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Arch Intern Med (Chic). 1927;40(1):73-79. doi:10.1001/archinte.1927.00130070076007.
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With the recent advances in the study of blood chemistry and metabolism, there has been gathered more and more evidence in support of the view that the nephritis often called chronic parenchymatous nephritis results from some general metabolic disorder. Epstein1 is one of the foremost exponents of this theory. He calls this type of nephritis nephrosis, regarding it as fundamenally different from all the other types. It is characterized by insidious onset, apparently unassociated with any known infection, by anasarca and effusion into the serous membranes, by marked albuminuria, with or without casts, by changes in the blood chemistry, namely, reduction of plasma protein, inversion of albuminglobulin ratio and increase of blood lipoids (cholesterol), and, finally, by a decrease of basal metabolism. In contrast to other kinds of nephritis, there is, at least in the early stages, no hypertension, cardiac enlargement, hematuria or marked retention of nonprotein nitrogen in the blood.


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