Multiple Risk Factors Induces Renal Papillary Necrosis

Introduction: Renal papillary necrosis (RPN) is a multifactorial complication that occurring under the following conditions: pyelonephritis, obstruction of the urogenital tract, NSAIDs abuse, diabetes mellitus (DM۲), and covid-۱۹. The present report presented a case of right ureteral obstruction created by renal papillary necrosis.Case Presentation: The patient in this study was a ۶۸-year-old woman who was referred to the hospital due to flank pain, fever, vomiting/nausea, frequency, and nocturia. Moreover, she had a history of DM۲, hypertension, dialysis, and covid-۱۹ as well as the use of NSAIDs and antihypertensive. The results of CT suspected a clot, bladder fungus or RPN and covid-۱۹. After performing the ultrasound, mild hydroureteronephrosis and two echogenic foci were seen in the right kidney, suggesting a possible RPN. Thereafter, she was transferred to the urology service. After cystoscopy and urethroscopy, a severe stenosis was seen in the distal right ureter. As soon as inserting double J, lots of pus came out. The definitive diagnosis was RPN, ureteral obstruction, and pyelonephritis.Conclusions: It is important to pay enough attention to the disorders related to the urinary system, especially in the elderly with a history of NSAIDs abuse, DM۲, hypertension, covid-۱۹, and renal diseases. Additionally, the underlying diseases, blood glucose, infection, dehydration, and use of NSAIDs must be well-controlled to protect nephro-ureteral structures.

کلیدواژه ها:

Renal papillary necrosis ، Nephropathy ، Ureteral Obstruction ، NSAIDs ، Diabetes mellitus ، Covid-۱۹