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Clinicopathological features of Zimbabwean patients with sustained proteinuria
M Z Borok1, K J Nathoo, R Gabriel
1Department of Medicine, University of Zimbabwe Medical School, Harare, Zimbabwe.
Objective:
To describe clinico-pathological features of patients admitted with significant proteinuria.
Design:
Hospital based prospective survey conducted from 1982 to 1987.
Setting:
Paediatric and medical wards at both tertiary referral hospitals in Harare.
Subjects:
119 patients who presented with significant proteinuria were investigated.
Results:
Of the primary nephritides, diffuse mesangial proliferative glomerulonephritis was the most common finding (25/119); IgM was the dominant or sole immunoglobulin identified in 17/25. Minor glomerular abnormalities were common (19/119); there were 11 patients with minimal change disease and this number accounted for 42% of the children aged three to 12 years who were nephrotic. This incidence is higher than previously reported from Africa. Diffuse membranous nephropathy was frequent (18/119); hepatitis B surface antigen was present in only five of these patients. Focal sclerosing glomerulo-sclerosis was as frequent as diffuse membranous nephropathy (18/119) and appeared to be idiopathic. Diffuse mesangiocapillary glomerulonephritis (membranoproliferative) was present in 15/119 patients; no causal association was made.
Conclusion:
The pattern of primary glomerulonephritis is described from 1982 to 1987. We describe a slightly higher number of patients with minimal change disease and minor glomerular abnormalities than previously reported and a surprisingly small number of patients with diffuse endocapillary glomerulonephritis. In common with other African series, no patient with IgA nephropathy was found.