50-year-old female, terminal renal failure following long-term abuse of saridon
Nephrectomy for transplantation
- The centre of the specimen shows necrotic, flattened and partly calcified cut papillae.
- The necrotic tissue
- The papillae are often shed into the calyx lumen.
- The renal parenchyma shows scars with interstitial fibrosis, tubular atrophy and loss of glomeruli.
- In some areas, the tubular apparatus has a strumiform appearance
- Chronic inflammation in the renal pelvis
Pathogenesis: Papillary necrosis occurs as a consequence of constricted capillaries (capillary sclerosis, refer to S VIII9) which is caused by the toxicity of analgesics. Secondary dystrophic calcification may occur. The remaining renal tissue shows chronic nephritis. Consequently the kidneys are predisposed to chronic recurrent pyelonephritis.