The prognostic value of glomerular immaturity in the nephrotic syndrome in children.

The study group consisted of 16 children (9 boys and 7 girls) aged 6-52 months (mean age 27 months) with a first episode of nephrotic syndrome. Histological diagnosis (diffuse mesangial proliferation with signs of glomerular immaturity) was established by renal biopsy. The control group consisted of 47 children (26 boys and 21 girls) aged 7-58 months (mean 29 months) hospitalized with a first episode of nephrotic syndrome with diffuse mesangial proliferation, documented exclusively by histological examination. The aim of the study was to analyze the clinical course of a first episode of nephrotic syndrome in children with diffuse mesangial proliferation with and without signs of glomerular immaturity. In children with a first episode of the nephrotic syndrome and glomerular immaturity steroid resistance was more frequent (P=0.0234). Furthermore, in the study group there was a less favorable clinical course of the disease in children younger than 1 year of age and with an original serum albumin concentration lower than 1.0 g/dl. Hence, the presence of relatively rare signs of glomerular immaturity influences unfavorably the course and treatment of nephrotic syndrome in children.