Abstract
In order to study the progress of chronic glomerulonephritis, the end-results of the treatment of 95 patients with chronic glomerulonephritis among the 239 patients with renal disease hospitalized at our clinic during the past 12 years were investigated and then the patients were examined. The group in which the preceding infection was unknown had poor results of the attack of the disease than the group in which there was a definite preceding infection. Patients who had had hyper-tension and hematuria clinically had poorer results. Of all the laboratory findings, renal clearance values and biopsy findings proved useful in prognostication. Then attempt were made to determine the factors involved in the exacerbation of nephritis. Those who had not followed physician's instruction or those who had had an increased tendency to upper respiratory infection had poor results. There were those in whom exacerbation could not be accounted for. It was thought that the production of autoantibodies in patients' bodies might be a factor in the exacerbation. So direct and indirect Coombs' tests were carried out to detect autoantibodies in the samples of sera of patients with chronic nephritis. They were all negative, Then a method for antigloburin consumption test was developed to detect a minute amount of incomplete antibodies. By this method, it was proved that there was a considerably high incidence of the production of incomlete antibodies in the above sample of sera. Moreover, these antibodies were absorbed by the renal tissue. This shows that these antibodies are the autoantibodies produced with the renal tissue as antigens. It was shown that during the phase of acute exacerbation the antigen-antibody reaction in the kidney became so vigorous that autoantibodies were consumed, with the result that the autoantibodies in the blood were reduced in number or disappeared. Patients who were positive for antiglobulin consumption test had poor results. In order to see how much the kidney are damaged by the antigen-antibody reaction there, a method of DPI reaction test was developed and performed on patients. This method is based on the discoloration of pigments by the reducing process brought about by cell respiration in the organs. Using this method, it was proved that autoantibodies damaged only the kidney through their reaction with antigens. It was shown in the present experiments that the autoantibodies detected by the author are a factor in the exacerbation of chronic nephritis.
