Renal Cortical Necrosis Treatment & Management
- Author: Prasad Devarajan, MD; Chief Editor: Craig B Langman, MD more...
Approach Considerations
The cornerstones of renal cortical necrosis therapy are to restore hemodynamic stability, institute early dialytic therapy, and treat the underlying cause of the disease.
Most cases of renal cortical necrosis initially require intensive care.
Dialysis
Early institution of dialysis treatment for renal failure is crucial for patients who are oliguric.
Most patients require an access (eg, hemocatheter, peritoneal dialysis catheter) to institute dialysis.
Dietary Measures
Ensure adequate energy intake.
Patients with compromised kidney function require a low-potassium, low-phosphorus diet.
Activity Restriction
Activity should continue as tolerated.
Consultations
Consult a nephrologist to manage acute renal failure and for ongoing chronic renal replacement therapy.
Consultation with other specialties may be needed, depending on the etiology of the renal cortical necrosis.
Kamioka I, Nozu K, Fujita T, Kaito H, Tanaka R, Yoshiya K, et al. Prognosis and pathological characteristics of five children with non-Shiga toxin-mediated hemolytic uremic syndrome. Pediatr Int. Apr 2007;49(2):196-201. [Medline].
Prakash J, Vohra R, Wani IA, Murthy AS, Srivastva PK, Tripathi K, et al. Decreasing incidence of renal cortical necrosis in patients with acute renal failure in developing countries: a single-centre experience of 22 years from Eastern India. Nephrol Dial Transplant. Apr 2007;22(4):1213-7. [Medline].
Ali A, Ali MA, Ali MU, Mohammad S. Hospital outcomes of obstetrical-related acute renal failure in a tertiary care teaching hospital. Ren Fail. 2011;33(3):285-90. [Medline].
Papnicolaou N, Francis IR, Casalino DD, Arellano RS, Baumgarten DA, Curry NS, et al. ACR Appropriateness Criteria renal failure. [online publication]. Reston, VA: American College of Radiology (ACR); 2008.
Archer L, Kilburn-Toppin F, Sneddon K, et al. A "fussy eater" with renal failure. Lancet. Feb 20 2010;375(9715):696. [Medline].
Krishna GS, Kishore KC, Sriram NP, et al. Bilateral renal cortical necrosis in acute pancreatitis. Indian J Nephrol. Jul 2009;19(3):125. [Medline]. [Full Text].

