Renal cortical necrosis

rare cause of AKI caused by acute generalized ischemic necrosis of the renal cortex in both kidneys

• Etiology: septic shock, disseminated intravascular coagulation (DIC), hemolytic uremic syndrome (HUS), obstetric complications (e.g., abruptio placentae, septic abortion, postpartum hemorrhage)

• Pathophysiology: vasospasms and microvascular injury with vascular thrombosis → prolonged severe renal ischemia → diffuse and/or patchy destruction of the renal cortex

• Clinical features: flank pain, CVA tenderness and signs of AKI (see also “Clinical features” above and shock)

• Management: Dialysis can improve outcomes (see “Management” below).

• Prognosis: high mortality rates without treatment