Jack Orloff

Renal Concentrating Defect in Sjögren's Syndrome

Excerpt In the course of a recent study at the National Institutes of Health of the clinical and immunological abnormalities present in patients with Sjogrens syndrome (1-4), persistent hyposthenu...

The effects of concentrated salt-poor albumin on the metabolism and excretion of water and electrolytes in nephrosis and toxemia of pregnancy.

Purified albumin was first prepared by Armstong and his co-workers (1) in 1940. It was hoped that it would provide a rational mode of therapy for the edema of hypoalbuminemia and serve as an experimental tool for the study of the formation of edema. Numerous investigators have described its use as a diuretic in nephrosis (2-6), cirrhosis of the liver (7-9), idiopathic hypoalbuminemia (10), and other conditions (10). In general the results have been extremely variable despite the fact that albumin induces the same initial hemodynamic events in all patients. Goodyer, Peterson, and Relman (11) have shown that normal subjects who experience similar changes in circulatory dynamics actually have a depression of salt excretion when concentrated albumin is administered intravenously. This has been confirmed by Welt and Orloff (12) under somewhat different conditions. However, the latter were able to augment urine flow profoundly when the albumin was introduced as an approximately iso-osmotic solution. In the past the diuresis which occurs in some patients had been ascribed to the expansion of plasma volume (10). More recently it has been