Widal and Javal1 recently called attention to the inability of many nephritics to eliminate sodium chlorid in a normal manner. The salt retained in the tissues required a certain amount of water to maintain it in the proper molecular concentration, thus leading to edema; they offer this as the probable cause of dropsy in nephritis. This chlorid retention was found chiefly in acute and chronic parenchymatous nephritis, and especially in patients who were edematous. This retention was not found in the interstitial form, and we know that when edema develops in these cases it is usually of cardiac origin. They, furthermore, decided that the impermeability of the kidney to urea and salts did not necessarily go hand in hand, as in the terminal period of Bright's disease there may be marked retention of chlorids, but none of urea, phosphates or sulphates. They report a case of uremia, with daily
MILLER JL. THE ELIMINATION OF CHLORIDS IN NEPHRITIS.. JAMA. 1905;XLV(26):1915–1917. doi:10.1001/jama.1905.52510260001001
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