Functional Pathology of the Denervated Kidney.

Abstract

Long established clinical observation has made evident the close association of chilling of the body surface with the inception of certain types of nephritis. In those cases where chilling has involved no evident bacterial invasion, this etiological relationship has continued a puzzling and perplexing factor—but one of importance because of the frequent clinical onset under such conditions.

From a series of studies on the leucocytic partition, 1 we have obtained considerable evidence indicating that the autonomic balance of the kidney follows that of the skin, i. e., where the vessels of the skin contract, those of the kidney are likewise contracted. Skin, muscles, brain, kidneys and lungs are apparently associated in this functional grouping of organs—the liver, stomach and spleen being oppositely oriented.

During the course of observations of animals during continuous intravenous injection of B. coli extending over long periods of time 2 we noted the effects on the urine. The urine changes give evidence of renal injury (albuminuria, red blood corpuscles and oliguria) which were definitely related to other concurrent systemic changes in the animal.

In further developments of these studies, we have carried out experiments on the denervated kidney. Dogs were used throughout in these experiments and a unilateral denervation carried out under general anesthesia and recovery was then permitted for 2 weeks.

We have previously noted that with bacterial injections there is no evidence of renal injury, as far as urinary changes are concerned, for the period of about 30 minutes after the beginning of the injection—however, with a chill, albumin, red blood corpuscles, etc., appear, later an oliguria and occasionally an anuria. The bacteria appear in the urine very promptly at the time of the chill.