The cause of low plasma protein concentration in nephritis

The Relationships Between Plasma Specific Gravity, Plasma Protein Content and Edema in Nephritis

“…CsatAry (1891) noted that the deficiency affected the serum albumin more than it did the globulins, so that the albumin: globulin ratio, normally 1.5 to 2.0, fell below 1. These observations have been confirmed and amplified by other authors, whose work up to 1923 has been reviewed by Linder, Lundsgaard, and Van Slyke (1924). Govaerts (1924) has found that the albumin fraction, which suffers as a rule the entire deficit that occurs in the plasma proteins in the nephritic, is osmotically about four times as active per gram as the globulin fraction.…”

“…There is furthermore an unknown physiological factor which, in cases where occurrence or non-occurrence of edema is in the balance, may determine whether edema will occur or not. Thus Linder, Lundsgaard, and Van Slyke (1924) The degree of correlation between plasma protein content and edema in the 75 successive patients represented in figure 3 is we believe, evidence in favor of the preponderating influence ordinarily exerted by the plasma proteins in determining the tendency to edema. It has happened that in the series we encountered no cases in which the influence of hospital regime and the unknown physiological factor dihcussed above interfered with the relationship between edema and plasma protein content to the extent that is occasionally observed; e.g., see figure 6, also certain cases of Linder, Lundsgaard, and Van Slyke (1924 Salvesen (1926) and the authors respectively for these values.…”

“…Epstein (1917) on the basis of Starling's (1895-96) physiological experiments expressed the belief that the relationship between plasma protein deficit and edema in the nephrotic types of Bright's disease was one of cause and effect, the edema accumulating in the tissues because the diminished protein osmotic pressure in the circulating plasma was insufficient to hold the fluid within the circulation. In the paper published 6 years ago from this laboratory by Linder, Lundsgaard, and Van Slyke (1924) a conservative attitude was taken towards acceptance of this explanation. Cases were observed in which low plasma proteins were not accompanied by edema.…”

“…Neuhausen and Rioch (1923) showed that when proper constants were used it gave good agreement with chemical analyses of normal human plasma. Linder, Lundsgaard, and Van Slyke (1924), however, found refractometric deviations from Kjeldahl results as great as 1.5 grams of protein per 100 cc. in normal plasma.…”

The Variations of the Specific Gravity of the Plasma of the Blood and the Means Available for Altering It

“…In experiments of 8 hours duration, amounts of water equal to 80 per cent of the initial weight of the animal were given. They also found that the amount of hemoglobin in the blood was reduced and that the decrease occurred most rapidly during the first 2 hours, but continued throughout the experiment; it was approximately 15 per cent. The total volume of circulating blood accordingly increased during the period of diminished hemoglobin concentration.…”