An adult patient is described with recurrent urinary tract infections who developed renal scarring while under observation. Intravenous urography (I.V.U.) and renal arteriography were performed during an initial attack of pyelonephritis and I.V.U.s were repeated at intervals during follow-up, when the patient was having recurrent infections. Over 2 years the right kidney size diminished from 10.5 to 7.0 cm, the cortex became irregular and calyceal clubbing occurred. During a further 2 years, when on regular treatment, attacks became less frequent but left-sided symptoms predominated. Repeat I.V.U. at the end of this period showed that the left kidney size had reduced from 12 to 10 cm, again with the development of cortical irregularity and calyceal clubbing. Biochemical evidence of renal impairment developed. At no time were obstruction, reflux or associated pathology demonstrated and there was no history of analgesic abuse. Recurrent infection is suggested as the etiology of the scarring.

Angiography↗

PubMed1975

Prospective survey of availability of cadaveric kidneys for transplantation.

A prospective study in Nottingham hospitals, serving 3/4 million population, identified 25 potential kidney donors in one year. Seventeen later died in circumstances when kidney donation would have been possible. Twelve kidneys were actually removedfor transplantation out of the possible 34. The reasons for failure to donate kidneyswere either relatives' refusal or a failure of the doctors looking after those patientsto consider them as potential donors. If all possible donors had their kidneys removed there would be sufficient available to approximately equal the numbers of patients likely to require renal transplatation.

Adolescent↗

PubMed1975

Chronic renal failure in Nottingham and requirements for dialysis and transplantfacilities.

A retrospective study of uraemic patients covering 12 months of 1970 and a prospective survey covering six months in 1973-4 is reported for a population of almost 3/4million. The number of patients requiring regular dialysis treatment or transplantation or both is considered to be 45 per million of population under 65, 39 per million under 60, and 29 per million under 50 years of age.

Adolescent↗

PubMed1975