Abstract: SA-PO0368
Unilateral Renal Cortical Necrosis
Session Information
- AKI: Case Reports - Drug/Toxin Injury, Crystals, Obstruction, and Unusual Presentations
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Shahzad, Varisha, Mater Misericordiae University Hospital, Dublin, Leinster, Ireland
- McDonald, Katherine, Mater Misericordiae University Hospital, Dublin, Leinster, Ireland
- O'Meara, Yvonne M., Mater Misericordiae University Hospital, Dublin, Leinster, Ireland
- Murray, John, Mater Misericordiae University Hospital, Dublin, Leinster, Ireland
- Sadlier, Denise M., Mater Misericordiae University Hospital, Dublin, Leinster, Ireland
- Doyle, Ross, Mater Misericordiae University Hospital, Dublin, Leinster, Ireland
- Cormican, Sarah, Mater Misericordiae University Hospital, Dublin, Leinster, Ireland
Introduction
Cortical necrosis clinically presents as a rapid reduction in glomerular filtration rate (GFR) accompanied by oliguria.In the native kidney, cortical necrosis can be caused by thrombosis of interlobular or larger arteries, massive cholesterol emboli, septic abortion, or other obstetrical complications. Cortical necrosis normally affects both kidneys, however, here we describe a case of unilateral cortical necrosis.
Case Description
A 51-year-old woman presented to her local emergency department with acute onset rightsided flank pain and nausea. Her blood results on admission were largely unremarkable aside from leucocytosis and neutrophilia. Two days after admission, she developed the following: stage 3 AKI with oliguria, anaemia, thrombocytopenia, and acute derangement of liver function tests.
A computed tomography of the kidney ureter bladder demonstrated a right-sided 4 mm obstructing vesicoureteric junction stone with associated hydronephrosis and hydroureter. She was transferred to a tertiary care centre; gram negative sepsis was confirmed with a Proteus on blood culture and laboratory findings were in keeping with DIC. She was treated with Tazobactam/Piperacillin and intravenous fluids.
In addition, further imaging showed improving right-sided hydronephrosis and left renal cortical necrosis. The aetiology of this presentation was sepsis complicated by disseminated intravascular coagulation. The coagulopathy likely contributed to the unilateral renal cortical necrosis.
Discussion
Cortical necrosis usually affects both kidneys, and is typically a complication of sepsis, shock, or obstetrical trauma. To our knowledge, there are only 2 reported cases of unilateral renal cortical necrosis and contralateral hydronephrosis with renal colic and septic shock. Most cases of unilateral cortical necrosis describe preserved renal function in the contralateral kidney, usually associated with hydronephrosis.