Clinical Course and Renal Function in Minimal Change Nephrotic Syndrome

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Abstract
Thirteen unselected children with the minimal change nephrotic syndrome were followed for 11 mo. -7.5 yr, during which time 32 renal function tets were performed. Glomerular filtration rate (GFR) was determined as clearance of insulin using a standard clearance technique. The children had between 0 and 34 relapses and 3 developed steroid resistance. Three patients had severe but reversible complications related to the corticosteroid therapy. Chlorambucil was given to 4 patients, of whom 3 with steroid resistance had lasting remissions, whereas 1 patient with frequent relapses had only transient improvement. The GFR was decreased at the 1st episode in 6 patients, whose clinical course did not differ from that of the others. None had a decreased GFR later in the course of the disease. Reduced GFR at the onset of the minimal change nephrotic syndrome is reversible and does not imply an unfavorable outcome.