The blood volume in cases of nephritis with edema and low serum protein concentration.

Abstract

Although a fairly large number of determinations of the blood volume have been made in cases of chronic nephritis with hypertension, very few are reported in cases of parenchymatous nephritis (nephrosis). Plesch, 1 using his infusion method, reported one case in 1909 in which the blood volume was about half the normal amount. Using the carbon monoxide method, Plesch 2 reported in 1922 a less marked decrease in the blood volume in one patient. In this paper, he also reported two cases of chronic nephritis with edema, which showed increasing blood volumes with decreasing edema. Linder, et al., 3 used the dye method on a number of cases of nephritis. They found slightly low blood volumes in two cases of parenchymatous nephritis.

The following cases are reported because of the strikingly low figures found. In all but one case, more than one determination was made.

Blood volumes were determined by the method of Keith, Rountree and Geraghtye 4 Three of the cases were typical instances of parenchymatous nephritis in every respect. One case (No. 2) was not entirely typical as the N. P. N. was elevated and blood cholesterol was normal. Otherwise the Mood of all the cases showed high cholesterol concentration, and only slight or no elevation of the non-protein-nitrogen. The urine of these patients was concentrated, showed large amounts of albumin, casts and only occasional red blood corpuscles. There was no elevation of blood pressure. Patient No. 2, on admission, was suffering from pneumonia, as well as chronic nephritis. This patient's urine was of high specific gravity, showed large amounts of albumin, but no red blood corpuscles. His whole blood non-protein nitrogen concentration was 115 mg. per 100 mm. and the whole blood cholesterol was 155 mg. per 100 mm.