ACUTE NEPHRITIS AND THE EFFECT OF SULFONAMIDES ON THE KIDNEYS

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Abstract
Sulfonamides may in some cases cure acute glomerulonephritis and other acute inflammatory lesions of the kidneys, but under certain circumstances they may cause kidney damage. This renal injury may be of 2 kinds: that caused by mechanical obstruction, and that due to direct nephrotoxic action in the absence of obstruction. Two cases of acute nephritis benefited by sulfonamide therapy are mentioned and a 3d case described more fully in which treatment with sulfathiazole resulted in complete recovery. A case illustrative of the nephrotoxic action of sulfathiazole is given, and the findings at autopsy are reported. Precautionary measures of proved value are outlined. Such safeguards as adequate intake of fluid, careful observation of the urine, gross and microscopic, are important. If crystals are present special care should be taken in regard to dosage, the optimal level in the blood stream and volume of urine excreted. The study of the relationship of urinary pH to crystalluria indicated that alkalinity may diminish its incidence.

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