Abstract
191 children with idiopathic nephrotic syndrome (absence of systemic disease or other known etiology) were studied from onset. Age and sex distribution were as expected. Renal biopsy revealed glomerulonephritis (GN) in of these were steroid non-responsive (continued proteinuria after 8 weeks prednisone). Of patients with “minimal lesions” (ML), 5% were steroid non-responsive; the other 95% were frequent relapsers, infrequent relapsers, and nonrelapsers. In ML no difference in response or course was found with sex or age of onset. The overall poorer prognosis in ♀ and in older children was due to underlying GN. Only 38% with ML, but 52% with GN were ♀. >½ patients >8 years old had GN. Hematuria did not predict the clinical course in ML. Marked hematuria was present in 19% with ML but 64% with GN. Thus the poor prognosis associated with hematuria is due to the likelihood of underlying GN. Despite striking exceptions, urinary selectivity index correlated in a general way with pathology and steroid response. Immunization preceded onset only in patients with ML, suggesting that it may be an etiologic factor. No correlations with histology or course were found with history of allergy in patient or family, infection preceding onset, urinary tract infection at onset, or family history of renal disease. Although histology between groups based on father's occupation was similar, there were significantly more nonrelapsing patients in the professional group.
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Edelmann, C. Clinical-pathological correlations in the nephrotic syndrome. A report of the international study of kidney disease in children. Pediatr Res 5, 383 (1971). https://doi.org/10.1203/00006450-197108000-00051
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DOI: https://doi.org/10.1203/00006450-197108000-00051