The Nature of the Renal Circulatory Changes in Chronic Congestive Failure as Reflected by Renal Tubular Maximal Functions 12

Intermittency of glomerular activity in man has not been demonstrated Therefore, functional changes in the renal hemodynamics of human sub- jects generally have been attributed to proportional changes in the flow to all nephrons. Thus, the well-es'tablished decrease of glomerular filtration rate and renal blood flow in chronic congestive failure (2, 3) has been considered a result of in- adequate cardiac output and secondary renal vaso- constriction, occurring without reduction in the mass of functioning tubules. Since the decrease in filtration reduces the quantity of electrolyte delivered to tubules normally adapted to handle a larger load (4, 5), it has been postulated that the resulting glomerulo-tubular imbalance contributes significantly to the salt and water retention of congestive failure.