The Effect of Corticotropin (ACTH) on Glomerular Permeability to Albumin in Children with the Nephrotic Syndrome 12

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Abstract
Simultaneous renal clearances of the blue dye T-1824 (CT i824) and of albumin (CAlb) have been shown by others to be nearly the same in patients with the nephrotic syndrome. Furthermore, the ratio of the clearances of albumin and inulin (CAlb/CIn) provides a rough indication of the minimum glomerular permeability to albumin, relative to permeability to water. In 10 edematous children with the nephrotic syndrome, 50-100 mg. of ACTH per day intramusc.for4i.l0days resulted in a marked decrease in CT-1824/Cln by the end of, or a few days after treatment. In all but 2 cases, the decrease was more than 10-fold. Cxn increased at least slightly in most, and more than doubled in 4. In one non-edematous boy who excreted only 1-2 g. of protein per day, CT-1824/cIn decreased from [degree]-07 to [degree]-006 ml./100 ml The data are interpreted as indicating that one of the favorable effects of ACTH treatment is a reversal toward normal of the increased glomerular permeability to albumin. The same restorative process is presumably responsible for some of the observed increase in Cin(glomerular filtration rate). These effects of therapy on the glomeruli are considered to be primary to most of the other beneficial results.