As the result of retrograde pyelography on the case of chronic pyelonephritis of 57-year-old diabetic woman, a ring shadow was observed in the upper calyx of bilateral kidney, and it created suspicion of renal necrotizing papillitis. By culture of renal urine, E. coli was revealed, and by aortography a flecked shadow was observed in the upper pole of both kidney. By the renal open biopsy of the upper pole of the left kidney, diabetic glomerulosclerosis was found.
On the seventh day after renal biopsy, one slaughted papilla was excreted with gross hematuria. And microscopically it was proved the tissue of necrotic papilla. From the 22nd day after renal biopsy, oliguria occured, and NPN increased. And on the 40th day, the patient died of heart failure due to renal insufficiency. On autopsy, certainly diagnosed as renal necrotizing papillitis.