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Behind a Paralyzing Pandemic: Renal Cortical Necrosis

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Detalhes bibliográficos
Resumo:ABSTRACT Renal cortical necrosis (RCN) is a rare cause of acute kidney injury (AKI) in developed countries. Drugs, especially non-steroidal antiinflammatory drugs, (NSAIDs) are very rarely described in the literature to cause cortical necrosis. It is characterized by confluent necrosis of the entire cortex apart from a thin rim of viable tissue in the subcapsular, juxtaglomerular areas, and medulla. Although the pathogenesis of the disease remains unclear, the final common pathway is permanent occlusion of afferent arterioles and interlobular arteries in the cortical vasculature. NSAIDs are widely prescribed in general clinical practice. Despite being readily available, a subset of individuals is susceptible to serious renal toxicity and caution should be exercised when these drugs are used. We present the case of a young adult who presented with renal cortical necrosis with irreversible renal failure. Unfortunately, it occurred as a result of inappropriate use of over-the-counter NSAIDs in the setting of the pandemic outbreak of COVID-19.
Autores principais:Furtado,Teresa
Outros Autores:Abrantes,Catarina; Domingues,Patrícia; Natário,Ana; Góis,Mário; Sousa,Helena
Assunto:Acute Kidney Injury/chemically induced Anti-Inflammatory Agents Non-Steroidal/adverse effects Kidney Cortex Necrosis/chemically induced
Ano:2022
País:Portugal
Tipo de documento:relatório
Tipo de acesso:acesso aberto
Instituição associada:Fundação para a Ciência e Tecnologia
Idioma:inglês
Origem:SciELO Portugal
Descrição
Resumo:ABSTRACT Renal cortical necrosis (RCN) is a rare cause of acute kidney injury (AKI) in developed countries. Drugs, especially non-steroidal antiinflammatory drugs, (NSAIDs) are very rarely described in the literature to cause cortical necrosis. It is characterized by confluent necrosis of the entire cortex apart from a thin rim of viable tissue in the subcapsular, juxtaglomerular areas, and medulla. Although the pathogenesis of the disease remains unclear, the final common pathway is permanent occlusion of afferent arterioles and interlobular arteries in the cortical vasculature. NSAIDs are widely prescribed in general clinical practice. Despite being readily available, a subset of individuals is susceptible to serious renal toxicity and caution should be exercised when these drugs are used. We present the case of a young adult who presented with renal cortical necrosis with irreversible renal failure. Unfortunately, it occurred as a result of inappropriate use of over-the-counter NSAIDs in the setting of the pandemic outbreak of COVID-19.

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