Simultaneous hemoglobin and creatinine renal clearance studies have been presented which indicate that hemoglobin is eliminated by the kidney at a rate which is 3 per cent of the creatinine clearance, above a plasma hemoglobin concentration of approximately 250 mg. per 100 cc. In dogs whose average glomerular filtration rate is 66 cc. per minute, about 2 cc. of plasma are cleared of hemoglobin per minute.
A definite renal threshold exists for hemoglobin at a plasma concentration of about 100 mg. per 100 cc., below which hemoglobinuria does not occur.
The uniformity of the process indicates that hemoglobinuria is not the result of a transient glomerular injury induced by the hemoglobin.
It is tentatively suggested that the experimental results obtained may be interpreted in terms of the following concept. The glomerulus permits the filtration of hemoglobin in amounts directly dependent upon plasma concentration. However, only 3 per cent of all the pores of the membrane are electrostatically large enough to permit the passage of an undissociated hemoglobin molecule. Of that hemoglobin which passes down the tubule, a relatively constant though small amount is recovered by the tubules by a process not unlike that of phagocytosis found elsewhere in the body. An average value for this "athrocytic" capacity in a medium-sized dog is 2 mg. of hemoglobin per minute. This pattern of renal hemoglobin excretion is in agreement with the principles of the modern theory of kidney function.