STUDIES OF THE KIDNEY IN ACUTE INFECTION

Abstract

Values for the standard and maximum urea clearance tests have been determined in 17 normal persons. In 16 patients in the acute febrile stage of rheumatic infection, clearance values were usually higher than the highest observed normal; and during the afebrile convalescent period, the clearance values are usually lower than the lowest observed normal, indicating a state of renal hyperfunction during the acute stage as a response to the demand of increased protein catabolism; later a state of renal hypofunction probably as a result of toxic injury to the kidney parenchyma. In all patients followed, complete restoration of renal function occurred within about 2 wks.[long dash]III. Observations with the urine sediment count were made in 44 adults with lobar pneumonia. Microscopic hematuria appeared to be of greater prognostic significance than the other formed elements or protein in the urine. Observations with the blood urea clearance test were made in 13 patients with lobar pneumonia. Renal hyperfunction (increased urea-excreting activity) was the rule during the acute stage of the disease. Slight to marked depression of renal function (decreased urea-excreting activity) occurred during both the acute and convalescent stages. In 2 patients in this series there were sufficient correlated clinical data to make certain a complicating acute diffuse glomerulo-nephritis.