CHRONIC RENAL INSUFFICIENCY. PART I: APPRAISAL OF THE PATIENT. PART II: TREATMENT
Authors: J HOPPER, A BOLOMEY, R WENNESLAND
Journal: Annals of Internal Medicine (1954)

Article1 July 1954CHRONIC RENAL INSUFFICIENCY. PART I: APPRAISAL OF THE PATIENT. PART II: TREATMENTJAMES HOPPER JR., ALFRED BOLOMEY, R. WENNESLANDJAMES HOPPER JR.Search for more papers by this author, ALFRED BOLOMEYSearch for more papers by this author, R. WENNESLANDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-41-1-18 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptProgress in the treatment of renal insufficiency has been spectacular in the past few years. We have seen a changing point of view with respect to the healing or alterability of renal lesions. Lesions once thought irreversible have in many instances proved to be highly reversible. While renal function in these instances has not always been completely recovered according to the physiologist's yardstick,† it has been sufficiently restored to allow a return to normal life—women have been able to undertake pregnancy and men to resume their activities as breadwinners.Probably the greatest stimulus to the changing point of view has...Bibliography1. Smith HW: The kidney: structure and function in health and disease, 1951, Oxford University Press, New York. Google Scholar2. Lucke B: Lower nephron nephrosis, Mil. Surgeon 99: 371-396, 1946. CrossrefMedlineGoogle Scholar3. BullJoekesLowe GMAMKG: Renal function studies in acute tubular necrosis, Clin. Sc. 9: 379-404, 1950. MedlineGoogle Scholar4. Moon VH: Acute tubular nephrosis, a complication of shock, Ann. Int. Med. 39: 51-61, 1953. LinkGoogle Scholar5. Earle DP: Introduction to the study of renal function, Am. J. Med. 9: 78-87, 1950. CrossrefMedlineGoogle Scholar6. 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Author, Article, and Disclosure InformationAffiliations: San Francisco, California*Received for publication December 8, 1953.From the Renal Clinic of the Department of Medicine, University of California School of Medicine, San Francisco, California.Presented in abstract form, Postgraduate Course in Internal Medicine, under the auspices of the American College of Physicians, Franklin Hospital, San Francisco, December 8-12, 1952.†Reference is made to measurement of renal dynamics, as described by Smith,1 using inulin clearance to determine glomerular filtration rate and para-aminohippurate clearance to determine renal plasma flow at low plasma concentrations and renal tubular mass at high plasma concentrations.‡The term "lower nephron nephrosis"2 was derived from pathologic demonstration of a lesion limited to the lower nephron or distal tubule. Since it is now apparent that either the upper or lower segments or the entire tubule may be involved, the term "acute tubular necrosis"3 or "acute tubular nephrosis"4 would seem more apt. It might suffice simply to divide nephroses into "acute" and "chronic" types. From the clinical point of view, the acute type, regardless of the tubular segment involved, is characterized by renal insufficiency and oliguria or anuria, whereas the chronic type is characterized by reasonably good or even superior renal function, in association with massive proteinuria, hypoalbuminemia and, frequently, hypercholesteremia.5-7 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byStörungen der HarnkonzentrierungORTHOSTATIC PROTEINURIAPATTERNS OF PROTEIN EXCRETION BY THE KIDNEYS*S. EDWARD KING, M.S., M.D., F.A.C.P.Extrarenale Azotämie und extrarenales Nierensyndrom 1 July 1954Volume 41, Issue 1Page: 18-35KeywordsAttentionBlood plasmaGlomerular filtration rateHospital medicineLesionsNecrosisNephronsPregnancyProteinuria ePublished: 1 December 2008 Issue Published: 1 July 1954 PDF downloadLoading ...