A Clinical Classification of Bright's Diseases

Addis, T.

doi:10.1001/jama.1925.02670030005002

Cited by 102 publications

(21 citation statements)

References 5 publications

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“…The method described by Smith, Finkelstein, and Smith (11) was used for the determination of mannitol except that the plasma and urine filtrates were oxidized at room temperature for 90 minutes (12) instead of for a shorter time in a boiling water bath. Protein-free filtrates of plasma were obtained using cadmium (14) (20).…”

Section: Methodsmentioning

confidence: 99%

Glomerulonephritis. A Survey of the Functional Organization of the Kidney in Various Stages of Diffuse Glomerulonephritis 1

Earle¹,

Taggart²,

Shannon³

1944

J. Clin. Invest.

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Section: Methodsmentioning

confidence: 99%

Glomerulonephritis. A Survey of the Functional Organization of the Kidney in Various Stages of Diffuse Glomerulonephritis 1

Earle¹,

Taggart²,

Shannon³

1944

J. Clin. Invest.

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“…The 972 Addis-Shevky test was performed on the same subjects, and in addition data were available for a number of other patients who had previously been put on the Addis 20-hour dry regime in order to obtain concentrated urine for count of the formed elements (Addis (1925)). The results of the Addis-Shevky'test are presented in Figure. Figure 5.…”

Section: Methodsmentioning

confidence: 99%

The Significance of Concentration and Dilution Tests in Bright's Disease

Alving¹,

Slyke²

1934

J. Clin. Invest.

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The first quantitative evidence that nephritis diminishes the ability to excrete urine of either high concentration or high dilution was apparently furnished by Koranyi (1899) and his collaborators, K6vesi and RothSchulz (1900), by means of the freezing point method. Regular application to studies of renal function, however, appears to have first begun in Volhard's (1918) clinic, where the " concentration and dilution " test has been in use since about 1908. In this test the renal function is estimated from the ability to excrete a urine of large volume and low specific gravity after drinking 1.5 liter of water (dilution test), and urine of high specific gravity after a subsequent period in which no fluid is drunk (concentration test). Modifications of these tests or their combination have been made by various authors. They have been reviewed by Pratt (1926) (with his own observations on 58 patients), by Mosenthal (1930), by Lashmet and Newburgh (1930), and with especial completeness by Volhard and Becher (1929). The simplicity of these tests, and their consequent wide application, render it desirable to define as exactly as possible the meaning of their results.In order to obtain information for this purpose we have made graphic statistical comparisons of results of concentration tests with results of the urea clearance test, the clinical significance of which has previously been established (Van Slyke, Stillman, M6ller, et al. (1930) (1930)) and one of the combined concentration and dilution test (Lundsgaard (1920)) have been used in this clinic for comparison with the blood urea clearance. In addition to our results with these tests we have charted the data of Ong (1932) and of Bruger and Mosenthal (1932). The different concentration and dilution tests, as used by the writers and the above authors, were applied as follows. Concentration testsThe concentration test of Addis and Shevky (1922). The subject abstains from fluids of all sorts from after breakfast on one day until he rises from bed on the morning of the following day. During the last 12 hours of the dry period (from 8 p.m. to 8 a.m.) the urine is collected, and the specific gravity of this specimen is measured. The Addis-Shevky test prescribes no preparatory period on a special diet.In applying this method to albuminous urines we have subtracted from the observed specific gravity a correction for the effect of the protein, in the manner described below for the Lashmet-Newburgh test. The gravities given in our charts are the corrected values. The urinometer used has been found accurate to within 0.001.Addis and Shevky have found that in normal individuals, previously on ordinary diets, the average specific gravity of urine obtained as above described was 1.032, that 95 per cent of normal subjects on ordinary diets showed values of 1.028 or above, and 100 per cent above 1.026.The concentration test of Lashmet and Newburgh (1930) 2 The subject remains in bed four days, during the first three of which he is on a special diet. The diet consists of 45 g...

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“…When, with constant blood urea content, the urine volume is less than the "augmentation limit" of about 2 cc. per minute, the urea concentration in the urine ordinarily varies inversely as the square root of the volume: if the volume is reduced to 1/4 the concentration is multiplied by 2 (3,12). Such a relationship is approximated by the data in Table 3 from a normal subject, and is not markedly disturbed by exercise, even when severe.…”

Section: The Effect Of Exercise On Urine Volumementioning

confidence: 99%

Studies of Urea Excretion. Vii the Effects of Posture and Exercise on Urea Excretion

Slyke

Alving²,

Rose³

1932

J. Clin. Invest.

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The studies reported in this paper were undertaken primarily to ascertain whether, in determining the blood urea clearance 1 as a measure of renal function, the previously utilized precaution of keeping the subject at rest in a recumbent position is necessary, and whether the mild exercise and change of posture associated with walking about has sufficient effect on renal activity to alter the clearance values obtained. Observations in the two conditions have been made on three normal men and nineteen nephritic subjects with varying grades of renal impairment. The effect of change of posture from lying in bed to sitting in a chair has also been studied. Furthermore, in three subjects with normal renal function, the effect was studied of exercise of the maximum severity which could be maintained for the 2-hour period.There is evidence that renal function in many details is affected by mere change in posture. Edel (5) in 1901 observed that change from the recumbent to the standing position decreased markedly the volume output of urine, and in subjects with cyclic albuminuria increased the protein excretion. Subsequent authors (6, 9, 15, 17, 22) have confirmed this observation, and have found that the excretion rate, not only of water, but of most of the other normal urinary constituents, is diminished by the change from recumbent to standing posture. Thus White, Rosen, Fischer and Wood (22) found that the average effect in three normal men of changing from lying to standing posture was to diminish the hourly excretions to the following proportions of the outputs in the recumbent position: urine volume to 30 per cent, chlorides to 45 per cent, phosphorus to 67 per cent, sulfur to 71 per cent, urea to 61 per cent, and creatinine to 91 per cent. Cordero and Friedman (4) found that change from recumbent to upright position caused an average decrease of 10 to 13 per cent in the proportion of injected phenolsulfonephthalein excreted in 2 hours by normal subjects.IThe terms, "standard blood urea clearance" and "maximum blood urea clearance," used in expressing the urea excreting efficiency of the kidneys, have been defined in the second paper of this series (12).

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A Clinical Classification of Bright's Diseases

Cited by 102 publications

References 5 publications

Glomerulonephritis. A Survey of the Functional Organization of the Kidney in Various Stages of Diffuse Glomerulonephritis 1

Glomerulonephritis. A Survey of the Functional Organization of the Kidney in Various Stages of Diffuse Glomerulonephritis 1

The Significance of Concentration and Dilution Tests in Bright's Disease

Studies of Urea Excretion. Vii the Effects of Posture and Exercise on Urea Excretion

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