In a 17-year-old male with gross hematuria, what condition is most likely indicated?

In a 17-year-old male presenting with gross hematuria, renal papillary necrosis is often indicated, particularly when associated with risk factors such as sickle cell disease, diabetes, or prolonged analgesic use. This condition leads to the ischemic necrosis of the renal papillae, which can result in bleeding into the urinary tract.

Gross hematuria can arise from several conditions, but renal papillary necrosis typically presents with symptoms that align with the patient's age and risk profile. The necrotic tissue may slough off and lie within the collecting system of the kidney, leading to visible blood in the urine.

While urinary tract infections can cause hematuria, they are less likely in this age group without accompanying urinary symptoms. Glomerulonephritis generally presents with dysmorphic red blood cells, proteinuria, and other signs of renal impairment, which may not be consistent with the sudden onset of gross hematuria. Nephrolithiasis can cause hematuria and is common in adolescents, but it more often presents with flank pain, which wasn't mentioned in this case.

Thus, considering age, presentation, and common etiologies for hematuria, renal papillary necrosis is the most