Cardiovascular adjustments that develop in chronic anaemia have been studied by many investigators. Studies of renal circulation in anmmia, however, are few (Bradley and Bradley, 1947;Whitaker, 1956). A characteristic reversible renal functional abnormality has been described in chronic anxmia. It has been suggested that cedema, which occurs in a large number of cases of anemia on some basis other than decreased plasma osmotic pressure or increased venous pressure, may be secondary to renal retention of salt and water, possibly attributable to glomerulotubular imbalance (Bradley and Bradley, 1947) or abnormal tubular reabsorption (Whitaker, 1956).Abnormalities of renal function in chronic anemia in patients with cedema have, however, not been reported. The present investigation of circulatory abnormalities, particularly of renal circulation, was undertaken to determine the etiological factor of cedema in patients with chronic severe anemia. SUBJECTS AND METHODSForty-five patients, 36 men and 9 women, admitted to the hospital for treatment of chronic anemia of not less than three months' duration and with hematocrit values of less than 30 per cent were selected for this study. Their ages ranged between 14 to 50 years with an average of 30 years. (Edema was present in 25 patients, 17 men and 8 women, in 8 of whom congestive heart failure was considered to be present. Dyspnoea, cedema of feet, and hepatic enlargement, which are usual manifestations of congestive heart failure, also occur in uncomplicated chronic aneemia. Heart failure was, therefore, considered to be present after careful consideration of these factors, and of elevated venous pressure, clinical and radiological evidence of pulmonary congestion, and rapid regression in size of the enlarged tender liver with improvement of the anwmia. The duration of symptoms of anmmia varied between four months and three years with an average of 15 months. The duration of anemia was presumably much longer, and was due to hookworm infestation in 21 cases, chronic dysentery in 13, bleeding hkmorrhoids in 4, and chronic malaria in 2 cases, and was of undetermined etiology in 5 cases. The hxematocrit values ranged between 8 and 28 per cent with an average of 14-4 per cent: they were up to 10 per cent in 18, between 11 and 19 per cent in 16, and 20 and 28 per cent in 11 cases. Care was taken to exclude patients with hypertension or any renal or cardiovascular disorder apart from anemia, which might interfere with the circulatory abnormalities. The laboratory data were obtained on admission in each patient, but could be obtained after treatment in only 14 patients as it was found difficult to persuade patients for follow-up study after they were cured. The data were also obtained in 20 others to serve as normal controls.

The pharmacokinetics of aspirin (ASA) has been studied in elderly Indians (greater than 60 y) of either sex, composing, apparently healthy subjects controlled hypertensives and NIDDM diabetics, in comparison with healthy young subjects. Serum salicylate levels were estimated a 0, 0.5, 1, 2, 4 & 8 h after ASA. The pharmacokinetics of serum salicylate were not changed in elderly subjects as compared to the young after the first dose or after one week of ASA therapy, although greater variability was observed in the elderly. Various laboratory investigations were unaltered after one week in all the groups, except that one elderly hypertensive patient gained weight, and a young subject showed an increase in SGOT & SGPT.

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