Book Description
The report dicussed the metabolic disorders; treatment of renal failure, and homotransplantation of tissue with particular reference to the kidney. Both in the uremic patients and in uremic animals we have endeavored to elaborate the metabolic defect which results in kidney failure. During the course of the studies with isotope dilutions we were able to elicit the fact that typically in acute renal failure, extracellular fluid volume is expanded, probably by the production of metabolic water from the catabolism of fat. In addition, in both acute and chronic renal failure serum citrate levels may be markedly elevated, possibly contributing to the so-called unidentified acid fraction about which there has been much speculation. A consequence of this work on body fluid volume were the observations that in man, renoprival hypertension does not exist. Our ability to maintain people with no renal function whatever in relatively good states of health enabled us to observe that in four patients in whom a single kidney had been removed accidentally, hypertension did not occur unless the volume of extracellular fluid was increased.
