American Journal of Nephrology
Origins of Nephrology – The Modern Era
Diagnosis of Renal Disease at the Beginning of the 20th CenturyCioffi M. · Esposito L. · De Santo D. · Giannattasio P. · Cappabianca F. · Mangiacapra S. · Materiale T. · Conte G.Chair of Nephrology, Second University of Naples, Italy
|
|
Log in to MyKarger to check if you already have access to this content.
KAB
Buy a Karger Article Bundle (KAB) and profit from a discount!
If you would like to redeem your KAB credit, please log in.
Save over 20% compared to the individual article price.
Article / Publication Details
Published online: April 23, 1999
Issue release date: March – April
Number of Print Pages: 4
Number of Figures: 0
Number of Tables: 1
ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)
For additional information: https://www.karger.com/AJN
Abstract
At the beginning of this century, the diagnosis of various renal diseases was made with relative accuracy although neither plasma markers of glomerular filtration nor renal biopsy nor imaging were available. Renal edema was identified by high albuminuria, hyalin cylinders, high urine density and oliguria. Renal hematuria was detected by cylinders of erythrocytes. Hallmarks of chronic renal insufficiency, recognized at autopsy by atrophic kidneys, were hyposthenuria, polyuria and slight albuminuria without edema associated with arterial hypertension, anemia, retinopathy and left ventricular hypertrophy. The detection of increased plasma volume in experimental toxic nephritis by St. Moscati proposed the underlying mechanism of arterial hypertension. Experimental and clinical research in the preinsulin era indicated the central role of the kidney in the functional alterations induced by diabetes. Indeed, glucosuria was known to appear only when glycemia was relatively high. The kidney appeared enlarged and hyperemic, i.e. the so-called glomerular hyperfiltration. Glucosuria was directly correlated with diuresis but it markedly decreased in renal insufficiency. In diabetes complicated by nephropathy, tolerance to carbohydrates improved. Correction of glucosuria by dietary treatment was followed by a prompt rise in body weight, due to retention that counterbalanced the previous losses. Diabetic ketoacidosis, determined by the measurement of urinary ketonic body excretion, was treated with sodium bicarbonate (30–50 g/day in severe acidosis) up to achieving an alkaline urine pH. It was known that high doses of sodium bicarbonate might induce edema which gradually disappeared with a reduction in the alkaline administration. Clinical significance of sodium balance was, in fact, recognized: the external NaCl balance between alimentary ingestion and urinary excretion was neutral in normal conditions and became positive at high body temperature or negative during reabsorption of exudates.
Related Articles:
References
-
De Carolis A: Prontuario per il medico pratico, ed 2. Bologna, Garagnani, 1910, p 668.
-
Rassegna della stampa Italiana ed estera; in Rummo A (ed): La riforma medica anno XXXVIII. Napoli, Muca, 1922, p 472.
-
Mohr L, Staehlin R: Diabete mellito; in: Trattato di medicina interna. Milano, Società Libraria, 1913–1914, vol 8, pp 664–723.
- Ritz E, Kuster S, Zeier M: Clinical nephrology in 19th century Germany. Am J Nephrol 1994;14:443–447.
-
Lanzillotta R: I metodi di indagine nella funzinalità renale. Napoli, Trinchera, 1921, p 200.
-
Zina A: Ricerche sul ricambio intermedio ed esterno nei nefritici ed uremici; in Rummo A (ed): La riforma medica anno XXXVIII. Napoli, Muca, 1922, pp 243–246.
- Richet G: Edema and uremia from 1827 to 1905: The first faltering steps of renal pathophysiology. Kidney Int 1993;43:1385–1396.
-
Koranyi A: Physikalisch-chemische Methoden und Gesichtspunkte in ihrer Anwendung auf die pathologische Physiologie der Nieren; in Koranyi A, Richter PF (eds): Physikalische Chemie und Medizin. Leipzig, Thieme, 1907, pp 133–190.
-
Eknoyan G: A history of edema and its management. Kidney Int 1997;51(suppl 59):118–126.
-
Moscati G, Napolitano G: La determinazione della quantità del sangue con il metodo ottico. Studio sulla quantità del sangue in alcune nefriti; in Rummo A (ed): La riforma medica anno XXXVIII. Napoli, Muca, 1922, pp 435–438.
- Conte G: Empiricism versus science in the teaching of nephrology. Am J Nephrol 1994;14:257–258.
Article / Publication Details
Published online: April 23, 1999
Issue release date: March – April
Number of Print Pages: 4
Number of Figures: 0
Number of Tables: 1
ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)
For additional information: https://www.karger.com/AJN
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
PubMed ID
