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July 14, 1928


JAMA. 1928;91(2):98-99. doi:10.1001/jama.1928.02700020032013

Although it is admitted that uremia is associated with a retention of certain substances within the organism, owing to a failure of adequate renal function, there has not as yet been general agreement with regard to a specific compound or even a group of substances that can be held responsible. In uremia the content of nonprotein nitrogen in the blood is usually found to be unduly high. This implies that urea and other nitrogenous catabolites fail to be eliminated with the usual readiness. From this it is tempting to conclude that one or more of the retained substances becomes responsible for the pathologic characteristics of the uremic condition. The attempts to fix such culpability on urea, quantitatively the most conspicuous of the circulating "metabolic waste" representatives, have not been successful. There are records, furthermore, of extremely high concentrations of catabolites occurring in the blood without the slightest indication of the

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