The relation between amylase retention and excretion and non-protein nitrogen retention in experimental uranium nephritis / R. Fitz, M.D. Boston.

  • Fitz, Reginald, 1885-1953
Date:
1915
Catalogue details

Licence: In copyright

Credit: The relation between amylase retention and excretion and non-protein nitrogen retention in experimental uranium nephritis / R. Fitz, M.D. Boston. Source: Wellcome Collection.

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    showed that in the majority of cases the nitrogen of the blood increases with an increasingly severe nephritis, and that the degree of accumu¬ lated blood nitrogen affords valuable information in regard to the prognosis. Heretofore, urinalysis, except in relation to the output of chlorids, nitrogen and water, has contributed little to our understanding of renal function. In 1908, however, Wohlgemuth7 began a series of studies with the starch-splitting ferment amylase (or diastase). He found that the amount of this enzyme which was excreted in the twTenty-four hour urine of normal men varied within narrow limits and was almost constant for a given individual. In the urine of nephritics, on the other hand, the amount of the enzyme excreted in the urine diminished in proportion to the severity of the disease. Wohlgemuth, therefore, suggested that the determination of amylase in urine afforded a valuable clinical test for renal function. His results with this test have been confirmed both by experiments and by clinical studies. Hirata8 showed that in rabbits, as well as in man, the twenty-four hour urine and the blood serum contained nor¬ mally a constant amount of amylase. When corrosive sublimate, uranium nitrate, or chromic acid nephritis was produced the amylase in the urine diminished, and accumulated in the blood in almost direct proportion to the severity of the existing lesions. Von Benczur,9 Wynhausen,10 Rosenthal,* 11 Marino,12 Corbett13 and Geyelin14 have observed the excretion of amylase in nephritis and have found that it diminishes as the severity of the disease increases. Therefore there is sufficient evidence to prove that of substances constantly found in urine the amylase excretion represents a reasonably accurate test for the renal function. The desirability of correlating as many tests for renal function as possible to determine their true values has been self-evident and has been attempted both in animal experiments and clinical studies. Frothingham, Fitz, Folin and Denis15 produced uranium nephritis in rabbits and followed the relation between the non-protein nitrogen retention in the blood and the excretion of phenolsulphonephthalein in the urine. The two tests paralleled each other as indicators of 7. Wohlgemuth: Ueber eine neue Methode zur quantitativen Bestimmung des diastatischen Ferments. 8. Hirata : Biochem.* Ztschr., 1910, xxviii, 23. 9. Von Benczur: Wien. klin. Wchnschr., 1910, xxiii, 890. 10. Wynhausen: Berl. klin. Wchnschr., 1910, xlvii, 2107. 11. Rosenthal: Deutsch. med. Wchnschr., 1911, xxxvii, 923. 12. Marino: Deutsch. Arch. f. klin. Med., 1911, ciii, 325. 13. Corbett: Quart. Jour. Med., 1913, vi, 351. 14. Geyelin: The Archives Int. Med., 1914, xiii, 96. 15. Frothingham, Fitz, Folin and Denis: The Archives Int. Med., 1913, xii, 245.
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