384 INANITION AND MALNUTRITION 



Kolster ('11) studied the mitochondrial changes in the renal cells of rabbits 

 in which urinary secretion was reduced to a minimum by total inanition or dry 

 food for 3 days. The central portion of the brush border apparently becomes 

 homogeneous and swollen, not through imbibition of fluid, but in association 

 with an increase in the cell mitochondria and related structures. The mito- 

 chondrial changes are described in detail. 



Suzuki ('12) investigated the excretion of carmine in the renal epithelium of 

 fasting and thirsting animals. 



It is impracticable to mention in detail the results of the preceding investiga- 

 tions on the finer cytological changes, especially in the mitochondria, of the renal 

 epithelial cells during hibernation and inanition, as resting conditions, in con- 

 trast with the active secretory condition. These results are reviewed fully by 

 Arnold ('14). More recently, Azzi ('16) concluded that in rabbits on total 

 inanition 24-48 hours the chondriosomes remain nearly unchanged, excepting 

 in the ascending limb of Henle's loop and the collecting tubules, where the 

 granules and filaments tend to become concentrated in the circumnuclear zone. 

 In rabbits fasting 9-17 days, Okuneff ('23) finds in some renal cells degenera- 

 tive changes in the mitochondria (chondriosomes) similar to those described in 

 the liver. 



(B) Effects of Partial Inanition 



The forms of partial inanition in which the kidneys have been studied include 

 dietary deficiencies of protein (in malnutritional edema and pellagra), of salts 

 (including rickets), of vitamins (including beriberi and scurvy) and of water 

 (thirst). 



The reasons for classifying malnutritional edema primarily as a protein 

 deficiency were given in Chapter V. Kohman ('20) produced edema in rats on 

 watery diets poor in proteins and fats. She stated that "There is some indica- 

 tion that the kidney cells are injured and therefore fail to eliminate the water. 

 Although very little work was done on the kidney tissues, sections were made of 

 a few kidneys and some albumin found in the tubules." Kohman's results were 

 confirmed in general by Maver ('20) on dogs, rats and guinea pigs. McCarrison 

 ('21), however, concluded from his experimental studies with variously deficient 

 diets on monkeys and pigeons that malnutritional edema is not due to organic 

 renal change. 



In human "famine edema," and allied conditions, the consensus of opinion 

 of numerous observers is likewise that the edema is not due to renal or cardiac 

 insufficiency, but is more probably due to the direct effect of the malnutrition 

 upon the vascular endothelium. Paltauf ('17) found the kidneys variable in 

 weight, with congestion and signs of edema. Schittenhelm and Schlecht 

 ('18, '19) found the kidneys nearly normal in size and condition. Oberndorfer 

 ('18) noted total absence of renal fat droplets and glycogen. The kidneys 

 appeared reduced in size in proportion to the heart (which was always small), 

 although the urine was increased in amount. Mann, Helm and Brown ('20) 

 reported the kidneys grossly normal in 200 necropsies. Prince ('21) found the 



