The Effect of the Toxemias of Pregnancy on Renal Function.

In a previous contribution (1) it was shown that there is a wider range of normal values for renal function tests in normal women in the last trimester of pregnancy than in normal non-pregnant individuals. The blood urea clearance (2) was shown to vary between 60 and 118 per cent of normal. The total protein content of the urine was within normal limits. The urinary sediment count of Addis (3) showed the casts to vary from 0 to 10,000, the red blood cells to range from 47,000 to 1,900,000 and the white blood and epithelial cells to vary from 25,000 to 6,000,000. These are the values which must be used for comparison when interpreting the results of renal function tests during the acute phase of the toxemias of pregnancy. When the patient has returned to her normal non-pregnant level, some three months postpartum, comparison can be made with the usual normal values established by Van Slyke and Addis. The above tests with the routine procedures as previously outlined (1) were made on each of thirty-three patients on three occasions; during the acute phase of the toxemia prior to delivery, in the early puerperium and three or more months postpartum. This method of study was followed in order that the course of renal function could be studied with the possible end in view of an earlier and better prognosis and perhaps a more simple classification of the toxemias of pregnancy. The cases studied have been divided into three groups; (I) preeclampsia including all types from the mild to the more severe; (II) eclampsia; and (III) nephritis complicating pregnancy. The results are shown in Tables I, II and III respectively. The cases in Tables I and II are subdivided into two groups, namely, those with no renal damage and those with possible renal damage. RESULTS