Renal papillary necrosis with special reference to chronic alcoholism. A report of 20 cases

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Abstract
In none of 20 cases of renal papillary necrosis occurring among 2,689 chronic alcoholic patients autopsied was there a background of diabetes mellitus or of obstructive uropathy. The clinical records disclosed that fever, leukocytosis, bacteriuria, oliguria, and a rapidly rising blood urea nitrogen level were the most common findings. The pathologic changes included acute suppurative pyelonephritis with bilateral papillary necrosis that occurred most often in kidneys that showed no evidence of antecedent disease. There was fatty change or cirrhosis of the liver or both in 16 of the 20 patients, 10 of whom were jaundiced. One hundred and seventy-five additional cases of renal papillary necrosis in the autopsy series of 42,611 cases are included in the report for comparison.

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