COMPARISON OF ASYMPTOMATIC AND SYMPTOMATIC CHILDHOOD GLOMERULONEPHRITIS PROGRESSING TO RENAL-FAILURE - A REPORT OF KYUSHU-PEDIATRIC-NEPHROLOGY-STUDY-GROUP

We evaluated the clinicopathological features and the outcome of 33 ch ildren with primary glomerulonephritis (GN) as the cause of renal fail ure; 17 had asymptomatic (ASP) haematuria and/or proteinuria and the r emaining 16 had symptoms suggestive of GN. The renal histology in the ASP group indicated IgA GN in 6 children, focal segmental glomerular s clerosis (FSGS) in 4, diffuse proliferative GN (DPGN) in 3, membranous GN (MGN) in 1, membranoproliferative GN (MPGN) in 1 and diffuse scler osing GN in 2. In the symptomatic (SYP) group, FSGS was evident in 9 c hildren, DPGN in 3, MGN in 2, IgA GN in 1 and MPGN in 1. There was no difference in the histological severity between the two groups. Fourte en children in the SYP group had nephrotic syndrome (NS) and/or hypert ension at their initial visits. Only 4 children in the ASP group showe d NS or hypertension during the period of follow-up. Eleven children i n the ASP group and all in the SYP group were treated with immunosuppr essive and/or antihypertensive drugs, but these did not improve the pr ognosis of the ASP children compared with those in the SYP group. Ther e was no significant difference in the mean duration between the onset of the disease and the start of dialysis in these two groups. In conc lusion, it is questionable whether the urinary mass screening programm e in Japan will alter the outcome of children with GN.