UNILATERAL INHIBITION OF THE RENAL SHWARTZMAN PHENOMENON FOLLOWING INJECTION OF BACTERIAL FILTRATE INTO THE RENAL...

A positive Shwartzman reaction, as indicated by thrombosis and focal hemorrhage in one or more organs, was elicited in 19 of 34 rabbits in which the preparatory injection of bacterial filtrate was made into the left renal artery and the reacting injection was made in the ear vein 24 hours later. In 24 of the 34 rabbits the kidneys were undisturbed throughout the duration of the experiment except for the intra-arterial injection of the left. In 12 of these 24 a positive Shwartzman reaction was observed in the uninjected right kidneys. In only 1 of the 24 injected left kidneys were there changes that might be construed as representing a positive Shwartzman reaction. The changes in this kidney consisted of glomerular thrombosis, not associated with hemorrhage or necrosis. The positive renal Shwartzman reactions seen in the right kidneys were similar to those reported by Apitz and Gerber as representing the renal changes occurring as part of a generalized Shwartzman reaction. The retention of the bacterial filtrate of the preparatory injection in the left kidney, by obstructing both vein and artery for 15 minutes, did not lessen the refractory state. The removal of the right kidney prior to the experiment, with the subsequent demonstration that circulation through the remaining left kidney was not impaired by the intra-arterial injection of filtrate, indicated that the refractory state of the injected kidney was not the result of failure of the reacting dose of filtrate to reach the kidney. In the unilaterally nephrectomized rabbits the development of a positive reaction in other organs indicated that the lack of reaction in the kidney represented a local refractory state. No explanation of the phenomenon was disclosed by these experiments.