SPECTRUM OF RENAL CORTICAL NECROSIS IN ACUTE-RENAL-FAILURE IN EASTERNINDIA

Renal cortical necrosis is an uncommon cause of acute renal failure. W e report 23 cases of biopsy-proven renal cortical necrosis which const ituted 6.3% (23/363) of all cases of acute renal failure studied over a period of seven years (1985-92). The patients were divided into two groups: obstetric and non-obstetric. Obstetric complications were resp onsible for renal cortical necrosis in 15 (65.2%) patients while non-o bstetric conditions accounted for the remaining eight (34.8%) cases. T he overall incidence of cortical necrosis in obstetric acute renal fai lure was 15/63 (23.8%) patients, the incidence being nearly equal in e arly (20.5%) and late (29%) pregnancy. Postabortum renal failure was t he sole cause of cortical necrosis in early pregnancy in the obstetric group. Haemolytic uraemic syndrome (three patients) and septicaemia ( two patients) were the main cause of necrosis in the non-obstetric gro up. The cortical necrosis was diffuse and patchy in 17 and six patient s, respectively. The disease had a fatal prognosis in 20 (87%) patient s; mortality was due to uraemic complications and infections in the ma jority of patients. The high frequency of post-abortum renal cortical necrosis in our patients is similar to the experience of other Indian workers.