Renal Papillary Necrosis and Phenacetin: Two Further Cases.

Progress. His post-operative course was satisfactory and he was discharged on June 15th, 1962-seven weeks after admission. On the second post-operative day the blood pressure was 170/120, on the fourth it was 160/105, and by the eleventh day (on discharge) the reading was 135/90. On June 8th, 1962, intensive antituberculous therapy was started: streptomycin sulphate 0.5 g. b.d. for six weeks, para-aminosalicylic acid 10 g. each day and iso-nicotinic acid hydrazide 200 mg. each day for eighteen months. Follow-up. When examined on February 19th, 1963, ten months after the operation, he had no complaint. He had no symptoms referable to the urinary tract. His appetite was good and his weight had increased by 10 lb. (4.4 Kg.). B.P. 120/80, X-ray examination of the chest showed no active lung disease and the cardiac shadow was normal. ECG normal. Urological examination on May 15th, 1963, showed a normal bladder, and on retrograde pyelography a normal left kidney. In August, 1964, more than two years after operation, the patient continued to be symptom-free. The blood pressure was 150/90 and the electrocardiogram was normal.