LOWER NEPHRON SYNDROME

Abstract

The clinical picture of the lower nephron syndrome, which is frequently encountered clinically, consists of injury, shock, edema, oliguria or anuria and uremia. This disease state may be produced by crushing injuries, transfusion reactions, burns, blackwater fever, and chem. poisons, among other etiologic agents. The typical pathologic change is degeneration of the lower portion of the nephron with the characteristic heme casts. The mechanism of production of uremia lies in the loss of selective reabsorption in the tubules. Decreased filtration may be contributory. Therapeutic measures include reduction of protein intake and protein catabolism and judicious use of fluids. The artifical kidney is not practical at present. The fatality rate may be as high as 90%.