DAS KLINISCHE SPEKTRUM NEPHRITISCHER 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-Schonlein 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-Schonlein nephritis and in autoimmune disease, with end-stage renal failure developing in more than 20% of each of these groups. Conclusion: The nephritic syndrome often manifests oligosymptomatically. An intensive nephrological work-up is indicated in order to early diagnose serious - and potentially treatable - glomerular diseases.