Observations on renal function in acute experimental unilateral nephritis / W.C. Quinby, M.D. and R. Fitz, M.D. Boston.

  • Quinby, W. C.
Date:
1915
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Licence: In copyright

Credit: Observations on renal function in acute experimental unilateral nephritis / W.C. Quinby, M.D. and R. Fitz, M.D. Boston. Source: Wellcome Collection.

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    the injection of phloridzin. In other words, all these various tests point to the same findings. The tests for renal function used in sur¬ gery are based on the facts that a diseased kidney is incapable of excreting solids, and that the degree of impairment of this fundamental function parallels in a general way the degree of existent disease. Therefore, the important feature in the selection of a test for renal function, when the urine from the two kidneys is compared, is to choose that one which is simplest for both surgeon and patient to perform, but which is delicate enough to point out the degree of exist¬ ent disease. Tests for renal function on our dogs with unilateral nephritis were undertaken to determine this point experimentally. METHOD Dogs were anesthetized with morphin and ether. In a few animals, abdominal section through the left rectus incision was made under aseptic precautions. The left kidney was freed from its capsule and its artery and vein were dissected clean by scissors and by wiping with dry gauze. Every effort was made to avoid rupture of nerve fibers. Rubber-tipped serrefines were placed separately on both vein and artery. The kidney itself was then delivered through the abdominal wound in such fashion as to expose the renal artery to best advantage without undue tension. One c.c. of distilled water which contained the desired dose of uranium nitrate was then injected into the vessel from a 2 c.c. Record syringe with a fine pointed needle, the tip of which was bent at right angles. In a few cases in which the renal artery was doubled, each branch was clamped and was injected with half the dose. In other animals, only one branch of the renal artery was injected. In a few experiments, 2 or 5 c.c. of injection fluid were used. After the artery was injected the arterial clamp was removed for a few seconds in order to distribute the uranium through the kidney substance as diffusely as possible. The slight bleeding at the point of puncture occasioned by this procedure was readily controlled, and the kidney as a whole became engorged. The arterial clamp was replaced. After intervals of from thirty seconds to five minutes, the point of the needle was inserted into the renal vein, and 5 c.c. of blood from the kidney were aspirated into the syringe. Whatever bleeding occurred around the needle point was controlled by walling-off sponges to pre¬ vent systemic absorption of the poison. Finally both the arterial and venous clamps were removed, the kidney replaced in its normal posi¬ tion and the wound closed according to usual methods. Virtually, the same technic was used in all our experiments. The only modification in our later studies was to use a lumbar incision for exposing the kidney, instead of reaching it through the peritoneum.