RENAL FUNCTION AND BIOPSY CHANGES DURING THE COURSE OF HENOCH‐SCHÖNLEIN GLOMERULONEPHRITIS

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Abstract
Renal function studies were performed in 18 subjects in different stages of Henoch-Schoenlein glomerulonephritis (HS GN). Nine children were serially investigated, and 9 adolescents or young adults, who were considered to have clinically recovered, were investigated only once, 10.5-14 yr after the onset. Inulin and PAH [p-aminophippuric acid] clearance, as well as Na excretion, were determined during hydropenia (HP) and 3% volume expansion (VE) with isotonic saline. In most patients in the former group a renal biopsy was performed during the 1st investigation and again 1 yr later. The early disturbances in renal function resembled those found in other types of GN. The GFR [glomerular filtration rate] was normal during HP or after VE in most cases 1 yr after the onset. The natriuretic response to VE was decreased in most patients initially, and this persisted in half of the patients 2-3 yr after the onset. Pathological urinalyses then indicated disturbances in the renal handling of Na. A reduced capacity to excrete Na did not seem to be of prognostic significance since all patients, except 1 who developed renal insufficiency and hypertension, had normal urinalyses and blood pressure 6 yr after the onset. Evidence that subjects with previous HS GN will later develop impaired renal function or be predisposed to hypertension was not provided.