REVERSIBLE ACUTE-RENAL-FAILURE IN IDIOPATHIC NEPHROTIC SYNDROME

Acute renal insufficiency developed in four idiopathic nephrotic patie nts with minimal change or mild proliferative glomerulonephritis. The reduction in glomerular filtration rate (C(Inulin) was not in proporti on to the renal plasma flow (C(PAH) as evidenced by a low filtration f raction. Diuretic therapy failed to reverse renal insufficiency, and r enal biopsy showed no evidence of interstitial nephritis, acute tubula r necrosis or interstitial edema. Corticosteroid therapy induced a rec overy of renal function with a decrease in proteinuria. These observat ions suggest that acute renal insufficiency in the idiopathic nephroti c syndrome might be caused by impaired glomerular permeability.