J.Jpn. Surg. Soc.. 53(11): 880-888, 1953
Original article
RENAL DISTURBANCES IN SURGERY.
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Department of Surgery, Tokyo University Branch Hospital. (Director: Assist. Prof. T. Hayashida) Iwao OZAKI |
During the test, urine was collected every 10 min. and output, specific gravity, pH., glycosuria, albuminuria, microscopic feature of sediment and indigocarmine excretion time were examined.
2) Urinary output began to diminish before or during operation, and even anuria occurred as operation proceeded. It reached the bottom at the end of operation, and recovered in 6 hours with postoperative treatments. Specific gravity was reversely proportioned to the output. PH. diminished accompanying with output.
3) Glycosuria began to appear during operation or rarely at the end of operation. It ranged from 0.10 to 0.84 gr/dl, and disappeared within 6 hours after operation. It did not appear in such operation as plain laparotomy or gestrectomy.
4) Albuminuria appeared in anesthesia alone. In the majority of cases, however, it began to appear during operation or rarely after that. It ranged from 0.02 to 1.59 gr/dl reaching to peak 6 hours after operation. Time of disappearance varied widely, but in the most of cases it was near the third postoperative day, and in a week all the cass became negative.
5) Albumin was the decisive major fraction of protein in urine (more than 70%), in the other hand, globulin increased in larger operations.
6) No particular findings was observed in microscopic examination of urinary sediment.
7) Indigocarmine excretion time prolonged at the end of operation.
8) In the animal experiment, mice were traumatized at their posterior extremities, and histology of kidney was studied. Pathological changes were found first in glomerulus within 30 minutes after trauma, then in tubulus. Changes became maximum in 3 to 6 hours, began to recover in 6 to 12 hours and almost recovered in 3 days. (Shrinkage and anemia of glomerulus, vacuolizing of epithel, and expansion of the lumen of tubulus and albuminous degeneration of epithel.) In the fatal cases, The strongest changes appeared in 3 to 6 hours. (Hyperemia of glomerulus, vacuolizing of epithel, and expansion of the lumen of tubulus and albuminous degeneration of epithel.) They tended to recover in 6 to 12 hours.
9) In conclusion, it can be said that these temporary renal disturbances in surgery are mostly reversible in accordance with clinical symptoms. And it seems to differ from the so-called "lower nephron nephrosis".
10) I wish to emphasize that the renal disturbances began to appear even before or during operation instead of postoperative period.
(author's abstract)
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