Renal Papillary Necrosis in Acute Pyelonephritis: Pathogenesis, Diagnosis, and the Role of Relook Flexible Ureterorenoscopy

Book Publisher International (a part of SCIENCEDOMAIN International) 2026 Book chapter

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Authors: Suryaram Aravind, Punith Jain, Hariharasudhan Sekar, Velmurugan Palaniyandi, Vivek Meyyappan, Sriram Krishnamoorthy
DOI: 10.9734/bpi/mono/978-93-47485-68-8/ch8
Cited by: 0

Abstract

Renal papillary necrosis (RPN) is an under-recognised complication of acute pyelonephritis (APN), especially in high-risk populations like diabetics. This chapter explores the vascular and infectious pathophysiology underlying RPN, describes its classic and atypical presentations, and highlights the emerging role of relook flexible ureterorenoscopy (F-RURS) in identifying and removing necrosed papillae. Recent case reports and small series suggest that timely endoscopic removal of necrotic debris reduces recurrence and improves renal outcomes. This chapter aims to equip clinicians with a structured approach to suspect, investigate, and intervene upon RPN in the APN setting.

Fields of Study & Subjects

Urinary Tract Infections Management Kidney Stones and Urolithiasis Treatments Pediatric Urology and Nephrology Studies

Publication details

Journal / source
Book Publisher International (a part of SCIENCEDOMAIN International)
Pages
92–110
Publication date
27 January 2026
Language
EN
Document type
Book chapter