Pulmonary Changes in Uremia

In recent years attention has been drawn to certain roentgenographic and pathological changes observed in the lungs associated with uremia. Although these changes seem to follow a certain pattern, there is no general agreement on their pathogenesis. The descriptions of these pulmonary alterations have not been numerous; on the contrary, there are few reports in the literature correlating the clinical, roentgenographic and pathological pulmonary changes in uremia. In 1932 Ehrich and McIntosh1reported the pathological changes in the lungs of 3 patients dying from Bright's disease. They found fresh areas of pneumonia associated with older, more extensive areas of bronchiolitis obliterans. They recognized that these changes differed from those of the bronchiolitis seen after infectious pneumonias or exposure to chemical irritants. They believed that some toxic or metabolic factor resulted in edema and congestion with formation of an exudate which failed to resorb and then went on to organization.