pathology
Last reviewed 01/2018
Both kidneys are affected, being shrunken with much subcapsular scarring though portions of the kidneys may spared with areas of undamaged cortex. The scarred areas are those drained by the necrotic papillae.
The necrosis may involve just the tip of the papilla or a much larger area extending up into the medulla. The necrotic tissue becomes detached, it may calcify or it may pass down the ureter. Typically it is not inflamed (cf diabetes and pyelonephritis) that is there is little in the way of a neutrophil reaction at the point of separation.