Survival in idiopathic glomerulonephritis.

Actuarial survival was studied in 285 adult patients with idiopathic glomerulonephritis (GN). Minimum follow-up was 7 years. 105 patients had minimal change GN (MC), 22 membranous GN (MGN), 20 acute GN (AGN), 11 mesangial sclerosis Gn (MSGN), 28 mesangiocapillary GN (MCGN), 8 crescentic GN (RPGN), 27 unclassifiable GN, 61 focal proliferative GN (FGN), and 3 focal segmental glomerular sclerosis and hyalinosis (FSGSH). Ten year survival was best in FGN (91%), and progressively poorer in MC (90%), AGN (85%), MSGN (83%), MGN (82%), MCGN (62%), unclassifiable GN (37%), and RPGN (16%). One of the three patients with FSGSH died during follow-up. At 10 years, survival differed significantly (p less than 0.01) from expected only in MCGN, RPGN and unclassifiable GN. Our results suggest that -- because survival was not significantly different from expected in most types of GN -- the current classification of GN is only a crude guide to prognosis. The nephrotic syndrome was found to worsen prognosis in MGN and MCGN.