The accumulation of inorganic sulfate in human serum above normal limits in advanced stages of renal disease was first observed by Denis1 in 1921. Subsequent work by various groups of investigators (Denis and Hobson;2 Loeb and Benedict;3 Cope;4 Hayman and Johnston5) substantiated these observations. Wakefield, Power and Keith6 pointed out that sulfate, the concentration of which normally is not in excess of 5.5 mg.7 per hundred cubic centimeters of serum, in an appreciable number of cases actually is the first substance to accumulate in the blood of patients with early renal insufficiency. Macy,8 amplifying the scope of the problem, investigated the clearance of inorganic sulfate. He found a certain number of patients in whom renal damage could be expected to exist whose clearance of inorganic sulfate was less than 20 cc. per minute (which he considered the lower limit of normal), whereas with none of the other tests of renal
GOUDSMIT A, KEITH NM. RELATIVE SIGNIFICANCE OF CONCENTRATION OF INORGANIC SULFATE IN THE SERUM AND OF ITS RENAL CLEARANCE: WITH SPECIAL REFERENCE TO DIFFUSE ARTERIOLAR DISEASE WITH HYPERTENSION. Arch Intern Med (Chic). 1940;66(4):816–832. doi:10.1001/archinte.1940.00190160033004
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