Differential diagnosis of nephritic and nephrotic syndroms in children

Jūratė Masalskienė

Clinic of Children’s Diseases, Kaunas University of Medicine Hospital, Lithuania

Key words: poststreptococcal glomerulonephritis, steroid sensitive nephrotic syndrome, clinical features, laboratory changes.

Summary. The aim of this study was to compare clinical and laboratory features of children with acute poststreptococcal glomerulonephritis and steroid sensitive nephrotic syndrome. We have examined 30 children with acute poststreptococcal glomerulonephritis and 17 children with steroid sensitive nephrotic syndrome, who arrived for hospitalization at Kaunas University of Medicine Hospital in 1997–2000. All patients not later than in ten days from the onset of acute glomerulonephritis and 14 days later were given a standartized clinical and laboratorical examination following a record. We determined that hematuria is universal finding of acute poststreptococcal glomerulonephritis and proteinuria was found in all patients with steroid sensitive nephrotic syndrome. Microscopic hematuria and proteinuria were persisted in children who had acute poststreptococcal glomerulonephritis. Anemia was found only in patients who were ill with acute poststreptococcal glomerulonephritis. After 14 days of treatment it was determined in 38.5% of children. Hypoproteinemia was established in 69.2% of children and hypercholesterolemia in 92.3% ofchildren with steroid sensitive nephrotic syndrome after two weeks of treatment. Decreased glomerular filtration rate was characteristic feature of acute poststreptococcal glomerulonephritis.

Correspondence to J. Masalskienė, Clinic of Children’s Diseases, Kaunas University of Medicine, Eivenių 2, 3007 Kaunas, Lithuania

Received 28 February 2003, accepted 5 May 2003