[Clinico-morphological characteristics and prognosis of glomerulonephritis in chronic alcoholism]

The paper is concerned with the results of a long-term study with clinicomorphological correlations of 86 patients with alcoholic glomerulonephritis (GN), i. e. 12% of all morphologically verified cases of primary GN. GN clinical features in alcoholism were painless microhematuria, moderate hyperuricemia, frequent combination with the alcoholic involvement of the other organs and the elevated blood serum IgA level. An important diagnostic sign in alcoholic GN was a positive clinicolaboratory time course in abstinence. A morphological study showed prevalence of mesangioproliferative GN with deposits containing IgA and C3, often with a noticeable tubulointerstitial component and fibroplastic glomerular transformation. The accumulation of podocytes and nephrocytes of intermediate filaments in the cytoplasm should be regarded as an important morphological feature of alcoholic GN. An unfavorable course of alcoholic GN with an outcome into chronic renal failure was observed in 35% of the patients. Prognostically unfavorable signs were the age under 40, the presence of considerable proteinuria (over 1 g/day), the nephrotic syndrome, the detection of the glomerular immune complexes, a tubulointerstitial component, fibroplastic transformation of mesangioproliferative nephritis as well as the detection of mesangiocapillary, diffuse fibroplastic and extracapillary nephritis.