Abstract
THE IMPACT of liver disease upon the function of the kidney was first described in 1863 by Austin Flint 1 who noted the presence of oliguria in patients with cirrhosis. This finding was confirmed in 1901 by Gilbert and Lereboullet. 1 In recent years a considerable body of literature has accrued dealing with the physiologic and clinical significance of renal involvement in liver disease. Many of these studies have been reviewed by Popper and Schaffner, 2 Eisner and Levitt, 3 and by Papper. 4 Some authors have implicated the kidney in the development of hepatic ascites and edema by pointing out disturbances in glomerular filtration rate, proximal tubular reabsorption, and renal blood flow. 5 Little emphasis, however, has been placed on morphologic alterations. Indeed, structural changes of the kidney in cirrhosis, when described, were concerned mainly with the more obvious tubular findings. Glomerular changes were first noted by Baxter and Ashworth 6 who described periglomerular
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