TREATMENT OF NEPHROTIC EDEMA

When the progress of medical therapy during the past twenty-five years is discussed, usually reference is made first to diabetes, second to pernicious anemia and third to various states of deficiency. Sometimes advances made in the chemotherapy and immunotherapy of infectious diseases are considered, but rarely is mention made of the great progress achieved in the treatment of patients who have nephrotic edema of moderate or extreme degree. Not long ago it was necessary for such patients to be hospitalized for many months before elimination of excessive fluids was accomplished, if it was accomplished at all. Thanks to the observations of clinicians all over the world and to better understanding of basic physiologic principles, such protracted invalidism is of comparatively rare occurrence at the present time.

In 1925, at the Mayo Clinic, dietary measures were supplemented by the administration of ammonium chloride and merbaphen (novasurol¹). Later, ammonium nitrate in