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So much discrepancy exists between our urinary findings and those noted post mortem that one cannot help wondering whether he is ever justified in placing great reliance on variations in the urinary output. The fact that albumin and casts may or may not mean a pathologic lesion of the kidneys has increased our uncertainty regarding diagnosis. This situation has led to the introduction of various tests of the functional activity of the kidneys. "The aim of recent advances in modern functional renal diagnosis is to substitute a diagnosis based on physiology for empirical rules, to complete the general judgment of the renal functions by 'topical' tests of the various separate functions of the kidney." Many of the tests advocated have been shown to be absolutely useless and unreliable. This is especially the case when these tests are used to decide the question of competency or incompetency of one kidney to
Renal Diagnosis in Medicine and Surgery. Being a Handbook of the Theory and Practice of Functional Testing of the Kidney.. JAMA. 1914;LXIII(5):422. doi:10.1001/jama.1914.02570050058028