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Nephrology & Renal Medicine

Acute Cortical Necrosis

ICD-10 Code
N17.8

Rare cause of acute renal failure involving ischemic necrosis of the renal cortex with sparing of the medulla. Strongly associated with severe obstetric catastrophes (placental abruption, amniotic fluid embolism) and severe shock.

Clinical Presentation & Protocol

Patient Usually Complains Of

Patient presents with sudden onset oliguria/anuria following a major obstetric event [e.g., placental abruption, amniotic fluid embolism] or severe hypotensive shock. Clinical course marked by rapid decline in GFR, flank pain, and hematuria.

Clinical Examination Findings

Patient appears acutely ill, lethargic, and potentially volume-overloaded. Skin may show signs of disseminated intravascular coagulation (DIC) or peripheral cyanosis. Vital signs reveal persistent hypotension or labile blood pressure.

Treatment Protocol

Immediate stabilization of hemodynamics. Initiation of renal replacement therapy (RRT/hemodialysis) is typically required. Management of underlying coagulopathy and potential surgical intervention for obstetric source control. Strict fluid balance and electrolyte monitoring.

Detailed clinical guide coming soon.