Renal papillary necrosis is known to be associated with all of the following, except: (AIIMS May 2011)
|D||Sickle cell disease|
a. When infection of the renal pyramids develops in association with vascular diseases of the kidney or with urinary tract obstruction, renal papillary necrosis is likely to result.
b. Patients with diabetes, sickle cell disease, chronic alcoholism, and vascular disease seem peculiarly susceptible to this complication.
c. Hematuria, pain in the flank or abdomen, and chills and fever are the most common presenting symptoms.
d. Acute renal failure with oliguria or anuria sometimes develops.
e. Rarely, sloughing of a pyramid may take place without symptoms in a patient with chronic UTI, and the diagnosis is made when the necrotic tissue is passed in the urine or identified as a "ring shadow" on pyelography.
f. If renal function deteriorates suddenly in a diabetic individual or a patient with chronic obstruction, the diagnosis of renal papillary necrosis should be entertained, even in the absence of fever or pain.
g. Renal papillary necrosis is often bilateral; when it is unilateral, however, nephrectomy may be a life-saving approach to the management of overwhelming infection.