Question

Renal papillary necrosis is almost always associated with one of the following conditions:

• A. Diabetes mellitus
• B. Analgesic nephropathy
• C. Chronic pyelonephritis
• D. Post streptococcal glomerulonephritis

Hint:

Which systemic disease with microvascular damage most often causes papillary necrosis?

Answer 1

The Correct Option is A

Step 1: Renal papillary necrosis is ischaemic coagulative necrosis of the renal papillae, often accompanying acute pyelonephritis, with a sharp demarcation between necrotic and viable tissue.

Step 2: Although several conditions can cause it, it is most often and almost always seen in diabetes mellitus, where microvascular disease and superadded infection injure the papillae. Hence option a is the best answer.

Step 3: Analgesic nephropathy is a recognised cause but is less common overall, chronic pyelonephritis contributes to but is not the classic single association, and post-streptococcal glomerulonephritis is a glomerular disease that does not typically cause papillary necrosis, so options b, c and d are not the best fit.