METABOLISM IN NEPHRITIS 



349 



TABLE 22 



DATA OF A CASE OF CHRONIC NEPHRITIS WITH UREMIA AND A FATAL TERMINATION, 

 SHOWING How RAPIDLY THE INORGANIC; PHOSPHATES MAY ACCUMULATE IN THE 

 BLOOD TOWARDS THE END OF LIFE IN NEPHRITIS. (Denis and Minot(ft) ). 



calcium in the serum. This is due to the fact that when the phosphates 

 no longer pass out in the urine a compensatory elimination through the 

 intestines occurs. The phosphates are excreted in this way only when com- 

 bined with calcium. The calcium of the blood in such cases of nephritis 

 is necessarily diminished. Conversely, the administration of calcium leads 

 to an increased elimination of phosphates by the bowels. The following 

 table illustrates these facts. 



TABLE 23 



THE Low CALCIUM CONTENT OF THE BLOOD, AND THE LABORATORY EVIDENCES OF ACTDO- 

 sis ACCOMPANYING AN INCREASE IN THE INORGANIC PHOSPHATES OF THE BLOOD IN 

 NEPHRITIS ARE SHOWN. (Marriott and Rowland) 



Renal Function 



The kidneys eliminate certain substances presented to them by the 

 blood ; the only additional work they perform is the synthesis of hippuric 

 acid. Even when the kidneys are physiologically and anatomically intact 

 there may be a deficiency in urinary excretion. Thus, oliguria or anuria 



