肾皮质坏死
| 肾皮质坏死 (Renal cortical necrosis) | |
|---|---|
| 类型 | 肾病变、肾皮质病变[*] |
| 分类和外部资源 | |
| 医学专科 | 泌尿外科 |
| ICD-10 | N17.1 |
| ICD-9-CM | 583.6 |
| eMedicine | article/983599 于 eMedicine |
肾皮质坏死(Renal cortical necrosis、RCN，弥漫性双侧肾皮质坏死(diffuse bilateral renal cortical necrosis、BRCN)、，弥漫性皮质坏死(diffuse cortical necrosis)、急性皮质坏死(acute cortical necrosis)、急性皮质坏死急性肾功能衰竭(acute renal failure with acute cortical necrosis))是急性肾功能衰竭的一种罕见病症。该病症"通常通过显著减少肾动脉灌注(Perfusion)继发于血管痉挛、微血管损伤，或弥散性血管内凝血"，以及由急性肾小管坏死的病理进展所致。[1]经常伴随着产科病症发生、诸如胎盘早剥(Placental abruption)及败血性休克，而且是三倍多见于发展中国家与工业化国家中(占急性肾损伤的病因2％-6％)。
病因
成年人
- 妊娠相关(病例>50％)。
- HIV[2]
- 蛇咬伤[3]
- 暴饮[4]
- 休克
- 创伤
- 镰刀型红血球疾病[5]
- 红斑性狼疮(SLE)[6]
- 败血症[7]
- SLE相关抗磷脂综合征[8]
- 维生素缺乏症[9]
- 胰腺炎[10]
- 疟疾[11]
- 脑膜炎球菌病(Meningococcemia)[12]
- 药物引起的中毒(比如NSAIDs、造影剂(Contrast Media)、奎宁、[13]或ATRA[14])
新生儿
- 先天性心脏缺损(Congenital heart disease)
病理生理学
诊断
治疗
患者需要以透析来弥补其肾脏的功能。
预后
皮质坏死是一种严重的危及生命的病症，且死亡率超过50％。
注释
- ^ Deverajan, Prasad. Langman, Craig B , 编. eMedicine: Renal Cortical Necrosis. Medscape. May 26, 2011 [27 March 2012]. （原始内容存档于2021-08-29）.
- ^ Bakshsish Singh, Ankur Gupta, Sandeep Mahajan, Ruchika Gupta. Acute cortical necrosis and collapsing glomerulopathy in an HIV-infected patient: a rare clinical scenario. Saudi Journal of Kidney Diseases and Transplantation: An Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia. 2012-03, 23 (2): 363–366 [2019-02-12]. ISSN 1319-2442. PMID 22382240. （原始内容存档于2019-08-23）.
- ^ Susheel Kumar, Aman Sharma, Kushaljit S. Sodhi, Ajay Wanchu, Niranjan Khandelwal, Surjit Singh. Renal cortical necrosis, peripheral gangrene, perinephric and retroperitoneal haematoma in a patient with a viper bite. Tropical Doctor. 2012-04, 42 (2): 116–117 [2019-02-12]. ISSN 1758-1133. PMID 22316624. doi:10.1258/td.2011.110281. （原始内容存档于2019-08-23）.
- ^ Yeon Soon Jung, Ho Sik Shin, Hark Rim, Kiseok Jang, Moon Hyang Park, Joon-Sung Park, Chang-Hwa Lee, Gheun-Ho Kim, Chong Myung Kang. Bilateral renal cortical necrosis following binge drinking. Alcohol and Alcoholism (Oxford, Oxfordshire). 2012-03, 47 (2): 140–142 [2019-02-12]. ISSN 1464-3502. PMID 22215004. doi:10.1093/alcalc/agr154. （原始内容存档于2019-08-22）.
- ^ S. Shiradhonkar, R. Jha, B. S. Rao, G. Narayan, S. Sinha, G. Swarnalata. Acute cortical necrosis following renal transplantation in a case of sickle cell trait. Indian Journal of Nephrology. 2011-10, 21 (4): 286–288 [2019-02-12]. ISSN 1998-3662. PMC 3193676
. PMID 22022093. doi:10.4103/0971-4065.78066. （原始内容存档于2019-08-13）.
- ^ Megha S. Uppin, Liza Rajasekhar, H. Swetha, V. R. Srinivasan, Aruna K. Prayaga. Renal cortical necrosis at presentation in a patient with systemic lupus erythematosus: an autopsy case report. Clinical Rheumatology. 2010-07, 29 (7): 815–818 [2019-02-12]. ISSN 1434-9949. PMID 20169460. doi:10.1007/s10067-010-1395-5. （原始内容存档于2019-08-21）.
- ^ Chun-Chao Huang, Jon-Kway Huang. Sepsis-induced acute bilateral renal cortical necrosis. Nephrology (Carlton, Vic.). 2011-11, 16 (8): 787 [2019-02-12]. ISSN 1440-1797. PMID 22029648. doi:10.1111/j.1440-1797.2011.01478.x. （原始内容存档于2019-08-21）.
- ^ Jin Ok Kim, Gheun-Ho Kim, Chong Myung Kang, Joon-Sung Park. Bilateral acute renal cortical necrosis in SLE-associated antiphospholipid syndrome. American Journal of Kidney Diseases: The Official Journal of the National Kidney Foundation. 2011-06, 57 (6): 945–947 [2019-02-12]. ISSN 1523-6838. PMID 21514023. doi:10.1053/j.ajkd.2011.02.381. （原始内容存档于2019-08-26）.
- ^ Cristina Novembrino, Rachele De Giuseppe, Federica de Liso, Paola Bonara, Fabrizia Bamonti. Vitamin deficiency and renal cortical necrosis. Lancet (London, England). 2010-07-17, 376 (9736): 160; author reply 161 [2019-02-12]. ISSN 1474-547X. PMID 20638557. doi:10.1016/S0140-6736(10)61101-4. （原始内容存档于2019-08-23）.
- ^ G. S. R. Krishna, K. C. Kishore, N. P. Sriram, V. V. Sainaresh, A. Y. Lakshmi, V. Siva Kumar. Bilateral renal cortical necrosis in acute pancreatitis. Indian Journal of Nephrology. 2009-07, 19 (3): 125 [2019-02-12]. ISSN 1998-3662. PMC 2859480 . PMID 20436735. doi:10.4103/0971-4065.57112. （原始内容存档于2019-08-22）.
- ^ K. V. Baliga, A. S. Narula, R. Khanduja, M. Manrai, P. Sharma, N. S. Mani. Acute cortical necrosis in Falciparum malaria: an unusual manifestation. Renal Failure. 2008, 30 (4): 461–463 [2019-02-12]. ISSN 1525-6049. PMID 18569922. doi:10.1080/08860220801964293. （原始内容存档于2019-08-18）.
- ^ H.-S. Toh, K.-C. Cheng, W.-K. Kuar, C.-K. Tan. The Case. Generalized petechiae and acute renal failure: bilateral renal cortical necrosis in meningococcemia. Kidney International. 2008-06, 73 (12): 1443–1444 [2019-02-12]. ISSN 1523-1755. PMID 18516063. doi:10.1038/ki.2008.143. （原始内容存档于2019-08-19）.
- ^ F. Leroy, F. Bridoux, R. Abou-Ayache, S. Belmouaz, E. Desport, A. Thierry, M. Bauwens, G. Touchard. [Quinine-induced renal bilateral cortical necrosis]. Nephrologie & Therapeutique. 2008-06, 4 (3): 181–186 [2019-02-12]. ISSN 1769-7255. PMID 18343736. doi:10.1016/j.nephro.2008.01.001. （原始内容存档于2019-08-20）.
- ^ A. Sastre López, E. Gago González, M. Baños Gallardo, E. Gómez-Huertas, F. Ortega Suárez. [All-trans retinoic acid syndrome [corrected] and renal cortical necrosis]. Anales De Medicina Interna (Madrid, Spain: 1984). 2007-11, 24 (11): 551–553 [2019-02-12]. ISSN 0212-7199. PMID 18275266.
