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[Clinical spectrum of nephrotic syndrome]
A Bökenkamp1, P F Hoyer, J H Ehrich
1Abteilung Pädiatrische Nieren- und Stoffwechselerkrankungen, Kinderklinik der Medizinischen Hochschule, Hannover, Bundesrepublik Deutschland.
Aim Of Study:
A wide spectrum of glomerular diseases manifests as a nephritic syndrome with haematuria, proteinuria, hypertension, edema, and impaired renal function. Little is known about the presentation of each symptom and the distribution of the underlying glomerular diseases.
Methods:
In order to delineate the clinical spectrum of glomerular disease presenting as a nephritic syndrome, we examined the records of 192 patients who had been followed in our paediatric nephrological outpatient clinic between 1973 and 1988 for a nephritic syndrome.
Results:
Oligosymptomatic courses with microhaematuria and proteinuria predominated. The mean age at presentation was 8.1 years. In a broad spectrum of 29 diagnoses, postinfectious glomerulonephritis and Henoch-Schönlein nephritis were the most prevalent. End-stage renal failure developed in 16% of the patients. Prognosis was poor in cases of rapidly progressive glomerulonephritis, focal segmental glomerulosclerosis, Henoch-Schönlein nephritis and in autoimmune disease, with end-stage renal failure developing in more than 20% of each of these groups.
Conclusions:
The nephritic syndrome often manifests oligosymptomatically. An intensive nephrological workup is indicated in order to early diagnose serious--and potentially treatable--glomerular diseases.