Correlation of proteinuria with histopathology in asymptomatic glomerulonephritis

The glomerular lesions of 90 patients with asymptomatic glomerulonephritis and proteinuria of more than 1.0 gm per day were compared with 8.3 similar patients with less than 1.0 gm proteinuria. 68% of those patients with more than Igm proteinuria had glomerular sclerosis compared to 19% of those with less than Igm proteinuria (p less than 0.001). Immunofluorescence studies revealed that 77% of patients studied had IgA deposits in the mesangial region. There was no correlation between the degree of microscopic haematuria and the severity of glomerular lesions. Patients with more than 1 gm proteinuria also had significantly higher incidence of granular casts (p less than 0.001) and the presence of casts was also significantly associated with the finding of glomerular sclerosis (p 0.005). The data suggest that 1 gm proteinuria is a useful predictive index of glomerular sclerosis in patients with asymptomatic urinary abnormalities.