Gladys H. Hirschman

Anorexia nervosa with Acute Tubular Necrosis Treated with Parenteral Nutrition

A patient with nonoliguric acute renal failure secondary to acute tubular necrosis in conjunction with anorexia nervosa is described. Parenteral feeding at a critical time has salutory effects on the biosynthesis of new protein and thereby reduces many of the hazards of azotemia. The technique of estimating endogenous acid production is applied for the first time in a severely malnourished subject and documents the retention of dietary sulfur which presumably is retained in the formation of new tissue in the recovery phase.

Nephrocalcinosis and Nephrolithiasis in Children

From the Section on Steroid and Mineral Metabolism, Hypertension-Endocrine Branch, National Heart Lung and Blood Institute; the Artificial Kidney/Chronic Uremia Section, National Institute of Arthritis Metabolism and Digestive Diseases, National Institutes of Health, Bethesda, Md. * Visiting Scientist, Section on Steroid and Mineral Metabolism, NHLBI, NIH, Bethesda, Md. t Staff physician, Artificial Kidney/Chronic Uremia Section, NIAMDD, NIH, Bethesda, Md. Correspondence to: James C. M. Chan, M.D., Bg 10 Rm8N214, National Institutes of Health, Bethesda, Md. 20014 CLINICAL DISORDER of calcium metabolism, nephrocalcinosis consists of calcium deposition in the renal tubular cells and the interstitium, with a predisposition to the renal medulla and the cortical medul-

NIH, Kidney Research, and the Patient with Renal Disease

The first venture of the Federal government into the support of catastrophic illness for almost all Americans afflicted with a disease was made on October 30, 1972, when PL 92-603, Section 299(I), known tersely as the End Stage Renal Disease (ESRD) Amendment, was enacted. In 33 lines of succinctly worded public law, it was stated that “every individual who ... is medically determined to have chronic renal disease and who requires hemodialysis or renal transplantation for such disease, shall be deemed to be disabled for the purposes of coverage under parts A and B of Medicare subject to the deductible, premium, and copayment provisions of title XVIII.”1