Abstract
Applying biopsy in clinical studies, the latters were carried out (1) to investigate natural history of glomerulonephritis, (2) to predict the effect of ACTH and Steroids on nephrotic syndrome and to examine the changes in kidney function and biopsy findings before, during and after the course of the therapy, and (3) to clarify diabetic nephropathy based on the study of the triad of proteinuria, hype-rtension and diabetic retinopathy. The following conclusions were reached:(1) Glomerulonephritis. (a) Normalization of kidney function occurred, and kidney function tests often showed raised values in the transitionary period from the acute to the chronic stage. Biopsy revealed a histologic picture of mild changes in many cases, but a picture consisting of a mixture of variable changes ranging from a mild damage to destruction of the tissue was revealed in a few cases. (b) Severity and duration of glomerulitis, and exacerbation and duration of an extrarenal focus are thought to be the factors concerned in the prognosis of glomerulonephritis. (c) Some cases of glomerulonephritis in which preceding infection was unknown showed a histologic picture of chronic nephritis, though early diagnosis of glomerulonephritis was made clinically.(2) Nephrotic Syndrome. (a) Biopsy findings seemed to serve as a more reliable guide to the result of ACTH and steroid therapy than renal clearance values. (b) When ACTH and steroid therapy had been effective, renal clearance values, GFR inn particular, rose. However, biopsy with light microscope revealed no structural changes in the glomeruli that were attributable to the hormones. (3) Diabetic Nephropathy. (a) One or more of the triad were found in the majority of cases of diabetic patients, Frequ-ency of Patients with proteinuria was 28.6 Per cent. (b) Diabetic patients with hypertension or those with hypertension and retinopathy had aa high incidence of proteinuria. However, renal clearance values and biopsy findings of the former differed from those of the latter. (c) Nodular Intercapillary Glomerulosclerosis were found in patients with the triad, while: arteriolo-nephrhsclerosis was the predominant change in patients with proteinuria and hypertension.
