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November 1923

A CONTRIBUTION TO THE BIOCHEMISTRY AND TREATMENT OF CHRONIC NEPHROSIS (EPSTEIN))

Author Affiliations

MONTREAL, CANADA

From the department of metabolism of the Montreal General Hospital.

Arch Intern Med (Chic). 1923;32(5):758-763. doi:10.1001/archinte.1923.00110230114010
Abstract

Following many observations made—clinical and chemical—in various forms of renal disorders, Epstein,1 in 1917, reported what he regarded as a clinical and pathologic entity, called by him a chronic nephrosis, which clinically simulates, although in many respects it differs from, the commonly known forms of chronic parenchymatous nephritis. Briefly, this condition is regarded as one of a metabolic nature, in which the renal and other clinical manifestations are concomitant or secondary in point of development and importance. Both the clinical and laboratory findings are characteristic in the pure form of the disease. Its origin is slow, insidious and of unknown etiology. The first intimation the patient may have of the disease is the pallor and evidence of edema. The course is protracted. Objectively, there is a general anasarca, oliguria and absence of increase in the blood pressure and cardiac hypertrophy. It occurs, as a rule, in relatively young people. The

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