Characterization of acute renal failure due to primary nephrotic syndrome

Acute renal failure (ARF) associated with primary nephrotic syndrome (PNS) was analyzed clinically in order to evaluate the mechanism of onset. The incidence of induced ARF with PNS was found to be cases (2.1%) out of 420 cases attending our outpatient clinic. The renal histological changes included 2 cases of minimal change nephrotic syndrome (MCNS), 6 of focal glomerular sclerosis (FGS) and one of unknown origin. The 6 cases which recovered from ARF were designated as group A. The 3 cases of group B required maintenance dialysis; they included one case of MCNS, one of FGS and one of unknown origin, and showed resistance to aggressive treatments, such as steroid pulse therapy, anticoagulants and plasmapheresis. In the patients of group A, follow up studies for 10 years confirmed that their condition was not progressive. There were no significant differences between the reversed group A cases recovering from ARF and the non-reversed group B cases in terms of their clinical parameters, such as age, sex, urinary protein excretion, initial renal function, blood pressure, renal histological damage and complications. Specific factors associated with the induction of reversibility from ARF could not be identified. Further research is needed to elucidate the precise characteristics of the ARF occurring in PNS.