Seasonal Variation in the Post‐mortem Incidence of Renal Papillary Necrosis

In a post-mortem survey conducted at the Royal Melbourne Hospital and the Melbourne City Coroner's Court, the incidences of renal papillary necrosis were 8–7% and 2–8% respectively. Analgesic abuse was found to be an important association. The high incidence of renal papillary necrosis in Australia is confirmed, and a close relationship between the incidence of papillary necrosis and mean monthly temperatures has been shown. This may have important implications in the understanding of the pathogenesis of papillary necrosis and its clinical management. Every patient with rheumatoid arthritis in this survey had renal papillary necrosis, and it is suggested that a constant high fluid intake may afford some degree of protection for such patients.