In chronic progressive renal disease, renal excretion of hydrogen ion may be impaired due to either decreased urinary titratable acid and ammonium ion excretion or decreased bicarbonate ion reabsorption by the renal tubule cell. In general, urinary ammonium excretion is markedly reduced in advanced renal disease, which results in positive hydrogen ion balance. Therefore, for the treatment of renal failure, it is necessary to give enough carbohydrate and tat so as to inhibit nrotein catabolism and also to reduce amount of protein intake which may induce hydrogen. In summary, blood hydrogen and bicarbonate concentration and urinary ammonium excretion rate are the most important indices to evaluate acid-base balance in advanced renal disease, whereas hydrogen ion clearance index is not dispensable except for renal tubular acidosis.

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We administred Furosemide (F) and Mercurhydrin (M) in rabbits and investigated the changes during elapsed time in the concentration gradients of sodium and potassium in various tissues (kidney, heart, aorta) and also changes in the serum and urine; these data were used to consider the mechanism of action of F as a diuretic and antihypertensive and to compare these with a Mercurial diuretic. The results were as follows: 1. In the group with kidney damage by potassium chromate, there was an increase in urinary excretion of sodium and decrease in potassium, in the 2 % saline-loaded group we saw an increase in serum sodium and an increase in urinary sodium excretion. 2. In both the normal and the potassium chromate damaged groups, sodium and potassium concentration gradients from renal cortex to papilla were present. These gradients were diminished to some extent by intravenous injection of either F or M. Further since after F i, v. injection the sodium concentration in the cortex was markedly decreased, we consider the likelihood of inhibition of sodium reabsorption in both the proximal and distal renal tubules. Since the decrease in concentration of potassium in cortex was greater than with M, we also considered the likelihood of a potassium secretory effect in the renal tubule. 3. In the salt-loaded group we saw an increase in sodium concentration in the renal medulla and the aorta with a high concentration in the aortic arch. 4. There was a decrease in the concentration of sodium in the heart 4 hours after i. v. administration of both F and M, the potassium concentration on the other hand showed a tendency to increase. 5. In both the normal and damaged groups the aortic sodium concentration showed an increase progressing from the arch through the thoracic to the abdominal aorta, the potassium concentration showed the opposite tendency. In the normal group after either F or M i, v, administratioo, the aortic sodium concentration showed a gradual increase and increased further after 4 hours. The potassium concentration tended to decrease temporarily after i, v. administration but returned to preinjection levels. Further the arch of the aorta and the heart showed a clear reaction in sodium and potassium concentration changes. The above facts give us some inklings on the mode of action of diuretic-antihypertensive agents.

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Pneumoretroperitoneum was carried out in 153 cases; of whom 90 cases were selected as the study objects by excluding both such renal diseases as acute, subacute and chronic nephritis, nephrotic syndrome, nephrolithiasis, and the cases over 50 years of age who might be considered of senile renal lesion. Out of the 90 cases, 44 were of movable kidney, and 46 of non-movable kidney. The author's respiration test, as an exercise test, was performed by a 3-minute (about 30-time) deep respiration. And, the author's walk test, as an exercise test, was performed by about 4-minute walking (back and forth) along a corridor about 100-meter long with 20-step stairs.The obtained results are as follows : 1. Maximal and minimal blood pressures elevated in many cases with movable kidney, though lowered in many cases without movable kidney, immediately after the respiration test. There was some peculiar aspect of pothological physiology as to the influence of deep respiration upon blood pressure in movable kidney : Physiologically, blood pressure is lowered by deep respiration. 2. Maximal and minimal pressures elevated in all the cases both with and without movable kidney immediately after the walk test. And, the grade of pressure elevation was more distinct in movable kidney than in non-movable kidney. 3. Concerning the maximal and minimal blood pressures at rest and their changes provoked by the exercise tests, there was no significant difference between the respiratory and the postural movable kidney. 4. The changed maximal and minimal pressures caused by exercise tests came back to the original pressures at rest, 1015 minutes after the exercise tests, in all the cases. From this fact, it is clear for the hypertension in movable kidney to be labile and changeable always.

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