PAPILLARY NECROSIS OF THE KIDNEY

Abstract

Papillary necrosis of the kidney is reported infrequently in the literature and is only rarely diagnosed during life. During the past year, we have encountered 3 morphologically proved cases as well as others in which such proof is lacking but which clinically were apparently in accord with this diagnosis. Since the original description of this condition by Friedreich in 1877,1papillary necrosis of the kidney (necrotizing renal papillitis) has been considered by most observers as a manifestation of pyelonephritis which occurs usually as a complication of diabetes mellitus.2However, as shown by Edmondson, Martin and Evans3in their recent review of this subject, 40 per cent of their cases occurred in nondiabetic patients with urinary tract obstruction. Among the few experimental observations are those of Mallory, Crane and Edwards,4who produced the lesion in rabbits by ligating one ureter and subsequently injecting pathogenic organisms intravenously. Our