慢性不全腎における水, 電解質および窒素の處理
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In order to study the renal function in chronic renal failure, I examined renal clearance of nitrogen, creatinine, sodium, chloride and potassium in early morning and water diuresis in patients with chronic renal failure, and compared with the results in compensated stage of chronic nephritis.In water diuresis the excretion of nitrogen, sodium, chloride and potassium increased in compensated stage of chronic nephritis, while little change was noted in chronic renal failure.In chronic renal failure, renal tubular reabsorption of water, sodium chloride, potassium and nitrogen was markedly decreased as glomerular filtration rate was decreased; in severe case of chronic renal failure potassium excretion was exceeded the filtrated volume in glomeruli, that may mean the tubular excretion of potassium.The excreted load of nitrogen in each nephron was calculated as N/GFR, which was markedly high in chronic renal failure, and showed significant relation between the lowered reabsorption rate of water. In chronic renal failure significant relation was found between the lowered sodium reabsorption rate and N/GFR both in water diuresis and in early morning, while in compensated stage of chronic nephritis the relation was noted only in water diuresis. The relation between the reabsorption rate of water and that of sodium was observed in water diuresis in either group, and only in early morning of renal failure group.With the results obtained, it may be acertained that in chronic renal failure as the glomerular filtration rate decreases the excreted load per nephron increased, which causes the osmotic diuresis and lowered reabsorption of water and sodium. However, as the total excreted volume of sodium changes little, the lowered reabsorption of sodium may not mean the lowered reabsorptive function, but it should be considered as the adaptive functional pattern of kidney with decreased nephron.
- 社団法人日本循環器学会の論文
- 1958-12-20
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