Blood Serum of Nephritic Patients. 27 



14 (i474) 



The protein and lipin content of blood serum of nephritic patients. 



By Max Kahn. 



[From the Department of Laboratories, Beth Israel Hospital, New 



York City.] 



It has been reported by Erben, 1 in 1902-3, that in the serum 

 of patients suffering from chronic parenchymatous nephritis, the 

 albumin-globulin ratio (which, normally is about 1.5-2.0 : 1) is 

 entirely disturbed, the figure being 0.2593 of albumin to 7.0352 of 

 globulin. This deviation in the ratio was confirmed by Epstein, 2 

 in 191 2. The latter author (basing his conclusion on his analyses 

 of nine cases of chronic parenchymatous nephritis, in whom, 

 besides the globulin increase, he also found a huge amount of 

 cholesterol in the serum) propounded the following theory of 

 the etiology of certain cases of chronic parenchymatous nephritis. 

 According to him, there is a group amon'g the cases of chronic 

 parenchymatous nephritis which is due to a constitutional dis- 

 order — of a metabolic or endocrinic nature — in which the renal 

 manifestations are concomitant or secondary in point of develop- 

 ment and importance. He does not, however, describe cases of 

 chronic parenchymatous nephritis in whom the protein or lipin 

 fractions should vary from the so-called "metabolic" type, and 

 which he should point out as "non-metabolic" in nature. 



In the series of cases investigated, the writer did not find 

 one case of the so-called "metabolic or endocrinic" type of chronic 

 parenchymatous nephritis, which would seem to indicate that the 

 type described by Epstein is very rarely met with. 3 The al- 

 bumin-globulin ratio does not seem to be markedly disturbed by 

 various diseases. Feeding of patients suffering with chronic 

 parenchymatous nephritis on a protein-rich, fat-poor diet is a 

 rather risky undertaking. 



1 Erben, Zeit. f. klin. Med., 1903 XL VIII, 450. 

 1 Epstein, Am. J. Med. Sc.. 1917, CLIV, 638. 



3 Epstein does not state what percentage of the cases of chronic parenchy- 

 matous nephritis are of his so-called "metabolic or endocrinic" group. 



