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HERMAN O. MOSENTHAL 



Phosphates and Calcium of the Blood in Nephritis 



According to Greenwald there are three classes of phosphorus com- 

 pounds in the blood serum: lipoid, inorganic and protein. Of these the 

 protein constitutes a very small fraction. The normal figures are given in 

 Table 21. In nephritis as a rule, when the excretion of phosphates is in- 

 adequate, inorganic phosphorus accumulates in the blood, the lipoid frac- 

 tion rarely rises and the protein phosphorus apparently never increases. 

 Usually, as the non-protein nitrogen increases the inorganic phosphates do 

 as well. That is, a renal insufficiency causing retention of the one also 

 brings about the retention of the other. In some cases these do not run 

 parallel, indicating that there is a different process within the kidney 

 responsible for the elimination of each. All these facts are brought out 

 in Table 21 taken from Green wald's researches. 



TABLE 21 



PHOSPHORUS OF THE BLOOD IN NEPHRITIS. THE INCREASE OF PHOSPHORUS is USUALLY 

 IN THE INORGANIC PHOSPHATES, THOUGH THE LIPOID PHOSPHATES MAY ALSO BE IN- 

 CREASED. THE INCREASED BLOOD PHOSPHATES ARE GENERALLY, BUT NOT ALWAYS 

 ACCOMPANIED BY AN INCREASE IN THE NON-PROTEIN NITROGEN OF THE BLOOD. 

 ( Greenwald ) 



There is a tendency for the plasma phosphates to accumulate very 

 rapidly towards the end of life. A high phosphate volume in the plasma 

 indicates a poor prognosis, a low phosphate that there is no immediate 

 danger. (Denis and Minot(fr)) (see Table 22.) 



The increase of phosphates in the blood is due to renal insufficiency, 

 and the resulting accumulation of urinary constituents in the body. About 

 90 per cent of the phosphates in the urine is in the form of acid phosphate. 

 A retention of this material would consequently bo responsible for acidosis. 

 This Marriott and Ilowland believe, would account for the acidosis in 

 nephritis, although they are unprepared to say that it is the sole factor. 

 Associated with the retention of phosphates is a marked reduction of 



