The Nephrotic Syndrome in Children. An Interpretation of Its Clinical, Biochemical, and Renal Hemodynamic Features as Variations of a Single Type of Nephron Disease 12

It is the purpose of this report to describe and interpret the varied renal hemodynamic patterns and associated clinical and biochemical features ob- served in 29 children with the nephrotic syndrome studied between January, 1949, and June, 1950. Cases of the "nephrotic syndrome" present cer- tain uniform and consistent clinical' features (1), but their separation into two groups, "nephrosis" and the "nephrotic stage of nephritis," has been rather arbitrary and frequently difficult. Normal or supernormal renal function (2) on the one hand, and hematuria, hypertension, and azotemia (3-6) on the other, have been the classical criteria for this distinction. However, review of the clinical course of patients classified as "nephrosis" with subsequent complete remission, has shown that moderate hematuria, hypertension and azotemia were common transiently observed phenomena (7-10). Moreover, serial renal function studies have demonstrated varying degrees of functional impairment in patients clinically classified as instances of either nephrosis (11, 12) or the nephrotic stage of glomerulonephritis (13-15).