腎皮質壞死

腎皮質壞死
(Renal cortical necrosis)
腎皮質壞死; (Renal cortical necrosis)
類型	腎病變、腎皮質病變[*]
分類和外部資源
醫學專科	泌尿外科
ICD-10	N17.1
ICD-9-CM	583.6
eMedicine	article/983599 於 eMedicine
	[編輯此條目的維基數據]

腎皮質壞死(Renal cortical necrosis、RCN，瀰漫性雙側腎皮質壞死(diffuse bilateral renal cortical necrosis、BRCN)、，瀰漫性皮質壞死(diffuse cortical necrosis)、急性皮質壞死(acute cortical necrosis)、急性皮質壞死急性腎功能衰竭(acute renal failure with acute cortical necrosis))是急性腎功能衰竭的一種罕見病症。該病症"通常通過顯著減少腎動脈灌注(Perfusion)繼發於血管痙攣、微血管損傷，或彌散性血管內凝血"，以及由急性腎小管壞死的病理進展所致。^[1]經常伴隨著產科病症發生、諸如胎盤早剝(Placental abruption)及敗血性休克，而且是三倍多見於開發中國家與工業化國家中(佔急性腎損傷的病因2％-6％)。

病因

成年人

妊娠相關(病例>50％)。
- 胎盤早剝(Placental abruption)。
- 感染流產。
- 長期胎死宮內(Prolonged intrauterine fetal death)。
- 重度子癇。
HIV^[2]
蛇咬傷^[3]
暴飲^[4]
休克
創傷
鐮刀型紅血球疾病^[5]
紅斑性狼瘡(SLE)^[6]
敗血症^[7]
SLE相關抗磷脂症候群^[8]
維生素缺乏症^[9]
胰腺炎^[10]
瘧疾^[11]
腦膜炎球菌病(Meningococcemia)^[12]
藥物引起的中毒(比如NSAIDs、造影劑(Contrast Media)、奎寧、^[13]或ATRA^[14])

新生兒

先天性心臟缺損(Congenital heart disease)

病理生理學

診斷

治療

患者需要以透析來彌補其腎臟的功能。

預後

皮質壞死是一種嚴重的危及生命的病症，且死亡率超過50％。

註釋

^ Deverajan, Prasad. Langman, Craig B , 編. eMedicine: Renal Cortical Necrosis. Medscape. May 26, 2011 [27 March 2012]. （原始內容存檔於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. （原始內容存檔於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. （原始內容存檔於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. （原始內容存檔於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. （原始內容存檔於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. （原始內容存檔於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. （原始內容存檔於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. （原始內容存檔於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. （原始內容存檔於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. （原始內容存檔於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. （原始內容存檔於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. （原始內容存檔於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. （原始內容存檔於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.

[Medscape-1] Deverajan, Prasad. Langman, Craig B , 編. eMedicine: Renal Cortical Necrosis. Medscape. May 26, 2011 [27 March 2012]. （原始內容存檔於2021-08-29）.

[HIV-2] 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. （原始內容存檔於2019-08-23）.

[snakes-3] 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. （原始內容存檔於2019-08-23）.

[4] 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. （原始內容存檔於2019-08-22）.

[SCD_and_RCN-5] 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. （原始內容存檔於2019-08-13）.

[6] 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. （原始內容存檔於2019-08-21）.

[Sepsis_and_RCN-7] 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. （原始內容存檔於2019-08-21）.

[APLS_and_RCN-8] 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. （原始內容存檔於2019-08-26）.

[Vitamins_and_RCN-9] 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. （原始內容存檔於2019-08-23）.

[Pancreatits_and_RCN-10] 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. （原始內容存檔於2019-08-22）.

[11] 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. （原始內容存檔於2019-08-18）.

[12] 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. （原始內容存檔於2019-08-19）.

[13] 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. （原始內容存檔於2019-08-20）.

[14] 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.

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