Histology Course S VIII 8 Departement of Pathology, University of Zurich Histokurs

S VIII 8 analgesic nephropathy HE further information (German) on HiPaKu
  ICD-10: N14.0

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 is calcified.
- 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.