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January 4, 1958


Author Affiliations


From the Research and Educational Hospitals and the Department of Medicine, University of Illinois College of Medicine.

JAMA. 1958;166(1):14-17. doi:10.1001/jama.1958.02990010016004

The relation of preoperative urinary findings to the pathological conditions revealed at operation was studied in 71 patients who underwent unilateral nephrectomy. After the operation the findings in the preoperative urinalysis done by customary procedures were reviewed and related to pyelonephritis and other diagnoses established by gross and microscopic study of the resected kidneys. Pyelonephritis was present in 42 and absent in 29. Pyuria was present in 88% of the patients with pyelonephritis and in 53 % of the patients without pyelonephritis. Miscroscopic hematuria was uncommon in the patients with pyelonephritis unless another abnormality of the urinary tract also was present. It occurred in 47% of those patients with kidney diseases other than pyelonephritis. No significant difference in the severity of proteinuria was found between the two groups. Pyuria, the absence of microscopic hematuria, and a low degree of proteinuria were therefore characteristic of but not specifically diagnostic of chronic pyelonephritis. Bacteriological studies showed that it was necessary to obtain urine specimens by catheter for reliable identification of the specific bacterial etiology of a urinary infection; the enumeration of bacteria in voided specimens was entirely suitable for detecting significant bacteriuria, and is recommended as the initial study in the diagnosis of chronic pyelonephritis.