagnosis of xanthogranulomatous pyelonephritis; serial imaging may be useful for differentiating this condition from kidney cancer. [10] Acute pyelonephritis with increased cortical echogenicity and blurred delineation of the upper pole [20]