26th June 2023

A 72-year-old female is admitted with nocturia, dysuria and flank pain. The patient is eventually referred to the renal team

A 72-year-old female is admitted with nocturia, dysuria and flank pain. The patient is eventually referred to the renal team who perform a renal biopsy and confirm the diagnosis of renal papillary necrosis. She has an extensive medical history, including type 2 diabetes mellitus, non-alcoholic fatty liver disease, recurrent urinary tract infections with two previous episodes of pyelonephritis, granulomatosis with polyangiitis (GPA), heart failure secondary to aortic stenosis and osteoarthritis.

If one predominant underlying cause of the renal papillary necrosis could be identified, which would have the worst prognosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.