RENAL TUBULAR FAILURE OF SHOCK AND NEPHRITIS

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Abstract
A review of experimental, clinical, and pathological observations. Tubular functions are outlined. Data from the laboratories of the author and others are summarized, indicating that renal ischemia, with renal constriction, occurs during shock from decreased circulating blood volume, whether caused by hemorrhage, trauma, or desiccation. Organic injury to the tubules, with functional tubular failure, can result from the ischemia. The effects of tubular failure on the water and electrolyte balance of the organism are outlined, in connection with the clinical problems that result. Evidence is presented that not only glomerular, but also tubular failure occurs in both acute and chronic nephritis, and that handling of the tubular factor can be important in treatment.

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