Rare that only one of these structures is affected; what happens to one frequently affects the others as well.

The disease in which the glomeruli are particularly involved is called glomerulo-nephritis. It may be acute or chronic, the first frequently leading to the second. It is often a sequel¹ to such a childhood infectious disease as scarlet fever. In glomerulo-nephritis, the glomeruli become clogged with exudate and cell debris so that the blood no longer flows through them. Here a clearance test is useful; it will show that much smaller quantities of filtrate are being formed than normally. The glomeruli being still open become permeable to protein and albuminuria becomes very marked. This leads to edema.

Diseases involving the tubules are called nephroses. They are usually caused by poisons of various kinds, such as mercury, bismuth, uranium, or carbolic acid. Some degree of tubular degeneration occurs, however, in such diseases as diabetes, malaria and pernicious anaemia², and also in traumatic shock. Finally, athero-sclerosis of the kidney may occur, reducing the total blood flow through the kidney's blood vessels.

What happens to the kidneys when incompatible blood has been used in a transfusion? Hemolysis of red cells occurs, of course, and the liberated hemoglobin circulates in the blood. Passing through the kidney, hemoglobin (although its molecular weight is 68.000) passes through the membrane into the tubules. If the amount is small, reabsorption occurs, but in the amounts increased after an incompatible transfusion the hemoglobin, passing through the tubules, is precipitated. This blocks the tubules; they cease to function and finally die. Patients having received the wrong type of blood can often be saved if the blood is thoroughly alkalin-ized; an alkaline filtrate is formed and thus prevents precipitation.

Epithelial cast

Blood cast

Fat cast

Wax cast

<== попередня сторінка	\|	наступна сторінка ==>
Text A Coronary Heart Disease	\|	Часть II С

Не знайшли потрібну інформацію? Скористайтесь пошуком google:

Генерація сторінки за: 0.004 сек.