RENAL LESIONS ASSOCIATED WITH GOLD THERAPY; LIGHT AND ELECTRON MICROSCOPIC STUDIES.
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Biomedical subjects
Publications and source records attributed to J HOPPER.
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Numerous reports of chronic renal disease in patients who habitually use phenacetin-containing compounds to excess have aroused considerable controversy over the possible relationship between phenacetin, alone or in combination with other analgesics, and the occurrence of renal damage. Between 1961 and 1964, we have seen 23 patients with severe renal failure and a history of prolonged, excessive use of phenacetin-containing compounds. In all instances the clinical and laboratory data were compatible with "phenacetin nephritis" as described in Europe and Australia and recently in the United States and Canada. This report evaluates the findings in the 23 cases and cautions against the use of phenacetin, particularly in patients with impaired renal function.
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Clearance of endogenous creatinine offers a reliable clinical means of determining quantitative renal damage. The rate of clearance (Ccr) is obtained by relating the amount of creatinine filtered by the glomerulus per unit of time to the concentration of creatinine in the serum. The technic is simple and practical for routine use. Since 1948, the creatinine clearance determination has been used extensively at the University of California Medical Center for the evaluation of renal function. The present report reviews our selected experience with this procedure during the past 14 years. Clinical examples are used to show that the Ccr is a more accurate index of glomerular filtration than the concentration of any of the nonprotein nitrogen components of the blood.
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