METABOLISM IN NEPHRITIS 



327 



TABLE 11 

 CREATININ OF HUMAN VOLUNTARY MUSCLE IN NEPHRITIS 



servers and championed by Myers and Fine(d) (1915) that creatinin is 

 probably formed from creatin unless ingested as preformed creatinin. 

 Furthermore, it may be concluded that creatinin, when once formed, 

 undergoes no chemical transformation but remains in the body until ex- 

 creted by the kidneys. 



It is probable that creatinin in itself has little or no toxic effect. This 

 is demonstrated by the absence of untoward symptoms In the numerous ex- 

 periments on man and animals in which creatinin has been injected or in- 

 gested. Myers and Killian(fr) believe that it may be the cause of uremia. 

 This, however, is only based upon theoretical grounds and is contradicted 

 by the evidence cited in the same paper that some cases, with a high 

 blood creatinin, survive a considerable length of time. A rise in the blood 

 creatinin certainly must be looked upon as a grave sign of renal insuffi- 

 ciency. The kidney eliminates creatinin with great ease and this sub- 

 stance is therefore among the last of the end products of protein metabo- 

 lism to be increased in the blood (see section on relation of uric acid, urea 

 and creatinin in the blood in nephritis). An augmentation of creatinin 

 in the blood is, however, only a signal of marked renal insufficiency; in 

 itself it has no further significance. The actual cause of uremia, brought 

 on by retention of waste products, can not be attributed to creatinin but 

 is to be sought in other substances which are simultaneously held back 

 by the damaged kidney. 



Creatin in Nephritis 



Not much attention has been paid to the metabolism of creatin in 

 nephritis. The observations which are at hand indicate that the estima- 



