The renal elimination of vancomycin has been determined in 18 patients. In 4 anuric patients in intermittent haemodialysis the dosage of vancomycin necessary to treat infections with penicillin‐resistant strains of Staphylococcus aureus was determined. In 14 patients with varying degrees of renal insufficiency vancomycin, creatinine and 125iothalamate clearances were measured and found to be closely correlated. After administration of the initial vancomycin dose and attainment of the serum concentration desired, the maintenance dose can be calculated on the basis of the GFR.

Simultaneous inulin, '"iothalamate, creatinine. In dogs rapid hypertrophy and hyperplasia have PAH and 1311-hippuran clearances have been performed in 18 prospective living kidney donors. Good correlation was found between inulin and l4othalamate and between PAH and B'I-hiDDuran clearances as well as between been shown to take place in the remaining kidney after unilateral nephrectomy (3) and GFR and ERPF increase to about 80% of the preoperative _ _ the above mentioned clearances and renal size. In 13 value in the course of a month. Also in man the instances '"iothalamate, creatinine and 1311-hippuran GFR and ERPF began to increase within 7 days clearances were carried out before and 26-53 months after after unilateral nephrectomy (8, 15, 24). unilateral nephrectomy. An increase was found in l=iothalamate, creatinine and 'glI-hippuran clearances of 66, Of the 67 and 3 1 % , respectively. These increases were indepen-traditional inulin and PAH clearance technique. dent of the age (range 19-65 years) and sex of the donor. Prior to nephrectomy simultaneous creatinine, Kidney function was studied by Clearance Values were however well correlated to the size inulin, 125iothalamate, pAH and 131I-hippuran clearances were carried out. Postoperatively crea-of the remaining kidney. Pattern of kidney function changes, the filtration fraction being significantly greater tinine, 125iothalamate and 131I-hippuran clear-DostoDerativelv. -~ ances were performed simultaneously. (Inulin, Laevosan). Priming and sustaining doses were given to achieve a plasma concentration of inulin between 15 and 25 mg/100 ml. Inulin was measured by Heyrovsky's method ( 14). METHODS InulinPAH (Sodium Aminohippurate, MSD) was used to determine ERPF. The plasma concentration of PAH was between 1.5 and 2.0 mg/100 ml during the study period. PAH was measured by Bratton and Marshall's method (1). . , clearances.'=iothalamate and "V-hippuran (Amersham Radio-7 -74298 1 Acta med. scand. 195

Abstract. Clearance studies in patients with markedly reduced renal function can be performed with satisfactory accuracy without catheterization of the bladder. A reliable infusion technique, careful instruction and supervision during the study, together with clearance periods of adequate length, are necessary. Endogenous creatinine clearance does not provide a reliable expression for glomerular filtration in patients with renal insufficiency and in patients with the nephrotic syndrome, because renal function is consistently overestimated. This overestimation is approximately 25 to 50% in patients with an inulin clearance less than 25 ml/min. 125iothalamate clearance in the same series of patients provided an exact measure of glomerular filtration rate, as the mean ratio cIo/cIn was 0.97.

Abstract. Two siblings with Wilson's disease are presented. They displayed no neurological symptoms and only minor hepatic dysfunction. In both patients signs of decreased tubular reabsorption of phosphate and urate were found. Measurements of clearances of the different single amino acids revealed initially high values for some of them, and later a definite and uniform decrease after treatment with penicillamine.