GLOMERULAR DEPOSITS AND HYPOALBUMINEMIA IN ACUTE POSTSTREPTOCOCCAL GLOMERULONEPHRITIS

In a search for correlations between glomerular morphology and clinica l manifestations in acute post-streptococcal glomerulonephritis, data for 40 biopsied patients were reviewed. A major correlation was observ ed between severe hypoalbuminemia and the absence of deposits on the p aramesangial portion of the glomerular basement membrane, Subepithelia l deposits were present on both the capillary loop and paramesangial s egments of the basement membrane in 29 patients, whereas in 11 the dep osits were present only on the capillary loop. Patients with paramesan gial segments devoid of deposits had a mean (+/-1 SD) nadir serum albu min level of 1.90 (+/-0.40) g/dl, whereas the mean nadir level in thos e with deposits in both locations was 2.83 (+/-0.64) g/dl (P<0.001). A lso significant was the difference in paramesangial deposit scores in patients with nadir serum albumin levels less than or equal to 2.5 g/d l versus those with levels >2.5 g/dl. The amount of subepithelial depo sit on the capillary loop was not significantly different in the two g roups, and no correlation was found between loop deposits and serum al bumin levels. Except for greater edema and significantly less-frequent gross hematuria in those with absent paramesangial deposits, clinical and laboratory findings far the two groups did not differ.