SIGNIFICANCE OF ALBUMINURIA IN THE FOLLOW-UP OF ACUTE POSTSTREPTOCOCCAL GLOMERULONEPHRITIS

The present study was aimed at assessing the diagnostic value of urina ry albumin (uA) excretion rate in the long-term follow-up of patients suffering from acute post-streptococcal glomerulonephritis (APSGN). 26 patients, who had presented primarily with nephritic syndrome and sho wing increased uA without a concomitant rise in total proteinuria (uTP ) were followed-up for 131 months on average (range 36-288). At the la st check, 14 patients did not show urinary abnormalities, 9 had a pers istent increase in uA, 1 increased uTP and 2 renal insufficiency. Urin ary and clinical signs of the disease were not seen during observation periods prolonged for 79 months on average (range 20-156) after norma lization of uA. No pathological findings were remarked in biopsy speci mens obtained in 3 patients when uA was normalized; in contrast, when both uTP and uA (12 cases) or when isolated uA (14 cases) were increas ed a pattern of diffuse mesangial proliferative glomerulonephritis was constantly observed. These results indicate that the abnormal uA excr etion rate during long-term follow-up of APSGN allows to identify a su bset of patients with persistent renal disease; conversely, the occurr ence of normal uA seems to point to a good diagnostic and prognostic s ignificance.