Renal Papillary Necrosis in Childhood

Renal papillary necrosis in infancy.

“…In children most cases occur under the age of 1 year and most commonly in association with episodes of asphyxia, dehydration, and septicaemia (Davies et al, 1969). A fairly characteristic clinical picture emerges from a consideration of our cases and others where clinical details are recorded (Stirling, 1958;Chrispin et al, 1970). The patients are usually under the age of 6 months and have an acute illness associated with shock and dehydration, most commonly due to diarrhoea and vomiting.…”

“…This author also comments on the short oliguric phase in acute tubular necrosis in infancy; in our second case oliguria was present for only 3 days. Stirling (1958) remained persistently hyponatraemic till death. Hyponatraemia in this condition probably usually occurs from the excessive administration of water during acute renal failure.…”

“…5) (Stirling, 1958;Chrispin et al, 1970 (Kerr, 1968). This author also comments on the short oliguric phase in acute tubular necrosis in infancy; in our second case oliguria was present for only 3 days.…”

“…In the newborn infant renal papillary necrosis has occurred with asphyxia (Bernstein and Meyer, 1961;Mauer and Nogrady, 1969), hyperbilirubinaemia (Watanabe and Sakaguchi, 1969), and haemorrhagic shock (Marks, 1960). In older children it has followed severe and prolonged hypotension with dehydration (Davies et al, 1969) or sepsis (Stirling, 1958;Swartz and Hoogstraten, 1959). Chrispin et al (1970) described the radiological appearances of papillary necrosis in 3 infants who survived.…”

Hemorrhagic Infarction of the Kidney

“…These authors concluded that venous thrombosis may be one of several mechanisms responsible for this lesion. Stirling [3] re ported the case of a child with papillary necrosis associ ated with thrombosis of the main renal, pelvic, and arcuate veins. He argued that the renal cortex was spared because of collateral circulation through subcapsular and perinephric venous channels.…”