RENAL PAPILLARY NECROSIS IN A HEMODIALYSIS PATIENT

We present the first case report of bilateral renal papillary necrosis developing in a patient on hemodialysis. A 37-year-old hypertensive m ale with chronic glomerulonephritis had a normal retrograde pyelogram one year prior to initiation of hemodialysis. After two years of maint enance dialysis, he presented with gross hematuria and was found to ha ve extensive bilateral renal papillary necrosis. His only predisposing factor was hepatic cirrhosis. It is postulated that recurrent hypoten sive episodes associated with hemodialysis may lead to renal papillary necrosis in predisposed individuals. This diagnosis should be conside red in hemodialysis patients who develop hematuria.