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October 16, 1954


JAMA. 1954;156(7):709-711. doi:10.1001/jama.1954.02950070037009b

Scant attention has been paid to the entity of renal papillary necrosis since it was first described by von Friedreich in 1877. It was not until 1937 that considerable interest in this condition was aroused when Gunther pointed to the frequent association of renal papillitis with diabetes mellitus. Until January of 1953, 180 cases had been published and of these only 10% lacked evidence of either diabetes or obstructive uropathy, or both. It is estimated that one-fifth of all diabetics have acute renal infection terminally, and that of these about one-fourth have renal papillary necrosis. It appears, therefore, that the association of papillary necrosis with diabetes, obstructive uropathies, and renal infections is a not uncommon clinical entity. However, it does not seem to be sufficiently appreciated that papillary necrosis can constitute a fatal complication of diabetic coma and that its presence should be suspected in diabetic coma not responding to

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