DURING a nine month period, 21 patients with azotemia and clinical uremia having serum creatinine concentrations of over 3 mg. and serum urea concentrations of over 80 mg. per hundred cubic centimeters were treated in the Clinic for Renal Disease of the Stanford University School of Medicine. Their illnesses varied in severity from azotemia without symptoms to frank clinical uremia. Most of these patients were in the terminal stage of glomerular nephritis. One patient had polycystic kidneys, and 1 had chronic uremia of obscure origin.
It has been our experience, which is in conformity with past experience gained in the Clinic, that such patients can be managed satisfactorily on an ambulatory basis until the final stages of renal failure. In addition, the irregular and unpredictable course of severe chronic renal insufficiency has impressed on us the fact that there is always some hope that the patient may continue to lead