Clinical recognition of chronic pyelonephritis.

In five cases of chronic pyelonephritis herein described, fulfilling the pathologic criteria established by Weiss and Parker, the diagnosis was not established until autopsy or until the patient had reached a terminal uremic state. Improvement in the clinical recognition of pyelonephritis at all stages would be of value in improving the results of specific therapy, in clarifying the relation of pyelonephritis to hypertension, and in establishing what conditions, in addition to urinary stasis, may predispose to pyelonephritis. The clinical situations in which pyelonephritis should be suspected are discussed, and diagnostic criteria based upon examination of the urine, pyelograms, renal function studies, and renal biopsy are described and their limitations discussed.