Cortical Necrosis

Abstract

The term cortical necrosis describes bilateral massive necrosis of both glomeruli and tubules, causing permanent loss of renal function. It is probably caused by the same mechanisms as those causing ATN; therefore the degree of recovery depends on how much of the cortex has been affected. Presumably a degree of cortical necrosis is common, and this explains the permanent reduction in GFR found in many patients after an episode of ATN. However, the full blown syndrome in which there is no recovery of renal function is very rare. The diagnosis is usually suspected when oliguria persists for more than four weeks, but there are clinical clues which may raise suspicions earlier. It is much commoner in accidents of pregnancy which account for 50 per cent of patients described. Heavy proteinuria or total anuria (both rare in patients with ATN) may also arouse suspicion.