Despite numerous studies of morphologic and functional changes in acute renal insufficiency, there is still no adequate means of determining kidney damage early while that damage is developing, and there is still no means of determining the relative importance of a variety of suspected causal factors. As a result the clinician is hampered in establishing an early diagnosis and prognosis, and has no way of evaluating therapy. In reviewing the extensive literature on the subject, one is impressed by the complexity of the problem, the large number of variables involved, and the seeming hopelessness of drawing any further conclusions without finding some simpler experimental approach for testing hypotheses. For this reason a series of experiments have been carried out through use of (1) the isolated perfused kidney, (2) a limited number of potential noxious variables, and (3) analyses of perfusate and urine for cellular moieties as indices of kidney damage.
MASON EE, WARD JW, DIERKS C, Mauch U, Polehna V, Kellogg RE. Ischemia, pH, and Renal Damage. Arch Surg. 1960;81(2):186-192. doi:10.1001/archsurg.1960.01300020014003