Studies on the Relation of the Kidney to Cardiovascular Disease. II *

Ligation of both ureters in the dog results, as has been reported briefly in an earlier communication," in extensive systemic lesions similar in every respect to those that follow the ligation of both main renal arteries. Ureteral ligation thus provides an opportunity not available in the latter circumstances for studying the effects of the necrotizing substance on the kidneys themselves. In the present paper the renal lesions will be described, the mechanisms involved in their production will be discussed, and the experimental findings will be considered briefly in relation to the interpretation of changes in the human hydronephrotic kidney. The effects of the ligation of one ureter will then be compared with those after ligation of one main renal artery, and both of these procedures will be shown to cause anatomical changes of varying degree in different animals of a single species. The lesions involve the contralateral normal kidney to a greater or less extent. This fact will be utilized in a discussion of the effects of a single ischemic kidney in man and the influence which its surgical removal may exert. Finally, the effects of incomplete compression of both ureters and the variation in the reaction of different animals subjected to this procedure will be reported. Here, as in the case of unilateral arterial or ureteral occlusion, it will be shown that no definite correlation exists between the degree of functional renal impairment, as manifested by the pressure or the non-protein nitrogen of the blood, and the anatomical changes disclosed at post mortem. The latter, it will be indicated, are important for the interpretation of lesions encountered in man, especially when the animal survives after narrowing of the ureters for several weeks.