N.F. Jones

ABNORMAL LEUCOCYTE COMPOSITION AND SODIUM TRANSPORT IN ESSENTIAL HYPERTENSION

Cation transport and electrolyte composition were studied in leucocytes from 17 patients with uncomplicated essential hypertension. Significant increases in cell sodium and water contents, associated with a depression of the rate-constant for active sodium efflux, were found in the hypertensive patients. These abnormalities in cell sodium transport may possibly be related to mechanisms of hypertension.

Use of co-trimoxazole in chronic renal failure.

Twenty patients with chronic renal failure and either urinary or respiratory tract infection were treated with co-trimoxazole. Seventeen patients showed no deterioration in renal function while receiving co-trimoxazole. Deterioration in renal function during treatment in the other three patients was due to factors other than administration of the drug. It is concluded that co-trimoxazole can be used in patients with chronic renal failure provided the dose is adjusted according to the degree of renal failure.

URINARY OSMOLALITY IN ACUTE RENAL FAILURE DUE TO GLOMERULONEPHRITIS

Abstract In thirteen patients with acute oliguric renal failure due to glomerulonephritis urinary osmolality was higher than that of the plasma in every case. In contrast, six of seven patients with acute tubular necrosis produced isotonic or slightly hypotonic urines (as had been reported by other workers). Details are given of one case which illustrates the possible value of urinary osmolality in diagnosis.

PHENFORMIN AND METABOLIC ACIDOSIS

Abstract A patient with oliguric renal failure complicating accelerated hypertension was given phenformin and ethylœstrenol as fibrinolytic therapy. On the fifth day of this treatment a profound and fatal metabolic acidosis developed despite good control of uraemia by peritoneal dialysis. The acidosis was resistant to 2500 meq. sodium bicarbonate given over five hours. Two diabetic patients are also described in whom severe metabolic acidosis developed during phenformin therapy. The blood-lactate level was raised in the one patient in whom it was measured. The risk of severe acidosis should preclude administration of phenformin in patients with renal impairment. Awareness of this hazard is particularly pertinent in view of claims for this drug in the treatment of the haemolytic-uraemic syndrome and pre-eclamptic toxaemia.