Changes in Blood Volume in Patients with Edema of Renal Origin.

The purpose of the present study was to apply the carbon monoxide method to the investigation of the circulating blood volume in cases of renal edema, and to follow by this means the changes in the blood volume of patients during the disappearance or reappearance of their edema. The problem appeared to us one of particular interest in view of the fact that the investigations that have been published so far have, with few exceptions, been carried out by means of the dye method; moreover the results that have been obtained by that method have shown remarkable differences in the hands of different observers, two groups of workers getting with it results not only opposed, but diametrically opposed, to one another. In looking through the literature it appears that three cases reported by Plesch are the only ones in which the blood volume deter-minations were made by methods other than the dye method. In 1909 (2) with his infusion method he found in a case of renal edema of the most extreme degree a blood volume that was only half the normal. In 1922 (1) with the carbon monoxide method the same author found in two cases of renal edema a small volume which increased as the edema became less. In 1924 (3) Linder and Lundsgaard found in cases of renal edema normal plasma volume using the dye method. In 1926 (4) Darrow reported four cases of nephritic edema-three children and one adult in which the blood volume had been determined by the dye method. In all four cases the blood volume was diminished, whether calculated as volumes per unit of actual weight or as volumes per unit of edema-free weight. In two of tlie cases-589