ITS 



FRANKLIN C. McLEAN 



TABLE XIII 



CHOLESTERIN CONTENT OF BLOOD SERA 

 (Epstein) 



form of chronic parenchymatous nephritis is characterized by low figures 

 for urea and total non-protein nitrogen rather than by an increase. 



The chlorid concentration of the serum is generally within normal 

 limits. 



Renal Function in Other Conditions Associated with Edema. In 

 heart failure there is usually evidence of impaired renal function, due to 

 injury of the kidney cells as a result of the circulatory condition, or 

 directly to disturbance resulting from the diminished rate and volume of 

 blood flow through the kidneys. Gerhardt(c) has shown, however, at least 

 in some cases of heart failure, that the kidneys are able to excrete large 

 amounts of water or salt, given intravenously instead of by mouth, indi- 

 cating that ordinarily these substances do not reach the kidneys in suf- 

 ficient concentrations to effect their elimination. 



Ziegler called special attention to the forms of edema in which there 

 are no direct evidences of disease of the kidneys or circulation. In such 

 cases the renal excretory function appears quite normal. This is the 

 case in edema occurring in diabetes, as the result of administration of 

 sodium bicarbonate, in edema due to cachexia or inanition, such as war- 

 edema, and edema occurring in disturbances of nutrition in infants. It is 

 also the case in the hereditary forms of edema described by Milroy, and in 

 various forms of paroxysmal edema (Palmer(fe)J. 



Summary. We may summarize the discussion of the role of renal 

 excretory function in the production of edema by saying that there is 

 evidence that impairment of this function may sometimes be an important 

 factor, but that edema occurs frequently without evidence of disturbed 

 renal excretory function, that the conditions in which there is severe dis- 

 turbance of renal function, such as total anuria and chronic interstitial 

 nephritis, are not accompanied by edema, and that there is no conclusive 

 evidence that disturbance of renal excretory function bears a direct causal 

 relationship to the production of edema. 



