Renal papillary necrosis classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nasrin Nikravangolsefid, MD-MPH [2]

Overview

Renal papillary necrosis may be classified according to the severity of renal parenchymal lesions into two subtypes: Medullary and Papillary.

Classification

• Renal papillary necrosis may be classified according to the severity of renal parenchymal lesions into two subtypes:
  • Medullary
    • focal necrotic areas, without fornices involvement
  • Papillary
    • involvement of the whole calyceal systems and papillary areas

Staging of Renal papillary necrosis

• According to the histological finding of renal papillary necrosis, there are five grades based on the severity. "Renal Papillary Necrosis - an overview | ScienceDirect Topics".
  • Grade 1
    • involvement of microvasculature, loop of Henle, and interstitial cells, which replaced by eosinophilic material
    • intact collecting ducts
  • Grade 2
    • necrosis of apex of the papilla
  • Grade 3
    • necrosis that extends to mid-papilla
  • Grade 4
    • necrosis that extends to base of the papilla
  • Grade 5
    • necrosis that extends to the extra-medullary area