THE CHANGES OF BLOOD CHEMISTRY AFTER THE PARTIAL NEPHRECTOMY

THE IIIrd. REPORT: A STUDY OF THE PARTIAL NEPHRECTOMY

Abstract

The changes of blood chemistry immediately after partial nephrectomy in clinical and canine cases were searched for by means of the measurements of non-protein nitrogen, urea nitrogen, creatinin, inorganic phosphor, plasma protein, and Na, Cl, and K as representative of electrolytes, and the following conclusions were obtained.
1) In cases with another healthy kidney, hardly any notable change of blood chemistry is noticed immediately after the operation except a temporary azotemia similar to what is observed after the usual nephrectomy, because the healthy kidney functions in complete compensation.
2) In cases with only one kidney, on the contrary, severe azotemia accompanied with oliguria occurs immediately after the operation. But this change is also temporary and returns nearly to normal range after a week.
3) In clinical cases with only one kidney, when the renal pedicle vessels are treated with digital pressing, oliguria and azotemia after the operation are of lighter degree than when treated with a clamp. In canine cases, however, any appreciable difference is not found between the postoperative renal functions after two treatments.
4) From the changes of blood chemistry mentioned above it necessarily follows that while the partial nephrectomy is safe in patients with another healthy kidney, it causes a temporary crisis immediately after it in those with only one kidney, which demands a careful postoperative observation: consequently, in the latter the renal pedicle must be treated not with a clamp but with digital pressing, in order to avoid its impairment as much as possible.