腎髄質壊死
WordNet
- of or relating to the medulla of any body part
- containing or consisting of or resembling bone marrow
- of or relating to the medulla oblongata
- the inner part of an organ or structure in plant or animal
- the localized death of living cells (as from infection or the interruption of blood supply) (同)mortification, gangrene, sphacelus
PrepTutorEJDIC
- 〈U〉骨髄 / =medulla oblongata
- 壊疽(えそ)
- 腎臓の
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/11/10 21:25:56」(JST)
[Wiki en表示]
| Renal papillary necrosis |
|
Frontal section through the kidney
|
| Classification and external resources |
| Specialty |
urology |
| ICD-10 |
N17.2 |
| ICD-9-CM |
584.7 |
| DiseasesDB |
9572 |
| MedlinePlus |
000488 |
| eMedicine |
med/2839 radio/523 |
| MeSH |
D007681 |
Renal papillary necrosis is a form of nephropathy involving the necrosis of the renal papilla.[1] Lesions that characterize renal papillary necrosis come from an impairment of the blood supply and from subsequent ischemic necrosis that is diffuse.[2]
Contents
- 1 Signs and Symptoms
- 2 Causes
- 3 Pathophysiology
- 4 Diagnosis
- 5 Treatment
- 6 References
- 7 Further reading
Signs and Symptoms
Symptoms (and signs) consistent with renal papillary necrosis are:[1]
- Back pain
- Cloudy urine
- Tissue pieces (in urine)
- Fever
- Painful/frequent urination
- urinary incontinence
Causes
In terms of cause, most 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 abuse, renal vein thrombosis, diabetes mellitus, and systemic vasculitis.[3] Often, a patient with renal papillary necrosis will have numerous conditions acting synergistically to bring about the disease.[4]
Analgesic nephropathy is a common cause of renal papillary necrosis. 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 The risk is higher for phenacetin (which was withdrawn from market in the United States) and paracetamol (acetaminophen) compared to aspirin and other NSAIDs.[medical citation needed]
Pathophysiology
The pathophysiology of this condition can be due to analgesic nephropathy, which in turn is a result of long-term use of aspirin.[5] It is a sequence of vascular occlusion, vasospasm, then infection and finally obstruction which leads to RPN.[6]
Diagnosis
Individuals with renal papillary necrosis due to excess use of analgesic have a elevated risk of epithelial tumors, hence a urine cytology exam is useful.[7] In terms of imaging this condition can be identified by retrograde pyelography (RGP).[8] The diagnosis of renal papillary necrosis is therefore done via:[9]
- Urinalysis
- Blood cell count
- Urine cytology study
- Imaging study (with intravenous contrast)
- Cystoscopy
- Ureteroscopy
Treatment
Treatment of renal papillary necrosis is supportive, any obstruction (urethral) can be dealt with via stenting. This condition is not linked to a higher possibility of renal failure.[10] Control of infection is important, thus antimicrobial treatment is begun, so as to avert surgery (should the infection not respond).[11]
References
- ^ a b "Renal Papillary Necrosis". Medline. NIH. Retrieved 15 October 2015.
- ^ Jung, Dae Chul; Kim, Seung Hyup; Jung, Sung Il; Hwang, Sung Il; Kim, Sun Ho (November 2006). "Renal Papillary Necrosis: Review and Comparison of Findings at Multi–Detector Row CT and Intravenous Urography1". RadioGraphics 26 (6): 1827–1836. doi:10.1148/rg.266065039. Retrieved 15 October 2015.
- ^ Kim, Seung Hyup (2011-11-19). Radiology Illustrated: Uroradiology. Springer Science & Business Media. p. 471. ISBN 9783642053221.
- ^ Powell, Christopher. "Papillary Necrosis". Medscape Reference. Retrieved 10 Nov 2011.
- ^ "Analgesic Nephropathy. Chronic kidney disease information. Patient | Patient". Patient (in en-GB). Retrieved 2015-10-15.
- ^ Greenberg, Arthur; Cheung, Alfred K. (2005-01-01). Primer on Kidney Diseases. Elsevier Health Sciences. p. 387. ISBN 1416023127.
- ^ Wein, Alan J.; Kavoussi, Louis R.; Novick, Andrew C.; Partin, Alan W.; Peters, Craig A. (2011-09-28). Campbell-Walsh Urology. Elsevier Health Sciences. p. 269. ISBN 1455722987.
- ^ Kim, Seung Hyup (2011-11-19). Radiology Illustrated: Uroradiology. Springer Science & Business Media. p. 472. ISBN 9783642053221.
- ^ "Papillary Necrosis Workup: Laboratory Studies, Imaging Studies, Diagnostic Procedures". emedicine.medscape.com. Retrieved 2015-10-15.
- ^ Schrier, Robert W. (2007-01-01). Diseases of the Kidney and Urinary Tract. Lippincott Williams & Wilkins. p. 2008. ISBN 9780781793070.
- ^ Schlossberg, David (2015-04-23). Clinical Infectious Disease. Cambridge University Press. p. 438. ISBN 9781107038912.
Further reading
- Steinberg, Martin H.; Forget, Bernard G.; Higgs, Douglas R. (2009-08-17). Disorders of Hemoglobin: Genetics, Pathophysiology, and Clinical Management. Cambridge University Press. ISBN 9780521875196.
- Stern, Adam W.; Ritchey, Jerry W.; Hall, Brittany; Ketz-Riley, Cornelia J.; Genova, Suzanne G. (2010-05-01). "Nonsteroidal Anti-Inflammatory Drug—Associated Renal Papillary Necrosis in a White-Tailed Deer (Odocoileus Virginianus)". Journal of Veterinary Diagnostic Investigation 22 (3): 476–478. doi:10.1177/104063871002200328. ISSN 1040-6387. PMID 20453233.
- Urinary system
- Pathology
- Urologic disease / Uropathy (N00–N39, 580–599)
|
|
| Abdominal |
Nephropathy/
(nephritis+
nephrosis) |
Glomerulopathy/
glomerulitis/
(glomerulonephritis+
glomerulonephrosis) |
Primarily
nephrotic |
| Non-proliferative |
- Minimal change
- Focal segmental
- Membranous
|
|
| Proliferative |
- Mesangial proliferative
- Endocapillary proliferative
- Membranoproliferative/mesangiocapillary
|
|
| By condition |
|
|
|
Primarily
nephritic,
RPG |
| Type I RPG/Type II hypersensitivity |
|
|
| Type II RPG/Type III hypersensitivity |
- Post-streptococcal
- Lupus
- IgA/Berger's
|
|
| Type III RPG/Pauci-immune |
- Granulomatosis with polyangiitis
- Microscopic polyangiitis
- Churg–Strauss syndrome
|
|
|
|
Tubulopathy/
tubulitis |
| Proximal |
|
|
| Thick ascending |
|
|
| Distal convoluted |
|
|
| Collecting duct |
- Liddle's syndrome
- RTA
- Diabetes insipidus
|
|
| Renal papilla |
|
|
| Major calyx/pelvis |
- Hydronephrosis
- Pyonephrosis
- Reflux nephropathy
|
|
| Any/all |
|
|
|
| Interstitium |
- Interstitial nephritis
- Pyelonephritis
- Danubian endemic familial nephropathy
|
|
| Any/all |
| General syndromes |
- Renal failure
- Acute renal failure
- Chronic kidney disease
- Uremic pericarditis
- Uremia
|
|
| Vascular |
- Renal artery stenosis
- Renal ischemia
- Hypertensive nephropathy
- Renovascular hypertension
- Renal cortical necrosis
|
|
| Other |
- Analgesic nephropathy
- Renal osteodystrophy
- Nephroptosis
- Abderhalden–Kaufmann–Lignac syndrome
|
|
|
|
| Ureter |
- Ureteritis
- Ureterocele
- Megaureter
|
|
|
| Pelvic |
| Bladder |
- Cystitis
- Interstitial cystitis
- Hunner's ulcer
- Trigonitis
- Hemorrhagic cystitis
- Neurogenic bladder dysfunction
- Bladder sphincter dyssynergia
- Vesicointestinal fistula
- Vesicoureteral reflux
|
|
| Urethra |
- Urethritis
- Non-gonococcal urethritis
- Urethral syndrome
- Urethral stricture/Meatal stenosis
- Urethral caruncle
|
|
|
| Any/all |
- Obstructive uropathy
- Urinary tract infection
- Retroperitoneal fibrosis
- Urolithiasis
- Bladder stone
- Kidney stone
- Renal colic
- Malakoplakia
- Urinary incontinence
|
|
|
Index of the urinary system
|
|
| Description |
- Anatomy
- Physiology
- Development
- Cells
|
|
| Disease |
- Electrolyte and acid-base
- Congenital
- Neoplasms and cancer
- Other
- Symptoms and signs
- Urine tests
- Blood tests
|
|
| Treatment |
- Procedures
- Drugs
- Intravenous fluids
|
|
|
|
Medicine
|
|
| Specialties&subspecialties |
|
Surgery
|
|
- Cardiac surgery
- Cardiothoracic surgery
- Colorectal surgery
- Eye surgery
- General surgery
- Neurosurgery
- Oral and maxillofacial surgery
- Orthopedic surgery
- Hand surgery
- Otolaryngology (ENT)
- Pediatric surgery
- Plastic surgery
- Reproductive surgery
- Surgical oncology
- Thoracic surgery
- Transplant surgery
- Trauma surgery
- Urology
- Vascular surgery
|
|
Internal medicine
|
|
- Allergy / Immunology
- Angiology
- Cardiology
- Endocrinology
- Gastroenterology
- Geriatrics
- Hematology
- Hospital medicine
- Infectious disease
- Nephrology
- Oncology
- Pulmonology
- Rheumatology
|
|
Obstetrics and gynaecology
|
|
- Gynaecology
- Gynecologic oncology
- Maternal-fetal medicine
- Obstetrics
- Reproductive endocrinology and infertility
- Urogynecology
|
|
Diagnostic
|
|
- Radiology
- Interventional radiology, Nuclear medicine
- Pathology
- Anatomical pathology, Clinical pathology, Clinical chemistry, Clinical immunology, Cytopathology, Medical microbiology, Transfusion medicine
|
|
Specialties
|
|
- Addiction medicine
- Adolescent medicine
- Anesthesiology
- Dermatology
- Disaster medicine
- Diving medicine
- Emergency medicine
- Family medicine
- General practice
- Hospital medicine
- Intensive-care medicine
- Medical genetics
- Neurology
- Occupational medicine
- Ophthalmology
- Oral medicine
- Pain management
- Palliative care
- Pediatrics
- Physical medicine and rehabilitation
- Preventive medicine
- Psychiatry
- Radiation oncology
- Reproductive medicine
- Sexual medicine
- Sleep medicine
- Sports medicine
- Transplantation medicine
- Tropical medicine
|
|
|
| Medical education |
- Medical school
- Bachelor of Medicine, Bachelor of Surgery
- Bachelor of Medical Sciences
- Master of Medicine
- Master of Surgery
- Doctor of Medicine
- Doctor of Osteopathic Medicine
- MD-PhD
|
|
| Related topics |
- Allied health
- Nanomedicine
- Molecular oncology
- Personalized medicine
- Veterinary medicine
- Physician
- History of medicine
|
|
|
|
|
UpToDate Contents
全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.
English Journal
- Qualitative and Quantitative Imaging Evaluation of Renal Cell Carcinoma Subtypes with Grating-based X-ray Phase-contrast CT.
- Braunagel M1, Birnbacher L2, Willner M2, Marschner M2, De Marco F2, Viermetz M2, Notohamiprodjo S1, Hellbach K1, Auweter S1, Link V3, Woischke C3, Reiser MF1, Pfeiffer F2, Notohamiprodjo M4, Herzen J2.
- Scientific reports.Sci Rep.2017 Mar 31;7:45400. doi: 10.1038/srep45400.
- PMID 28361951
- Renal papillary necrosis in patients with sickle cell disease: How to recognize this 'forgotten' diagnosis.
- Henderickx MM1, Brits T2, De Baets K2, Seghers M3, Maes P4, Trouet D4, De Wachter S2, De Win G2.
- Journal of pediatric urology.J Pediatr Urol.2017 Mar 7. pii: S1477-5131(17)30086-4. doi: 10.1016/j.jpurol.2017.01.020. [Epub ahead of print]
- PMID 28341428
- Cystic and necrotic papillary renal cell carcinoma: prognosis, morphology, immunohistochemical, and molecular-genetic profile of 10 cases.
- Peckova K1, Martinek P1, Pivovarcikova K1, Vanecek T1, Alaghehbandan R2, Prochazkova K3, Montiel DP4, Hora M3, Skenderi F5, Ulamec M6, Rotterova P7, Daum O1, Ferda J8, Davidson W9, Ondic O1, Dubova M1, Michal M1, Hes O10.
- Annals of diagnostic pathology.Ann Diagn Pathol.2017 Feb;26:23-30. doi: 10.1016/j.anndiagpath.2016.10.007. Epub 2016 Oct 20.
- PMID 28038707
Japanese Journal
- Atrial natriuretic peptide enhances recovery from ischemia/reperfusion-induced renal injury in rats(GENETICS, MOLECULAR BIOLOGY, AND GENE ENGINEERING)
- Chujo Kousuke,Ueno Masaki,Asaga Takehiko,Sakamoto Haruhiko,Shirakami Gotaro,Ueki Masaaki
- Journal of bioscience and bioengineering 109(6), 526-530, 2010-06
- … This repair process involves epidermal growth factor (EGF) synthesized in medullary the thick ascending limbs (mTAL) of Henle. … Atrial natriuretic peptide (ANP), a hormone synthesized by the cardiac atria, increases glomerular filtration rate and renal medullary blood flow. … However, the effects of ANP on renal recovery after I/R-induced renal injury remain unclear. …
- NAID 110007641895
- Tempol Protects against Ischemic Acute Renal Failure by Inhibiting Renal Noradrenaline Overflow and Endothelin-1 Overproduction(Pharmacology)
- FUJII Toshihide,TAKAOKA Masanori,OHKITA Mamoru,MATSUMURA Yasuo
- Biological & pharmaceutical bulletin 28(4), 641-645, 2005-04-01
- … The effects of tempol, a superoxide dismutase mimetic, on ischemia/reperfusion-induced acute renal failure (ARF), noradrenaline (NA) overflow and endothelin-1 (ET-1) overproduction in rats were examined. … Ischemic ARF was induced by occlusion of the left renal artery and vein for 45 min followed by reperfusion, 2 weeks after contralateral nephrectomy. …
- NAID 10016662131
Related Links
- THE PATHOGENESIS of renal medullary (or papillary) necrosis is still quite obscure. The lesion has all the earmarks of an ischemic infarct, in the absence of obstruction of a major blood vessel. Furthermore, the necrosis never involves the cortex. An apparent counterpole to this lesion is symmetrical cortical necrosis, a pathologic entity for ...
- SUMMARY AND CONCLUSIONS Renal medullary necrosis is a serious and often fatal complication of pyelonephritis and is there- fore most frequently encountered in patients suffering from diabetes, or urinary obstruction or both
- The necrosis is anatomically limited to the renal medulla, hence the term "renal medullary necrosis" is preferable to such terms as necrotiz- ing papillitis, papillary necrosis or necrotizing pyelonephritis, even though the initiating fac- tors, such as pyelonephritis, may be present throughout the cortex.
★リンクテーブル★
[★]
- 英
- renal papillary necrosis、kidney papillary necrosis
- 同
- 腎髄質壊死 renal medullary necrosis
- 関
- 急性腎乳頭壊死
病因
[★]
- 関
- bulbar、medulla、medulla oblongata
[★]
毛
副腎
脳神経
[★]
- 関
- kidney、renally