Reactions Following Transfusion of Blood, With Urinary Suppression and Uremia

Bordley, John E.

doi:10.1001/archinte.1931.00140200131008

Cited by 60 publications

(5 citation statements)

References 13 publications

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“…The possibility that methemoglobin might be filtered more readily through the giomeruli than hemoglobin and thus be found in greater concentration in the tubular lumen was considered, but comparison of renal clearances of hemoglobin and methemoglobin does not show any consistent differences (22). Histological evidence of necrosis of renal tubule cells was found in these studies as in many of the earlier reports of renal injury due to hemoglobin (4,5). The maximum degree of necrosis was found 1½ to 2 days after the infusion and unquestionably served as an additional factor which in combination with the increase in resistance of urinary flow due to the viscosity of the tubular contents could account for the persistent impairment of renal function seen in these animals.…”

Section: Discussionsupporting

confidence: 84%

“…Similar disturbances of kidney function are observed following the crush injury of skeletal muscle with liberation of myoglobin from the injured muscle and excretion of metmyoglobin in the urine (3). Three general hypotheses have been suggested to explain this type of renal injury: obstruction of the renal tubules by the precipitation of derivatives of hemoglobin or myoglobin in their lnmlna (1), injury of renal tubule cells by toxic concentrations of these heine pigments (4)(5)(6), and diminished renal bloodflow due to vasoconstriction of renal blood vessels (7,8). Various modifications and elaborations of all of these hypotheses have been proposed and the possibility that all three mechanisms may be involved in varying degrees has been appreciated.…”

Section: (From the Department Of Pathology Yale Uninersily School Ofmentioning

confidence: 95%

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The Pathogenesis of the Renal Injury Produced in the Dog by Hemoglobin or Methemoglobin

Harrison

Bunting

Ordway

et al. 1947

Journal of Experimental Medicine

158

111

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Severe and persistent impairment of kidney function has been produced in dogs by intravascular hemolysis due to arsine, or by the intravenous injection of solutions of dog hemoglobin and methemoglobin. The kidneys of these animals have been examined by the usual histological methods and also by means of the ferrocyanide histochemical method to determine the pathogenesis of the renal injury. These observations indicate that obstruction to flow of urine through the renal tubules is an important factor in the early reduction of kidney function. The material filling the lumina of the renal tubules was found to be chiefly methemoglobin in concentrated solution of gel-like consistency. No evidence of formation of a pigment insoluble at the pH of the urine such as hemochromogen or hematin was found. The cessation of urine flow is most readily explained by the increased viscosity of the tubule contents. The intravenous administration of methemoglobin was found to produce more severe renal injury than the injection of equal amounts of oxyhemoglobin. Necrosis of the proximal convoluted tubule cells was present as a late lesion in animals injected with methemoglobin, large amounts of hemoglobin, or following extensive intravascular hemolysis. Such injury is probably a contributing factor in the persistent severe depression of renal function seen in these animals. Following disappearance of most of the intratubular pigment, a large number of collapsed tubules lined by hemosiderin-filled cells were found. The ferrocyanide histochemical studies indicated that these represented non-functioning nephrons although no obstructing intratubular material was present. Direct measurements in two animals failed to reveal any reduction of renal blood flow following the injection of methemoglobin in amounts sufficient to produce renal injury.

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Section: Discussionsupporting

confidence: 84%

Section: (From the Department Of Pathology Yale Uninersily School Ofmentioning

confidence: 95%

The Pathogenesis of the Renal Injury Produced in the Dog by Hemoglobin or Methemoglobin

Harrison

Bunting

Ordway

et al. 1947

Journal of Experimental Medicine

158

111

View full text Add to dashboard Cite

show abstract

“…The injection of either an autogenous hemolyzed blood preparation or a commercially prepared hemoglobin solution promptly resulted in the following physiological changes: (1) an increase in the systolic and diastolic blood pressures, (2) a decrease in the pulse rate, (3) a decrease in the clearances of inulin and PAH, (4) an increase in the filtration fraction, (5) a decrease in the urine flow, and (6) an increase in the per cent of glomerular filtrate reabsorbed by the renal tubules. The renal extraction of PAH at low plasma levels was essentially unchanged following the administration of hemoglobin.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Hemoglobin on Renal Function in the Human

Miller¹,

McDonald²

1951

J. Clin. Invest.

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“…of incompatible Rh-positive blood was given. Bordley (1931) stated that cases receiving larger volumes of incompatible blood tend to be more serious-a conclusion with which Muirhead et al (1948) are in general agreement. On the other hand, one of us (J. W.) has recently seen a Group 0 patient who had only a transient haemoglobinuria following a transfusion of 4 pints (2.27 litres) of Group A blood and did not develop renal failure.…”

Section: The Severity Of Renal Failurementioning

confidence: 92%