[Clinical and ultrastructural studies of the kidneys of children in families with endemic nephropathy].

Examinations of clinically healthy children, coming from families with endemic nephropathy (EN) were carried out with a view to establishing initial manifestations of endemic nephropathy. No clinico-laboratory and functional disorders were found. Pathological type erythrocyturia was provoked by prednisolon test, supplying grounds to admit the presence of latently developing renal disease. Renal biopsy was taken for disease confirmation. One-type pathological changes with manifested focal character were found in all children examined through the electron microscopic investigation of renal tissue. The capillary loops of glomeruli are segmentally injured. Tubular changes are mainly found in the proximal canaliculi curves. Cellular cytoplasma reveals the picture of vacuolar dystrophia. Changes in mitochondria were also found and most frequently osmiophilic formations with dimensions 0.1 to 0.5 mu were observed. Basal membrane of the tubules injured is unevenly thickened, often stratified. The ultrastructural kidney disorders of the children examined are identical, in character and localization, to those in case of clinically manifested forms of EN. According to degree and spread, they are not sufficiently manifested, to conditioned the clinical-laboratory and functional signs of the disease. The data found reveal that EN develops at a rather early age than thought so far and progresses latently in its initial stage.