Renal papillary necrosis is almost always associated with one of the following conditions -

Analgesic nephropathy is a form of the chronic renal disease caused by excessive intake of analgesic mixtures and characterized morphologically by chronic tubulointerstitial nephritis and renal papillary necrosis. phenacetin metabolite acetaminophen which can deplete cells of glutathione then injures these cells by subsequent generation of oxidative metabolite. Aspirin induces its potentiating effect of prostaglandins, predisposing the papillae to ischemia. poorly controlled diabetics are paicularly susceptible to bacterial infections .pappillary necrosis is an impoant complication of DM that result in acute pyelonephritis. Ref: Pathologic basis of disease Robbins 8th edition, pg no:945; Textbook of pathology Harsh Mohan 7th edition, pg no:665,669.