RENAL papillary necrosis (RPN) is characterized by necrosis, demarcation, and sequestration of parts of renal papillae, which slough into the pelvis of the kidney and may be passed in the urine. RPN is always accompanied by pyelonephritis, and there is much to suggest that it is caused by, or is a complication of, pyelonephritis, instead of the reverse. According to statistical data in the literature up to a few years ago, about 90% of all cases of RPN occurred in diabetics or in patients with urinary tract obstruction, the ratio being about 2 to 1.1-3 The frequency of RPN in diabetes can be judged from the fact that RPN was found at autopsy in about 3% of all diabetic deaths.4,5 However, in the past 5 years, a sharp increase of cases of RPN has been reported in a number of papers from European, especially Scandinavian, countries. This
Rony HR. Renal Papillary Necrosis in Diabetes: Report of a Case Under Good Control. JAMA. 1961;177(12):862–864. doi:10.1001/jama.1961.73040380023011
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