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June 25, 1960


Author Affiliations

Atlanta, Ga.

From the Joseph Scinocca Renal Laboratory, Piedmont Hospital.

JAMA. 1960;173(8):905-911. doi:10.1001/jama.1960.73020260010010

Proper management of the patient with chronic renal failure entails a knowledge of how the normal kidney does its work, common kidney function tests and their differential value, chemical abnormalities in chronic renal failure, and chemical derangements in various types of renal disease.

Functions of Normal Kidney  The functional unit of the kidney is the nephron, of which there are roughly two million. Each has a glomerulus with an efferent arteriole, which breaks up into a group of collateral capillaries that rejoin to form the efferent arteriole. Bowman's capsule is a membrane, the visceral layer of which is closely applied to each of the capillaries and the parietal layer of which reflects backward in a cup-like fashion. The base of the cup is continuous with the kidney tubule which undergoes a series of loops and contortions known as the proximal convoluted tubule. This becomes continuous with a long, thin, U-shaped