The dubiety of the hitherto existing conception of untroubled life-expectancy in cases of solitary kidneys is discussed relating to the statistics of Rockstroh on 500 follow-up examinations after nephrectomy. The result induces more intensive and more detailed examinations before nephrectomy concerning capacity, anatomical conditions of urinary outflow, urinary infection of the remaining kidney. Besides the necessity of removal of a kidney strictly has to be proved in regard to the possibilities of conservative operation of plastic corrections. Detailed discussion of the extent of compensatory regulations of remaining kidneys after nephrectomy and of solitary kidneys after partial resection and of the anatomical and functional adaption, which does not always turn out positively, and of the limits of compensatory possibilities. The opinion of a group of investigators who tried to prove that the immense and rapid adaption of a remaining kidney might be due to the fact that a portion of physiological resting nephrons can be mobilized immediately under increased inquirements – the number of nephrons remaining constant – is of greatest interest. Finally the author analyses different indications and modifications of surgical procedures in solitary kidneys on account of some X-rays, tables out of his own material, particularly with critical evaluation of the failures and death cases.

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