The most common symptoms of renal papillary necrosis include back pain, fever and urinary symptoms. History of medical conditions such as diabetes and sickle cell disease and long term analgesics use such as acetaminophen and NSAIDS should be considered.

• History taking plays a major in the diagnosis of renal papillary necrosis.
  
• Past medical history and medications history that can make diagnostic clues, include ^[1]:
  • history of diabetes
  • history of Sickle cell disease
  • history of Urinary tract obstruction
  • history of Renal vein thrombosis
  • history of pyelonephritis
  • history of Tuberculosis
  • history of systemic vasculitis
  • history of Renal transplant rejection
  • history of long term analgesics abuse such as acetaminophen and NSAIDS

• Common symptoms of renal papillary necrosis include:^[2]:
• Back or flank pain
• Fever
• Chills
• Urinary symptoms:
  • presence of tissues in urine
  • Cloudy urine or hematuria
  • dysuria
  • frequency
  • urgency
  • urinary incontinency
  • urinary hesitancy
  • polyuria
  • nocturia
• If left untreated or progressed, symptoms of chronic renal failure may be developed.