Glomerulonephritis in Africans in Uganda

and Universitv of Bristol Nephritis is a common disease in the African (Gelfand, 1957) and is a common cause of death from hyper- tensive heart failure.Becker (1946), from Johannes- burg, found that out of a total of 3,000 necropsies hypertensive heart failure was present in 247 cases and that 85 of these were due to glomerulonephritis, the great majority being in the chronic phase of the disease.Uys (1954), again from necropsy studies, found glomerulonephritis to be the commonest cause of secondary hypertension.In Uganda, Davies (1949) found " some form of nephritis " to be present in 301 out of 2,994 necropsies, and, in these, congestive heart failure was the commonest single mode of death.Raper (1953), however, reporting on " nephritis and allied lesions in Central Africans," found only 23 cases of nephritis among 92 necropsies in which advanced renal disease had been present.No comprehensive clinical studies of gloinerulonephritis have been made on the African native in his home environment, the only recorded study being an analysis by Furman (1955) from Johannesburg of the case-records of European and Bantu patients suffering from nephritis.The present study was therefore made in order to learn more of the clinical features, the biochemical and histological findings, and, if possible, the course of glomerulonephritis in the Bantu.Material and Method.-BetweenJanuary, 1956, and February, 1957, all patients admitted to the wards of a medical unit, Mulago Hospital, in whom clinical evidence of renal disease was present, or who were otherwise hypertensive, were studied.An exception was made in the case of patients in whom transient albuminuria wal present during the course of another illness-for example, pneumococcal pneumonia.,Patients who were found on investigation to be suffering -from renal disease other than glomerulonephritisfor example, pyelonephritis, amyloidosis, or essential hypertension-have been excluded from the present series and are reported elsewhere (Leather, 1959; and ,awaiting publication).The details of the method used in this study are also -recorded elsewhere (Leather, awaiting publication).Findings.-Glomerulonephritis was found in 33 of the 67 patients in the entire study.It was the com- monest cause of renal disease in each of the first four decades, and was present in 12 of the 13 children studied.It was not always possible to tell which stage in the natural history of the disease process a particular patient had reached.Classification, which was there- fore difficult, has been made from a combination of clinical and histological findings and is as follows: I. Glomerulonephritis in childhood II.Glomerulonephritis in adults .. " Acute " nephritis Rapidly progressive "acute " nephritis Subacute nephritis Latent nephritis " Intermediate" nephritis Chronic nephritis 12 cases 21 3 cases 3 ,, 1 case 1 ,, 3 cases 10 .-I.