In the study of any metabolic process account has to be taken of the excretion of waste products, the food intake, and also the various changes which this food undergoes in the body before the end-products are ready for excretion. The last constitutes the intermediary metabolism, of which our knowledge is still very imperfect. If any one of these groups of processes is studied to the exclusion of the others, very erroneous ideas regarding the metabolism will be obtained. Likewise, in the study of renal function chemical observations of any one of these processes (nitrogen intake or output, or retention of waste nitrogen) will fail to give accurate information unless something is known of the other metabolic factors. Little value can be attached to the finer changes in the level of the blood urea, or total nonprotein nitrogen, as a gage of renal function, unless the protein intake is
LEWIS DS. THE CLINICAL VALUE OF AMBARD'S COEFFICIENT OF UREA EXCRETION. Arch Intern Med (Chic). 1917;XIX(1):1–52. doi:10.1001/archinte.1917.00080200006001
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