Clinical and histopathologic findings in adults with the nephrotic syndrome

  • W. Medawar
  • A. Green
  • E. Campbell
  • M. Carmody
  • J. Donohoe
  • G. Doyle
  • J. J. Walshe
Article

Summary

The clinical and histopathologic findings in 225 Irish adults with nephrotic syndrome were reviewed. Membranous nephropathy was the most common lesion found (28%), followed by proliferative glomerulonephritis (17%), and focal sclerosing glomerulonephritis (16%). Minimal change disease was the least frequent cause for idiopathic nephrotic syndrome (12%). The major secondary cause of nephrotic syndrome was amyloidosis (13%). The patients were analysed for the predictive value of the level of renal function, presence or absence of hypertension, and the degree of proteinuria. It was not possible to determine the nature of the underlying lesion giving rise to the nephrotic syndrome using any of these variables. There was also no significant difference between primary and secondary glomerular disease with regard to these factors. It is concluded that renal biopsy remains the only definitive method of establishing the underlying lesion causing idiopathic nephrotic syndrome.

References

  1. 1.
    Bamess, L. A., Moll, G. M. and Janeway, C. A. Nephrotic syndrome I. The natural history of the disease. Paediatrics 1950: 5, 486.Google Scholar
  2. 2.
    Rubin, H. M., Blau, E. B. and Michaels, R. H. Haemophilus and pneumococcal peritonitis in children with nephrotic syndrome. Paediatrics 1975: 56, 598.Google Scholar
  3. 3.
    Elidrissy, A. T. H. Primary peritonitis and meningitis in nephrotic syndrome in Riyadh. Int. J. Paediatric Nephrology 1982: 3, 9.Google Scholar
  4. 4.
    Krensky, A. M., Ingelfinger, J. R., Grupe, W. E. Peritonitis in childhood nephrotic syndrome. Am. J. Dis. Child. 1982: 136, 732–736.PubMedGoogle Scholar
  5. 5.
    Heslan, J. M., Lautie, J. P., Intrator, L., Blanc, C., Largue, G., Sobel, A. T. Impaired IgG synthesis in patients with the nephrotic syndrome. Clin. Nephrol. 1982: 18, 144–147.PubMedGoogle Scholar
  6. 6.
    Fodor, P., Saitua, M. T., Rodriguea, E., Gonzalez, B., Schlesinger, L. T cell dysfunction in minimal change nephrotic syndrome of childhood. Am. J. Dis. Child. 1982: 136, 713–717.PubMedGoogle Scholar
  7. 7.
    Mallick, N. P., Short, C. D. The nephrotic syndrome and ischaemic heart disease. Nephron. 1981: 27, 54–57.PubMedGoogle Scholar
  8. 8.
    Wass, V. and Cameron, J. S. Cardiovascular disease and the nephrotic syndrome: the other side of the coin. Nephron. 1981: 27, 58–61.PubMedGoogle Scholar
  9. 9.
    Cameron, J. S. Coagulation and the thromboembolic complications in the nephrotic syndrome. Adv. Nephrology 1984: 13, 75–114.Google Scholar
  10. 10.
    Sullivan, M. J., Hough, D. R., Agodoa, L. Peripheral arterial thrombosis due to the nephrotic syndrome: the clinical spectrum. South Medical Journal 1983: 76, 1011–1016.Google Scholar
  11. 11.
    Llach, F. Hypercoagulability, renal vein thrombosis, and other thrombotic complications of nephrotic syndrome. Kidney Int. 1985: 28, 429–439.PubMedCrossRefGoogle Scholar
  12. 12.
    Glassock, R. J. The nephrotic syndrome. Hosp. Pract. 1979: 14, 105.PubMedGoogle Scholar
  13. 13.
    Brenner, B. M. and Stein, J. H., Eds. The nephrotic syndrome. Contemporary issues in nephrology. Vol 9. Churchill-Livingstone. New York, 1982.Google Scholar
  14. 14.
    Cameron, J. S. Glomerulonephritis: In Postgraduate nephrology. Marsh, F. P. Ed. p. 274. London, Heinemann Ltd. 1987.Google Scholar
  15. 15.
    Faulkner, W. R., King, J. W. Renal Function: p. 337, in Fundamentals of Clinical Chemistry. 2nd Ed. Tietz, N. W., Ed. Philadelphia. W. B. Saunders, 1976.Google Scholar
  16. 16.
    Ibid. p. 996–9.Google Scholar
  17. 17.
    Habib, R. Focal glomerulosclerosis. Kidney Int. 1973: 4, 355–361.PubMedCrossRefGoogle Scholar
  18. 18.
    Cameron, J. S. The Problem of Focal Segmental Glomerulosclerosis. In: Kincaid Smith, P., D’Apice, A. J. F., Atkins, R. A. L., Eds. Progress in glomerulonephritis. New York. John Wiley. 1979: 209–229.Google Scholar
  19. 19.
    Vosnides, G., Sotsiou, F., Papadakis, G., Haddad, M., Edipidis, K., Moutounis, D., Billis, A. Frequency of various forms of primary glomerulonephritis in Greek adults. abstract IX Congress of Int. Society of Nephrology. Los Angeles. June 1984. p. 139A.Google Scholar
  20. 20.
    Collaborative study of the adult idiopatic nephrotic syndrome. A combined study of short term prednisone treatment in adults with membranous nephropathy. N. Eng. J. Med. 1979: 301, 1301–1306.Google Scholar
  21. 21.
    Seggic, J., Davies, P. J., Ninim, D., Henry, J. Patterns of glomerulonephritis in Zimbabwe: survey of disease characterised by nephrotic proteinuria. Q. J. Med. Winter 1984: 209, 109–118.Google Scholar
  22. 22.
    Kibukamusoke, J. W., Hutt, M. S. R., Wilkes, N. E. The nephrotic syndrome in Uganda and its association with Quartan malaria. Q. J. Med. 1967: 36, 393–407.PubMedGoogle Scholar
  23. 23.
    Gills, H. M., Hendrickse, R. G., Nephrosis in Nigerian children. Role of plasmodium malariae and effects of anti-malarial treatment. B.M.J. 1963: 2, 27–31.CrossRefGoogle Scholar
  24. 24.
    Chen, B. T. M., Boon-Sing, O., Kheng-Khoo, T.,Oon-Teik, K. The nephrotic syndrome in Singapore. J. Chron. Dis. 1973: 26, 237–242.PubMedCrossRefGoogle Scholar
  25. 25.
    Ipachki, E., Kashmian, B., Khanmohamadi, M., Peikal, E., Light microscopy in idiopathic proteinuria and nephrotic syndrome in Iran. Abstracts VII Int. Congress Nephrology. Montreal. June 1984. p. 273A.Google Scholar
  26. 26.
    Hunt, L. P., Short, C. D., Mallick, N. P. Prognostic indicators in patients presenting with the nephrotic syndrome. Kidney Int. 1988: 34, 382–388.PubMedCrossRefGoogle Scholar
  27. 27.
    Cameron, J. S. The nephrotic syndrome and its complications. Am. J. Kidney Dis. 1987: 10, 157–171.PubMedGoogle Scholar
  28. 28.
    Deckert, T., Paulsen, J. E. Prognosis for juvenile diabetes with late diabetic manifestations. Acta Med. Scan. 1968: 183–356.Google Scholar
  29. 29.
    Hall, C. L. Gold and D-penicfflamine induced disease. In: Bacon, P. A., Hadler, N. M., eds. The kidney and rheumatic disease. London: Butterworths Scientific 1982. p. 246–266.Google Scholar
  30. 30.
    Textor, S. C., Gephardi, G. N., Bravo et al. Membranous glomerulopathy associated with Captopril therapy. Am. J. Med. 1983: 74, 705–712.PubMedCrossRefGoogle Scholar
  31. 31.
    Lomvardias, S., Pinn, V. W., Wadhwa, M. I., Kosby, K. M., Heller, M. Nephrotic syndrome associated with sulindac. N. Eng. J. Med. 1981: 304, 424.Google Scholar
  32. 32.
    Glassock, R. J. Pathogenesis of the nephrotic syndrome in humans in The Nephrotic Syndrome. Cameron, J. S., Glassock, R. C., eds. Marcel Dekker. New York and Basel. 1988: 163–192.Google Scholar
  33. 33.
    David, B. B. Extrarenal complications of the nephrotic syndrome. Kidney Int. 1988: 33, 1184–1202.CrossRefGoogle Scholar

Copyright information

© Springer 1990

Authors and Affiliations

  • W. Medawar
    • 1
  • A. Green
    • 1
  • E. Campbell
    • 1
  • M. Carmody
    • 1
  • J. Donohoe
    • 1
  • G. Doyle
    • 1
  • J. J. Walshe
    • 1
  1. 1.Departments of Nephrology and PathologyBeaumont HospitalDublin 9Ireland

Personalised recommendations