WordNet

(botany) a tiny outgrowth on the surface of a petal or leaf
a small nipple-shaped protuberance concerned with taste, touch, or smell; "the papillae of the tongue"
a small projection of tissue at the base of a hair or tooth or feather
the localized death of living cells (as from infection or the interruption of blood supply) (同)mortification, gangrene, sphacelus
of or relating to or resembling papilla (同)papillose

PrepTutorEJDIC

乳頭;(毛根・歯根などにある)微小乳頭状突起物
壊疽(えそ)
腎臓の

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/12/02 01:54:47」(JST)

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Renal papillary necrosis is a form of nephropathy involving the necrosis of the renal papilla,^[1] which is supplied by the vasa recta.

Signs and Symptoms

Renal papillary necrosis presents acutely with gross hematuria, flank pain, and tissue fragments in the urine. It may also include non-specific findings such as fever and chills. Alternatively, it can also present in a chronic form that remains asymptomatic and is diagnosed incidentally.^[2]

Causes

Any condition that involves ischemia can lead to renal papillary necrosis. The four most significant causes are sickle cell disease or trait, analgesic use, diabetes mellitus, and severe pyelonephritis.^[2]

A mnemonic for the causes of renal papillary necrosis is POSTCARDS: pyelonephritis, obstruction of the urogenital tract, sickle cell disease, tuberculosis, chronic liver disease, analgesia/alcohol abuse, renal transplant rejection, diabetes mellitus, and systemic vasculitis. Often, a patient with renal papillary necrosis will have numerous conditions acting synergistically to bring about the disease. ^[3]^[4]

Analgesic nephropathy is a cause of renal papillary necrosis.^[5] The damage is cumulative and most patients of renal papillary necrosis would have ingested at least 2 kg of analgesics in the past. The risk is higher for phenacetin (which has been withdrawn from the market in the United States) and paracetamol (acetaminophen) compared to aspirin and other NSAIDs. Combination analgesic products, such as Goody's, also have a high risk of causing papillary necrosis.

References

^ Jung DC, Kim SH, Jung SI, Hwang SI, Kim SH (2006). "Renal papillary necrosis: review and comparison of findings at multi-detector row CT and intravenous urography". Radiographics : a review publication of the Radiological Society of North America, Inc 26 (6): 1827–36. doi:10.1148/rg.266065039. PMID 17102053.
^ ^a ^b Kumar, Vinay (2009). Robbins & Cotran Pathologic Basis of Disease. Saunders.
^ Zadeii G, Lohr JW (June 1997). "Renal papillary necrosis in a patient with sickle cell trait". J. Am. Soc. Nephrol. 8 (6): 1034–9. PMID 9189873.
^ Powell, Christopher. "Papillary Necrosis". Medscape Reference. Retrieved 10 Nov 2011.
^ "Renal Pathology". Retrieved 2008-11-26.

External links

00312 at CHORUS
Papillary Necrosis at eMedicine

UpToDate Contents

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1. 鎮痛剤性腎症の臨床症状および診断 clinical manifestations and diagnosis of analgesic nephropathy
2. 鎌状赤血球症の腎症状 renal manifestations of sickle cell disease
3. 成人における血尿の原因および評価 etiology and evaluation of hematuria in adults
4. 鎮痛剤による慢性腎臓病 analgesic related chronic kidney disease
5. 非ステロイド性抗炎症剤（NSAIDs）：急性腎障害（急性腎不全） nsaids acute kidney injury acute renal failure

English Journal

Chemotherapy-related complications in the kidneys and collecting system: an imaging perspective.

Jia JB1, Lall C, Tirkes T, Gulati R, Lamba R, Goodwin SC.
Insights into imaging.Insights Imaging.2015 Aug;6(4):479-87. doi: 10.1007/s13244-015-0417-x. Epub 2015 Jul 11.
Nephrotoxicity is a common adverse effect of many chemotherapeutic agents. The agents most commonly associated with chemotherapy-associated nephrotoxicity are methotrexate, semustine, streptozocin, mithramycin, and cisplatin. Certain chemotherapeutic agents have adverse effects on the kidneys and ur
PMID 26162467

Renal Papillary Necrosis Due to Invasive Candida Infection in a Morbidly Obese Patient.

Chalhoub NE1, Riley K1, Siddiqui N1, Assaly R1, Shahrour K2, Booth R3, Duggan J4.
The Journal of urology.J Urol.2015 Jul 13. pii: S0022-5347(15)04366-9. doi: 10.1016/j.juro.2015.07.036. [Epub ahead of print]
PMID 26184064

Clear Cell-Papillary Renal Cell Carcinoma of the Kidney Not Associated With End-stage Renal Disease: Clinicopathologic Correlation With Expanded Immunophenotypic and Molecular Characterization of a Large Cohort With Emphasis on Relationship With Renal Angiomyoadenomatous Tumor.

Aron M1, Chang E, Herrera L, Hes O, Hirsch MS, Comperat E, Camparo P, Rao P, Picken M, Michal M, Montironi R, Tamboli P, Monzon F, Amin MB.
The American journal of surgical pathology.Am J Surg Pathol.2015 Jul;39(7):873-88. doi: 10.1097/PAS.0000000000000446.
Clear cell-papillary renal cell carcinoma (CC-Pap RCC) is a recently described renal tumor initially reported in the setting of end-stage renal disease (ESRD). It has unique morphologic and immunohistochemical features that differentiate it from the more common clear cell RCC and papillary RCC. Rece
PMID 25970682

Japanese Journal

Renal Tubular Cyst Formation in Newborn Rats Treated with p-Cumylphenol

Nakazawa Tomomi,Kasahara Kenichiro,Ikezaki Shinichiro [他],YAMAGUCHI Yuko,EDAMOTO Hiroshi,NISHIMURA Nobuo,YAHATA Megumi,TAMURA Kazutoshi,KAMATA Eiichi,EMA Makoto,HASEGAWA Ryuichi
Journal of toxicologic pathology 22(2), 125-131, 2009-06-01
… In this study, we investigated the sequential changes in the development of renal tubular cysts in newborn rats treated with p-cumylphenol (PCP). … On PNDs 8 and 12, slight dilatation of the collecting ducts was frequently observed in the medulla and slight papillary necrosis was also noted in some cases. …
NAID 10030977996

Thirteen-week Inhalation Toxicity of ρ-Dichlorobenzene in Mice and Rats

Aiso Shigetoshi,Arito Heihachiro,Nishizawa Tomoshi [他],NAGANO Kasuke,YAMAMOTO Seigo,MATSUSHIMA Taijiro
Journal of occupational health 47(3), 249-260, 2005-05-00
… The exposure to p-DCB vapor retarded the growth rate in the male mice, and induced hepatotoxicity in the mice and rats of both sexes and renal and hematological toxicity in the male rats. … Liver necrosis and increased serum levels of AST and ALT were observed in the exposed mice, whereas these changes, which indicate hepatocellular death, did not occur in any of the exposed rats. … p-DCB-induced renal lesions occurred only in the male rats. …
NAID 110003723272

P7-18 Urinary protein analysis and renal mRNA expression in dogs with renal papillary necrosis induced by nefiracetam, a neurotransmission enhancer(IMMUNE AND ALLERGIC SYSTEM/KIDNEYS AND URINARY EXCRETION SYSTEM/CYTOTOXICITY/OTHERS-1)(GENERAL SESSION BY POSTER PRESENTATION)(Proceedings of the 31st Annual Meeting)

TSUCHIYA Yoshimi,TOMINAGA Yuri,MATSUBAYASHI Kyuichi,JINDO Toshimasa,FURUHAMA Kazuhisa,SUZUKI Kazuo T.
Journal of toxicological sciences 29(4), 447, 2004-10-29
NAID 110001816930

Related Pictures

★リンクテーブル★

リンク元	「腎乳頭壊死」「RPN」
関連記事	「papillary」「renal」「papilla」

「腎乳頭壊死」

Renal papillary necrosis
	Classification and external resources
ICD-10	N17.2
ICD-9	584.7
DiseasesDB	9572
MedlinePlus	000488
eMedicine	med/2839 radio/523
MeSH	D007681