Renal papillary necrosis in diabetes mellitus.

Renal papillary necrosis in 4 diabetic patients is described. Two of them had underlying diabetic nephropathy. Urinary tract infection was present in all of them. Three patients had passed fleshy material in the urine while in one the diagnosis was established by excretory urography. Two patients required haemodialysis for acute renal failure caused by sloughed papillae. The condition should be suspected in diabetic subjects who develop recurrent episodes of urinary tract infection, renal colic, haematuria or obstructive uropathy.