Concepts of Pyelonephritis: Experience With Renal Biopsies and Long-Term Clinical Observations

T H E differentiation of pyelonephritis from the causes of Bright's disease, and the concepts of its pathogenesis, course and sequelae, constitute serial advances in our understanding of the nature of urinary tract infections.1"6 These classic works still leave large areas where further knowledge is de-sirable. Most of the previous data have been derived only from autopsies, and the clinical correlations have been retrospective. The present paper considers some concepts of pyelonephritis derived from the study by means of renal biopsies of patients with urinary tract infections. Preliminary correlative observations have been reported.7'8 Analysis of autopsy and surgical records, diagnostic criteria and results of treatment, and experi-ments on the pathogenesis of pyelonephritis, have been corollary studies.9'10' 11, 12, 13 In an era of successful treatment of most of the serious infections, chronic renal inflammation has continued to be an important accessory or direct cause of death, and a prevalent clinical problem. In an analysis of 4,425