CLINICAL COURSE AND OUTCOME OF IDIOPATHIC MEMBRANOUS NEPHROPATHY IN JAPANESE CHILDREN

We retrospectively studied 12 Japanese children (8 boys, 4 girls) with idiopathic membranous nephropathy (IMN), aged 2.9-15.8 (mean 7.7) yea rs at onset. All patients were identified through either screening or a routine urinalysis; proteinuria was present in all, haematuria, whic h was macroscopic in 4, in 11. Three had nephrotic syndrome (NS) at or soon after onset. Stages on electron microscopy, performed in 10 pati ents, were 1 in 3, II in 5 and III in 2. Steroids alone or with cyclop hosphamide were administered to 5 patients, including the 3 patients s howing NS. Complete remission of proteinuria occurred in 8 patients 0. 3-1.6 (mean 0.6) years after onset, and proteinuria did not recur. Aft er a follow-up of 1.6-11.6 (mean 5.9) years, these 8 patients were in complete remission and the remaining 4 had only mild proteinuria; none had hypertension or impaired renal function. Thus, we infer that IMN in Japanese children may have a better course and outcome than IMN in non-Japanese children. Based on a comparative study of Japanese (previ ously reported cases added to ours) and non-Japanese (mostly Caucasian ) children with IMN, this was confirmed; it is possible that steroid t herapy in Japanese patients is more effective in inducing remission of NS and preserving renal function.