Many conditions and factors can cause renal papillary necrosis. The most common are: Diabetes. Overuse of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen and naproxen. Sickle cell disease. Other conditions and diseases that can lead to renal papillary necrosis include: Chronic liver disease. Pyelonephritis, a bacterial infection of your kidney. Renal tuberculosis, a form of tuberculosis found outside of your lungs. Renal vein thrombosis, a blood clot in the vein that carries blood away from your kidneys. Ureteral obstruction, blockage of your ureter. Vasculitis, inflammation of blood vessels.