Abstract
It has been reported by Erben, 1 in 1902-3, that in the serum of patients suffering from chronic parenchymatous nephritis, the albumin-globulin ratio (which, normally is about 1.5-2.0 : 1) is entirely disturbed, the figure being 0.2593 of albumin to 7.0352 of globulin. This deviation in the ratio was confirmed by Epstein, 2 in 1912. The latter author (basing his conclusion on his analyses of nine cases of chronic parenchymatous nephritis, in whom, besides the globulin increase, he also found a huge amount of cholesterol in the serum) propounded the following theory of the etiology of certain cases of chronic parenchymatous nephritis. According to him, there is a group among the cases of chronic parenchymatous nephritis which is due to a constitutional disorder—of a metabolic or endocrinic nature—in which the renal manifestations are concomitant or secondary in point of development and importance. He does not, however, describe cases of chronic parenchymatous nephritis in whom the protein or lipin fractions should vary from the so-called “metabolic” type, and which he should point out as “non-metabolic” in nature.
In the series of cases investigated, the writer did not find one case of the so-called “metabolic or endocrinic” type of chronic parenchymatous nephritis, which would seem to indicate that the type described by Epstein is very rarely met with. 3 The albumin- globulin ratio does not seem to be markedly disturbed by various diseases. Feeding of patients suffering with chronic parenchymatous nephritis on a protein-rich, fat-poor diet is a rather risky undertaking.
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