Well before the modern era of diagnosis and management of nephrotic syndrome (characterized by proteinuria, hypoalbuminemia, edema, and hypercholesterolemia), pediatricians recognized a different, more benign form of the disorder than did internists. This age difference has been borne out by the remarkable international collaborative studies in children's renal centers. With the advent of more precise renal biopsy diagnosis by thin section and electron microscopy, pathological diagnosis now includes minimal glomerular changes, focal glomerulosclerosis, mesangial proliferation, and mesangial proliferation with focal segmental glomerulosclerosis. Eighty percent of patients with primary nephrotic syndrome or minimal change nephrotic syndrome experience symptoms before 6 years of age, but membranoproliferative glomerulonephritis rarely appears before this age.
Variants of alpha 1-proteinase inhibitor in black and white South African patients with focal glomerulosclerosis and minimal change nephrotic syndrome.
