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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Renal Cortical Necrosis (RCN) is a rare and devastating entity mainly occurring in settings of obstetric acute kidney injury (AKI), toxins and severe sepsis. There are only handful of cases of RCN in the settings of acute pancreatitis (AP).
We describe a patient who presented to hospital with AP and anuria. A kidney biopsy done in view of non-resolving AKI revealed pachy RCN.
A 62-year-old female with no previous co-morbidities was admitted to hospital with complaints of pain epigastrium, vomiting for 2 days and anuria for 1 day. Examination was unremarkable except tachycardia, tachypnea, pedal edema, epigastric tenderness and fine bibasilar crepitation. Investigations showed: hemoglobin 12.5 gm/dl, total leucocyte count 19350/µl, platelet: 96000/µl, Bilirubin 1.6 mg/dl, AST: 803 IU/L, ALT 214 IU/L, Urea 169 mg/dl, creatinine 6.1 mg/dl, amylase 487 IU/L, Lipase 916 IU/L and ultrasound sound showed bulky head of pancreas, gallbladder sludge, with normal sized kidneys. Optimal supportive care was started for the management of AP (severe AP as per revised Atlanta Criteria 2012) and in view of advanced renal dysfunction haemodialysis (HD) was initiated. Over the period of next 4-5 days features of AP resolved but anuria persisted even beyond 2 weeks. So, a kidney biopsy was done. Kidney biopsy on light microscopy showed global tuft necrosis in 08/14 (57.1%) glomeruli along with necrosis of adjacent tubules and vasculature (cortical necrosis), ischemic changes in remaining glomeruli, patchy acute tubular injury and necrotic process involved about 30-35% of sampled cortical area with unremarkable immunofluorescence and electron microscopy (Image 1). After 4 weeks of onset of illness patient began to pour urine which increased to about 700-800 ml/day with pre-HD creatinine staying < 5mg/dl, so HD was gradually tapered off. Six months on follow up patient is in CKD stage V without need of hemodialysis.
RCN has been rarely reported in AP, mainly in the background of multi-organ dysfunction syndrome (MODS). Our patient developed RCN without significant another organ dysfunction. The case highlights the rare occurrence of acute RCN in patient with AP, and diagnostic implications of kidney biopsy in non-resolving AKI.
