Clearance法を用いた腎機能の研究 第1編 流行性肝炎における腎機能について

1. Regarding the function of kidney under the clearance method in an acute instance of epidemic hepatitis, urine volume per minute and glomerular filtration rate decrease at the early stage of disease, and especially effective renal plasma flow and effective renal blood flow decrease remarkably. Therefore, filtration fraction stands a high degree, while reabsorption rate undertakes no greate change and tubular excretory mass decreases remarkably. At the stage of jaundice, both urine volume and glolmerular filtration rate return to the normal state, while effective renal plasma flow and effective renal blood flow are still somewhat lower and filtration fraction is a little higher, and reabsorption rate is normal, and tubular excretory mass still stands a low degree. At the stage of recovery, urine volume increases remarkably, glomerular filtration rate a little, effective renal plasma flow and effective renal blood flow considerably; therefore, filtration fraction turns low, reabsorption rate rises a little, and in many cases tubular excretory mass increases. 2. The function of kidney under the clearance method in chronic hepatitis corresponds, at the time of taking a serious turn, to the one at the early stage of disease in case of acute hepatitis, and, at the time of taking a favorable turn, to the one at the stage of recovery. 3. The function of kidney under the clearance method in case of form Ⅱ by H.Eppinger corresponds to the one at the early stage of acute hepatitis or at the aggravation stage of chronic hepatitis, but in case of the former, glomerular filtration rate decreases and effective renal plasma, flow and effective renal blood flow falls more remarkably than either of the latter. Regarding form Ⅲ, it looks similar to the one at the recovering atage of acute hepatitis, but urine volume effective renal plasma flow and effective renal blood flow increase more, filtration fraction grows lower, and tubular excretory mass is observed to increase slightly more than in case of the latter. 4. At the early stage of hepatitis, more often than any other stage the quantity of bilirubin in urine in a minute is larger than that of bilirubin in serum. It is considered due to the fact that some bilirubin leaks out the glomerulus at the early stage of the disease. At the stage of jaundice it is difficult to find some mutual relation between those two bilirubin and the function of the kidney under the clearance method.