J.Jpn. Surg. Soc.. 57(7): 1200-1213, 1956

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EXPERIMENTAL STUDY ON RENAL FUNCTIONS DURING SHOCK AND THE EFFECTS OF AUTONOMIC NERVOUS BLOCKADE ON THE RENAL CLEARANOE

The author has studied renal functions during shock due to electric injuries (by passing electric current, 8.000-10.000 Joules through both hind limbs of rabbit), and their modifica tions by the autonomic nervous blockade and adrenal cortical extracts as shown in the renal clearance test.
The results are as follows :
1) Reduction of the renal clearance is slight after doses of electricity below those sufficient to produce shock, while shock-producing doses cause a marked reduction in the renal clearance along with time and this effect appears earlier and to a greater extent than that on the circulating blood volume and blood pressure fall. In other words, the renal circulatory disturbance during shock appears earlier and is severer than the peripheral circulatory disturbance. The renal plasma flow and the glomerular filtration rate, however, are reduced proportionately, so that the filtration fraction remains within the normal limits.
2) Stripping of the adventitia of the renal vessels markedly increase renal blood flow. But when shock-producing doses of electricity are applied to this preparation, the renal blood flow is reduced as much as or more than that after section of the splanchnic nerves or administration of Hexamethonium bromide, and the circulating blood volume is also reduced. However, the difference is that while the onset of shock is always prevented in the latter two cases, the shock-preventing effect is uncertain in the former. It is considered, therefore, that although nervous factor may not be denied in the mechanism of renal circulatory disturbance in shock, humoral factor is more important. It is also felt that mechanism of blood pressure maintenance and circulatory adjustment of renal origin should not be overestimated.
3) When electricity is applied after adrenalectomy followed by adrenal cortical extract administration or adrenalectomy followed by adrenal transplantation, or wnen shock is followed by adrenal cortical extract administration, reduction, of the renal clearahce is great and protection from the lethal effects is not demonstrated. It is felt that the mechanism of death in these cases is different from that due to shock.
(author's abstract)

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