Newer renal efficiency tests and their value in diagnosis and prognosis

Abstract

It is probable that, at the present day, the function of no organ in the body is being investigated by so many methods . in the course of hospital treatment, as that of the kidney. The large number of methods used is the result of the fact that there is no general consensus of opinion as to any one method being definitely better than the others. A great deal of work has been done, comparing the relative values of these tests, the one with the other, in different types of nephritis, and in different stages of the disease. Much investigation has also been carried out to demonstrate how the results of these biochem- ical tests compare with the clinical findings, such as the presence, and severity of ha m at ura, albumin - uria, anaemia and elevation of blood pressure. One feels that in the multiplication of the kidney function tests, we are getting further and further away from the patient, and our attention is being diverted too much from the ward towards the laboratory. In the following pages, it is our inten- tion to pick out the salient points from the vast amount of recent investigation into kidney function, and in the light of these findings, to discuss the various kidney function tests in daily use, and their relative merits. Thereafter we intend to present the records of an investigation carried out by ourselves. The object of the investigation has been to correlate more closely the results of the kidney function tests to other clinical findings recorded simultaneously. The clinical tests used deal chiefly with changes in the condition of the cardio- vascular system, as indicated by the systolic and diastolic blood pressure, the pulse pressure, and the pulse rate. The justification for such an investigation will be discussed later. It is hoped that by this co- relating the clinical findings to the kidney function, one might be able, by the clinical findings alone, to assess the kidney function. In this way much time- consuming and expensive laboratory investigation might be eliminated, without loss of efficiency, or insight into the true condition of the patient, and the course of his disease

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