Renal papillary necrosis (RPN) occurs following Ischemic, inflammatory, infectious, or toxin-mediated damage to the renal papilla and describes the sloughing and loss of the papillae including substructures such as the distal collecting tubule.
RPN can be triggered by infections (eg. acute pyelonephritis), diabetes mellitus, sickle cell disease, or NSAIDs.
It typically presents with gross hematuria and proteinuria on urinalysis.
submitted by โcassdawg(1780)
Renal papillary necrosis is a common complication of sickle cell disease which would cause gross hematuria (FA2020 p602, p422).
Glomerulonephritis would be associated with RBC casts rather than gross hematuria (casts are present if they are released from the glomerulus or tubules). Nephrolithiasis (kidney stones) are not associated with sickle cell and would likely be associated with crystals of some sort on urinalysis. Prostatitis would likely present with more WBCs and does not commonly present with hematuria but rather urgency and dysuria. Transitional cell carcinoma is rare in the kidney and transitional cell carcinoma of the bladder is associated painless hematuria.