Influence of obstructed renal lymph flow on effects of a nephrotoxin on renal function

To study the influence of disrupted renal lymph drainage on the effects of a nephrotoxin, uranyl acetate (0.028 to 0.05 mg/kg body weight) was injected into dogs the same day that the renal lymphatics were ligated and transected bilaterally. Larger doses produced effects which masked the influence of lymphatic ligation; a control group receiving uranyl acetate underwent a sham ligation of renal lymphatics. In renal function studies at 1, 3, 8 and 12 weeks after surgery and uranyl acetate, the urea, creatinine, PAH and electrolyte clearances of the "ligated" dogs were lower than those of the "non-ligated" shams. Daily clearances of urea and creatinine of the ligated were also lower than those of the shams. Urinary volume and protein excretion were also greater in the ligated subjects although elevated in both groups. The significance of the differences in the daily electrolyte clearances was less convincing. Renal lymphatic ligation with uranyl acetate injection produced greater changes than either lymphatic ligation or uranyl acetate alone. That the changes were not permanent or did not lead to chronic renal disease was probably due to regeneration of lymphatics, development of alternate routes of lymph flow and/or the small dose of uranyl acetate used to demonstrate the influence of lymphatic dysfunction on response to the nephrotoxin.