Renal Functions in the Course of the Nephrotic Syndrome in Children 12

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Abstract
In 45 children with the nephrotic syndrome renal clearances were detd. repeatedly over periods up to 7 yrs. Of these patients 24 had evidence of glomerulonephritis, 21 did not (the criteria were azotemia, considerable or persistent hematuria, persistent hypertension or autopsy findings). In patients who had, or subsequently developed, glomerulonephritis, the filtration fraction (F. F.) was low; the glomerular filtration rate (G. F. R.) was frequently, though not consistently, reduced; a rapid fall of the G. F. R. is a bad prognostic sign. In patients without glomerulonephritis the G. F. R. and F. F. were normal or above normal. In all patients with the nephrotic syndrome TmPAH was normal or high, except during the terminal stage of nephritis. The ratio G. F. R./TmPAH (max. tubular excretory capacity for para-aminohippuric acid) was low in most cases. Fluctuation of functional values was frequently observed, particularly during complications. Problems of technique and of interpretation of clearances values in diseased kidneys are discussed.