Renal Functions in the Course of the Nephrotic Syndrome in Children 12

Selectivity of Protein Excretion in Patients with the Nephrotic Syndrome*

“…It has been observed in children (28) and young adults (29) that the glomerular filtration rate is frequently reduced and the BUN elevated in the initial stages of the nephrotic syndrome, particularly in edematous states. These values returned to normal when diuresis occurred (30) after steroid therapy.…”

Functional adaptation of nephrons in dogs with acute progressing to chronic experimental glomerulonephritis.

“…from the APGN kidney, 1.6%, than from the intact kidney, 4.0%, (P <0.01). Maximum tubular secretion of p-aminohippuric acid/GFR (TmPAH/GFR) measured in three dogs was higher in the APGN kidney than intact kidney, 13.1 vs. 9.3 mg/dl.…”

Nephrotic syndrome complicated by tubular dysfunction. Case report and review of possible mechanisms

“…Abnormalities of proximal tubular function in the nephrotic syndrome are not generally seen until end-stage renal failure has been reached (Bruck et al, 1954), but there are well documented cases of proximal tubular abnormalities and nephrotic syndrome in the absence of end-stage uraemia in children (Shwayder et al, 1976;Stanbury and Macaulay, 1957;Burke et al, 1971) and adults (Sherman and Becker, 1971;Weinreb et al, 1970. The pathophysiological mechanisms underlying tubular damage in this context remain unknown, but many have been proposed, including the damaging effect of heavy proteinuria (Pabico et al, 1976;Weinreb et al, 1970), hypokalaemic nephropathy (Stanbury and Macauley, 1957), glycogen deposition in distal tubule cells (Kovnat and Lin, 1974), specific autoimmune tubular and glomerular disease (Shwayder et al, 1976;Naruse et al, 1976) and the general tissue damage associated with end-stage glomerulonephritis and uraemia (Sherman and Becker, 1971). A variety of histological patterns has been described in this mixed syndrome, the most common of which is MCGN with immune complex deposition (Dreher, Zimmerman and Simpson, 1977;Vitacco et al, 1970).…”

“…Abnormalities of proximal renal tubular function in the nephrotic syndrome are rare but well documented (Bruck, Rapoport and Rubin, 1954; Kovnat and Lin, 1974;Pabico et al, 1976), particularly in children. The mechanisms underlying this combination remain obscure; a number have been proposed (Vitacco et al, 1970) including the recent speculation that a common mechanism linked by immune-mediated processes could be at work in some cases (Shwayder et al, 1976).…”