Glomerular deposits and hypoalbuminemia in acute post-streptococcal glomerulonephritis

In a search for correlations between glomerular morphology and clinical manifestations in acute post-streptococcal glomerulonephritis, data for 40 biopsied patients were reviewed. A major correlation was observed between severe hypoalbuminemia and the absence of deposits on the paramesangial portion of the glomerular basement membrane. Subepithelial deposits were present on both the capillary loop and paramesangial segments of the basement membrane in 29 patients, whereas in 11 the deposits were present only on the capillary loop. Patients with paramesangial segments devoid of deposits had a mean (+/-1 SD) nadir serum albumin level of 1.90 (+/-0.40) g/dl, whereas the mean nadir level in those with deposits in both locations was 2.83 (+/-0.64) g/dl (P<0.001). Also significant was the difference in paramesangial deposit scores in patients with nadir serum albumin levels < or =2.5 g/dl versus those with levels >2.5 g/dl. The amount of subepithelial deposit on the capillary loop was not significantly different in the two groups, and no correlation was found between loop deposits and serum albumin levels. Except for greater edema and significantly less-frequent gross hematuria in those with absent paramesangial deposits, clinical and laboratory findings for the two groups did not differ.