Renal Papillary Necrosis

Abstract

The clinical and pathological findings in 16 human cases of renal papillary necrosis are presented. The disease is a special form of acute pyelonephritis occurring almost exclusively in patients with diabetes mellitus or chronic urinary tract obstruction. The lesions appear as multiple, bilateral areas of ischemic necrosis of papillae and subjacent pyramids in kidneys of normal or increased wt. Important pathogenic factors are bacterial infection and acquired renal ischemia due to severe vascular sclerosis. Thrombosis is rarely encountered. The normal relative ischemia of the renal papilla apparently localizes the lesion to its characteristic site.