Acute renal cortical necrosis

Acute renal cortical necrosis is a rare cause of acute renal failure secondary to ischemic necrosis of the renal cortex. It accounts for only 2% of all causes of acute renal failure in developed countries (Grünfeld et al., 1981), but occurs more frequently in developing world (Chugh et al., 1976; Chugh et al., 1983; Hassan et al., 2009; Parkash et al., 1995). The obstetric complications are the commonest (50 – 70%) cause of renal cortical necrosis (Hassan et al., 2009), non-obstetric causes account for 20-30% of all cases of cortical necrosis. The classic description of this condition by Sheehan & Moore (1952) still holds true to this day. They described the lesion at different stages in evolution as seen in autopsy material. The pathogenesis of cortical necrosis is far from clear, and probably many factors are involved. Acute renal failure as a result of acute cortical necrosis cannot be distinguished readily from other forms of acute renal failure such as acute tubular necrosis and renal biopsy is the only sure way of making the diagnosis during life (Lauler & Schreiner, 1958). Partial recovery of renal function has been reported and it is likely that recovery is governed by the extent of the lesion (Walls et al., 1968).