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Fred W. Whitehouse, M.D.; Howard F. Root, M.D.
JAMA. 1956;162(5):444-447. doi:10.1001/jama.1956.02970220008003.
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• Necrosis of the renal papillae, ascribed to local ischemia and accompanied by general septicemia, was demonstrated in 10 instances in the course of 266 postmortem examinations of 416 diabetic patients who died during a five-year period; in addition the papillary necrosis was found in a kidney removed surgically from a diabetic patient who was relieved by the nephrectomy but who died two years later because of the functional inadequacy of the remaining kidney. To prevent this complication of diabetes, catheter drainage should be avoided whenever possible, and the importance of proper perineal hygiene in women should be emphasized. If genitourinary infections do occur, they should be treated vigorously with the correct antibiotic and obstructive Uropathy should be eradicated; the diabetes should be well controlled. Necrotizing renal papillitis should be considered as a possibility whenever sepsis or progressive renal failure is observed in a diabetic patient.


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