464 V. BLOOD LIPIDS 



and co-workers 705 pointed out that a hy perch olatemia (increase in bile 

 acids in the blood) occurs in human patients with nephrosis. This condi- 

 tion was also observed in rats in whose case an experimental nephrosis had 

 been induced by the injection of anti-rat kidney serum, 705a whenever hy- 

 percholesterolemia was also present. Moreover, the nephrotic rat was 

 found to exhibit a diminished ability to rid the blood of injected cholate. 



In later work by Byers, Friedman, and Rosenman 705b in which this method 

 for producing experimental nephrosis in the rat was confirmed, it was found 

 that the hypercholesterolemia produced in rats by the injection of anti-rat 

 kidney serum was not associated with any change in the rate of cholesterol 

 synthesis. The conclusion is reached that the hypercholesterolemia in the 

 nephrotic is neither initiated nor maintained by an accelerated rate of 

 cholesterol production in the liver. It has also been established that the 

 hypercholesterolemia in the nephrotic rat cannot be ascribed to an in- 

 creased absorption of dietary cholesterol from the gastrointestinal tract. 7050 



(b) In Nephritides. In those forms of kidney disease in which edema is 

 not a prominent symptom, hyperlipemia may be absent. Thus, in acute 

 nephritis, blood lipids remain at a normal level in the early stages, but a 

 hyperlipemia develops in the later stages, coincident with the edema. 704 

 In forms of nephritis in which little or no edema exists, the blood lipids 

 usually remain at a normal level. 696 - 697 When lipemia develops in nephritis, 

 neutral fat plays an important role. 340 The amounts vary greatly, and do 

 not exhibit the regular relationships shown by phosphorus and cholesterol. 

 The differences in response may be related to the effects of a single large 

 fatty meal 196,706 ; however, the fat intake apparently does not affect the 

 postabsorptive level of serum lipids. 361 ' 699,706 ' 707 



The basic reason for the hyperlipemia in kidney disorders is not clear. 

 According to the data of Hiller et a/., 340 there would not appear to be any 

 inability to burn fat. According to Peters and Van Slyke, 202 an impair- 

 ment in the processes concerned with the mobilization of lipids would seem 

 to be the main cause of the abnormality. Epstein 707 suggested the use of 

 thyroid preparations in the treatment of nephrosis, since he believed that 

 the disorder was caused by hypothyroidism. However, Page and Farr 699 

 could not alter the characteristic hypercholesterolemia of nephritis by the 



705 R. H. Rosenman, M. Friedman, and S. 0. Byers, J. Clin. Invest., 32, 121-124 

 (1953). 



705a W. Heymann and H. Z. Lund, Pediatrics, 7, 691-706 (1951). 



705b g q Byers, M. Friedman, and R. H. Rosenman, Am. J. Physiol., in press (1954). 



705C R. H. Rosenman, M. Friedman, and S. 0. Byers, Am. J. Physiol., in press (1954). 



708 A. I. Odinow and S. N. Guschtschina, Z. klin. Med., 128, 358-364 (1935). 



707 A. A. Epstein, Am. J. Med. Sci., 163, 167-186 (1922). 



