PROTEINURIA FOLLOWING MOMENTARY VASCULAR CONSTRICTION

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Abstract
47 women, ranging from the 3d mo. of pregnancy to the 9th mo. after delivery, were used in a study of the relation of proteinuria to vascular constriction. Some subjects had normal pregnancies, some had toxemia; some had preexisting proteinuria, others had not; some had demonstrable renal disease, the majority had not. Urine was collected at short intervals from ureteral catheters, during which time a transitory vasospasm, appearing and disappearing within 120 secs., was produced by immersing one hand in ice water for one min. 22 patients showed only slight vascular constriction as judged by the small rises in blood pressure. None of these showed any increase in protein excretion. 25 subjects showed blood pressure rises of more than 16/16 min. Hg. systolic/diastolic; all but 2 of these had a transitory rise in protein excretion. In thin 2d series, the increased excretion of protein actually occurs as shown by the protein excretion/endogenous creatinine excretion ratio. This ratio indicates that after vascular constriction more protein escapes per unit of glomerular filtration. Incomplete collections of urine would not vitiate this conclusion. The right and left kidneys usually react similarly. In a few cases one kidney showed increased proteinuria while the other did not. From the promptness of reaction, independence of venous return from the chilled hand, and from calculations of the renal tubular vol. capacity, it is probable that the proteinuria begins with the release of the vascular spasm.