Serum Albumin in Uremia: A Clinical Investigation Correlated With Reversible Uremia in Dogs

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Abstract
A new and simple method is described for the production or reversible exptl. uremia which permits immediate termination of the uremia by simple nonoperative intervention. In the dog the ureters were exposed, a length of empty Penrose drain was passed beneath them and the ends brought through a separate stab-wound in the midline. Uremia was induced by increasing tension on the drain. Cutting the restraining suture terminated uremia. Since a specific degree of uremia and recovery therefrom may be obtained as desired, the method is useful for investigation of renal insufficiency. The return to normal of clinical and chemical observations demonstrate the reversible feature of the technic. As only one operation is necessary to repeatedly produce uremia in a laboratory animal, the procedure may be considered practical for repeated observations over a long period of time. This procedure was designed and applied to a study of the serum proteins of uremic dogs; the findings concerning the serum proteins were also confirmed in a series of patients in uremia of various etiologies. The data presented demonstrated that in uremia there is an altered serum albumin as detd. by impaired ability to bind the dye phenosulfonephthalein. This alteration of albumin is both of quality and quantity. In the clinical and laboratory series studied this pathological protein was consistently present Further, it is unrelated to age or sex and is generally directly proportional to the degree of uremia. The abnormality of serum albumin is apparently independent of either the etio-logical factor producing the uremia or the anatomical renal unit involved. The nature of the change in the albumin molecule is discussed.

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