[Clinical spectrum of nephrotic syndrome].

AIM OF STUDY

A wide spectrum of glomerular diseases manifests as a nephritic syndrome with haematuria, proteinuria, hypertension, edema, and impaired renal function. Little is known about the presentation of each symptom and the distribution of the underlying glomerular diseases.

METHODS

In order to delineate the clinical spectrum of glomerular disease presenting as a nephritic syndrome, we examined the records of 192 patients who had been followed in our paediatric nephrological outpatient clinic between 1973 and 1988 for a nephritic syndrome.

RESULTS

Oligosymptomatic courses with microhaematuria and proteinuria predominated. The mean age at presentation was 8.1 years. In a broad spectrum of 29 diagnoses, postinfectious glomerulonephritis and Henoch-Schönlein nephritis were the most prevalent. End-stage renal failure developed in 16% of the patients. Prognosis was poor in cases of rapidly progressive glomerulonephritis, focal segmental glomerulosclerosis, Henoch-Schönlein nephritis and in autoimmune disease, with end-stage renal failure developing in more than 20% of each of these groups.

CONCLUSIONS

The nephritic syndrome often manifests oligosymptomatically. An intensive nephrological workup is indicated in order to early diagnose serious--and potentially treatable--glomerular diseases.