CHRONIC NEPHRITIS
Published Sep 1, 1920 · A. E. Russell
Medical Journal of Australia
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Abstract
Within recent years various endeavours have been made to arrive at a better understanding of the impairment of excretory function which results from chronic disease of the kidney, and to place the concept of renal insufficiency upon a more scientific basis. Formerly the accepted classification of chronic nephritis was based in part upon clinical observations and in part on the evidence of pathological changes found post mortem. Sufficient attention has not been given to the estimation of the functional capacity of the kidney, which can be satisfactorily investigated only by the correlation of the results of clinical observation and biochemical examinations. In a recent article dealing with the investigation and treatment of nephritis, Drs. H. Maclean and A. E. Russell 1 summarize the specific functions of the kidney under three headings :-;-(i.) Removal of waste nitrogenous products of metabolism, such as urea, uric acid, ereatinin, etc.; (ii.) Removal of acid products from the body; (iii.) Maintenance of the necessary concentration of salts in the body fluids and tissues. It has been shown that in severe cases of chronic interstitial nephritis there is a definite retention of nitrogenous waste products in the blood, as well as a diminution of the acid excreting function of the kidney. Defective excretion of nitrogen causes an increased concentration of such bodies as urea and