Renal Papillary Necrosis

Renal Papillary Necrosis With Special Reference to Chronic Alcoholism

“…This study overlaps by six months a similar review of the autopsy population prior to July 1,1945, that was the subject of a previous report .5 In the present study, the frequency of renal papillary necrosis among the different pre¬ disposing diseases was noted, with special attention to the coexistence of chronic al¬ coholism and the renal lesion.…”

Renal Papillary Necrosis

“…Similarly, in a review of 155 reported cases of papillary necrosis, including 16 of their own, Knutsen et al (1952) found 87 (56%) were diabetic. In non-diabetics there is usually urinary obstruction; Robbins and Angrist (1949) computed that urinary obstruction was present in 85% of 48 cases without diabetes.…”

“…In Case 5 the diagnosis was made in this way. There are four previous records of this (Edmondson et al, 1947;Johnston, 1952;Knutsen et al, 1952;Mandel, 1952). As in Case 3, renal pain and haematuria may lead to surgical intervention; if the kidney is removed papillitis necroticans may be discovered in it (Alken, 1938;Mellgren and Redell, 1941 ;Robbins et al, 1946;Edmondson et al, 1947;Gunther, 1949).…”

“…Furthermore, as illustrated by Case 5, healing may occur (Alken, 1938;Robbins and Angrist, 1949;Knutsen et al, 1952;Johnston, 1952). It would therefore seem that clinical diagnosis may sometimes be impossible.…”

Hematuria in a 42-Year-Old Woman

“…Experimentally RPN can be produced in the rat by the injection of human serum, presumably due to the formation of microthrombi in the medullary vasculature [82], Liver disease has been suggested as a cause of papillary necrosis. A careful review of the literature, however, reveals only a few cases in whom the only underlying disease is chronic alcoholism and liver cirrhosis [9,[83][84][85]. Although cirrhosis of the liver may be associated with renal hemodynamic changes, there is no conclusive evidence that cirrhosis may result in RPN.…”