Treatment of experimental uremia by means of peritoneal irrigation.

The need for a temporary substitute for renal function has been emphasized recently by the report from battle fronts of a high incidence of fatal uremia in the severely wounded following kidney shutdown in the post-operative and post-transfusion period. It is probable that the acute renal damage of wounded men and in some other conditions is reversible, so that death from uremia might be prevented if retention products could be excreted through an extra-renal outlet during the healing period. Three ways of decreasing uremia by extrarenal excretion have been suggested in the past: (1) excretion through the intestinal tract, by gastro-duodenal suction and the production of diarrhea, and through the skin by the production of sweating; (2) "vivi-difusion," by which the circulating blood is submitted to dialysis outside the body and returned to the circulation (1 to 3); (3) peritoneal dialysis, by which fluid, introduced into the peritoneal cavity and allowed to equilibrate with the blood, is afterward removed with nitrogenous and. other diffusible substances (4 to 6). The peritoneum is an efficient dialyzing membrane (7), but utilization of this function for the treatment of uremia (4, 6, 8) to date has not been applied with success.2 To determine whether this method can be made practical for clinical use, studies have been made on man and animals. This report deals with the experimental data in dogs.