HERMAN O. MOSENTHAL 



A milky plasma lipemia has been frequently observed in nephritis. 

 (Fisher, B. ; Chauffard, La Roche and Grig-ant ; Widal, Weill and Laudat ; 

 J. Muller(c).) Greeiiwald (15>15) noted a high lipoid phosphorus in the 

 blood of nephritics ; Erben found increased values for lecithin and fat in 

 a sub-chronic case. J. Miiller and Bonniger demonstrated an increase in 

 the total blood lipoids. 



The greatest amount of attention has been devoted to the cholesterol 

 content of the blood. This may be within normal limits in all cases of 

 nephritis (Bloor(d), Denis(c), Kahn(c)) or may be found to be increased 

 moderately in every form of nephritis (Gorham and Myers) or may be 

 normal in certain types of Bright's disease while it is distinctly increased 

 in others (Stepp(&), Kollert and Finger, Epstein(fc), Port(&)). It is 

 gradually becoming apparent that the findings of the last group of authors 

 are the correct one, namely, that the most marked hypercholesterinemia is 

 present in parenchymatous nephritis or ncphrosis (a form of kidney dis- 

 ease characterized by edema, albuminuria and usually a low blood pres- 

 sure). It is not present in every case, nor does it necessarily remain high 

 when it has increased. These facts may account for the variety of results 

 that have been obtained thus far. The following data are those of Epstein. 

 (Table 20.) 



TABLE 20 

 CHOLESTERIN CONTENT OF BLOOD SERUM IN NEPHRITIS. (Epstein) 



The cause of the increased blood cholesterol in nephrosis is not clear. 

 It is not due to insufficient renal activity, for the lipoids, except for traces, 

 are not present in the normal urine. That it is due to some metabolic dis- 

 turbance is stating an obvious fact and does not further the solution of 

 the problem. It has been attributed to non-utilization of ingested or 

 mobilized fat inasmuch as the lipemia disappeared on a low fat diet 

 (Epstein and Rothschild). Denis makes a similar explanation to account 

 for the low values found in some cases suggesting that they are due to a 

 diet which contains little cholesterol. Port(&) believes that the cholesterol 

 may originate from degenerating epithelial cells or to a disturbed action 

 of the suprarenal gland. Whether in nephritis the suprarenal gland plays 

 an active role in producing cholesterin (Albrecht and Wei tm aim) or 



