Objective: To explain the differences in the clinical course of membranoproliferative glomerulonephritis (MPGN) in children and to find some prognostic markers at the disease onset that correlate with the disease outcome.
Study Design: We reviewed clinical histories and laboratory findings, reexamined kidney biopsies performed at the disease onset and evaluated volume relations between kidney components in children with the diagnosis of MPGN.
Results: Children were divided into three groups based on their final clinical status: I. children without features of active nephropathy, II. children with persistent nephropathy, and III. children who died of kidney disease and those who had chronic renal insufficiency. Reevaluation of kidney biopsies led to a change in the histopathologic diagnosis in several cases in all three groups. Morphometric analysis showed increasing interstitial tissue volume from group I through group III in MPGN and other forms of glomerulonephritis diagnosed after reevaluation. All the morphologic, clinical and laboratory features estimated by means of multivariate analysis of variance showed statistically significant individual characteristics of each group defined by clinical outcome.
Conclusion: Increased interstitial tissue volume in the kidney biopsy at the disease onset is a negative prognostic factor in MPGN.
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