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Renal cortical necrosis — RACP Paediatrics MCQ

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HardNephrologyRenal cortical necrosisRACP Paediatrics

A sick neonate with perinatal asphyxia, DIC, and multiorgan failure develops oliguria and rapidly rising creatinine. Renal ultrasound shows bilaterally enlarged kidneys with absent corticomedullary differentiation and absent renal blood flow on Doppler. What is the most likely renal diagnosis?

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Correct answer: E — Renal cortical necrosis

Bilateral renal cortical necrosis occurs in the setting of severe perinatal asphyxia, DIC, or sepsis. Absent cortical blood flow on Doppler ultrasound is characteristic. It carries a very poor renal prognosis with most surviving infants developing ESKD. Supportive management including dialysis may be needed.

Reference: RACP Paediatric Curriculum – Nephrology/Neonatology; RCH Melbourne – 2023