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January 1924


Author Affiliations


From the Department of Medicine, Johns Hopkins Hospital, Baltimore.

Arch Intern Med (Chic). 1924;33(1):58-70. doi:10.1001/archinte.1924.00110250061006

In pernicious anemia there is frequently evidence of mild renal damage, manifesting itself by albumin, casts or both in the urine. Up to the present time it has been assumed that this renal irritation or damage is a result of malnutrition and anoxemia of the kidneys because of the anemia. On the other hand, the incidence of albuminuria and other clinical evidence of renal disturbance is low in cases of secondary anemia. The hemolytic intoxication of pernicious anemia may also injure the kidneys directly, but it has long been known that in pernicious anemia there is a superabundance of "free" or inorganic ionizable iron in the blood and tissues. That the deposition of iron in the kidneys may cause mild nephritic changes in experimental animals was demonstrated several years ago.1 The presence, therefore, of renal hemosiderosis might be responsible for the renal disturbance in pernicious anemia. It was with this

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