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September 1, 1956


JAMA. 1956;162(1):5-9. doi:10.1001/jama.1956.02970180007002

• Roentgenograms of the chest in cases of so-called pulmonary azotemia, uremic lung, and uremic pneumonia show bilaterally symmetrical densities in the central lung fields with comparatively clear peripheral zones. The latter have been assumed, in the past, to be characteristic of the lung in uremia and to be absent when pulmonary congestion and edema arise from other causes.

Study of roentgenograms previously published by others and of roentgenograms from a group of six original cases showed that the value of the clear peripheral zones as diagnostic criteria must be doubted; they were not always distinct in cases of uremia and were sometimes present when the primary disturbance was not renal but cardiovascular.

The roentgenographic appearances in question, therefore, should be interpreted simply as representing pulmonary congestion and edema due to fluid retention from whatever cause and should not be considered as diagnostic of nitrogen retention caused by renal failure.