日本腎臓学会誌
Online ISSN : 1884-0728
Print ISSN : 0385-2385
ISSN-L : 0385-2385
36 巻, 10 号
選択された号の論文の17件中1~17を表示しています
  • 木村 玄次郎
    1994 年 36 巻 10 号 p. 1075-1081
    発行日: 1994年
    公開日: 2010/07/05
    ジャーナル フリー
    The renal mechanisms of hypertension were reviewed, and new way to classify hypertension based on renal mechanisms was proposed. Theoretically, the pressurenatriuresis relationship can be affected in two different ways; either a parallel shift along the blood pressure axis toward a higher blood pressure level or a depression in the slope. The parallel shift of the pressure-natriuresis relationship induces non-sodium sensitive hypertension, while the depressed slope induces sodium sensitive hypertension. Since the degree of the shift of the pressure-natriuresis relationship is determined by the preglomerular vascular resistance from heart to glomeruli, non-sodium sensitive hypertension should be based on the increased preglomerular vascular resistance. On the other hand, the slope of the pressure-natriuresis relationship is determined by glomerulo-tubular balance of sodium, which is mainly controlled by the difference between the whole kidney ultrafiltration coefficient and the rate of tubule sodium reabsorption. Therefore, sodium sensitivity of blood pressure is based on a decrease in the whole kidney ultrafiltration coefficient (due to a decrease in either filtration surface area per glomerulus, hydraulic permeability of glomerular filtration barrier or the number of glomeruli) and/or an increase in tubule sodium reabsorption. In sodium sensitive states, whether whole kidney ultrafiltration coefficient is reduced or tubule sodium reabsorption is enhanced, the glomerular capillary hydraulic pressure rises to compensate for the impairments in sodium excretory capability. If there is a linkage between sodium sensitivity of blood pressure and glomerular hypertension as proposed, renal failure may be expected to be more common in sodium sensitive types of hypertension than in non-sodium sensitive types. Thus, new classification of hypertension based on renal mechanisms may provide an important key to understand pathophysiology of hypertensive diseases as well as nature of their renal lesions.
  • 萩原 清和, 小篠 栄, 太田 和夫, 市川 富夫
    1994 年 36 巻 10 号 p. 1082-1089
    発行日: 1994年
    公開日: 2010/07/05
    ジャーナル フリー
    Four-week-old Wistar male rats were fed a vitamin E(VE)-deficient diet for 8 weeks, followed by intraperitoneal injection of DL-buthionine-[S, R]-sulfoximine (BSO), an inhibitor of γ-glutamylcysteine synthetase, at the dose of 1 mmol/kg body weight. As we reported previously, GSH depletion by administration of BSO induced acute tubular necrosis in the kidney of VE-deficient rats and was accompanied by decrease of renal TBA value and marked increase of renal lipofuscin content. In this study, we examined the effect of administration of AsA or Trolox C on these kidney injuries. AsA or Trolox C treatment increased renal GSH content and inhibited the increase of renal lipofuscin production. The increase of BUN and creatinine levels and LDH activity in the sera of rats administered BSO were inhibited by AsA or Trolox C treatment. AsA treatment completely protected the necrosis of epithelia of proximal renal tubules. These results suggest that GSH has an important role in preventing lipofuscin production through the reaction of lipid peroxides with amino acids. AsA spares GSH indicating that these compounds have similar antioxidant actions and that AsA can serve as an essential antioxidant in the presence of severe GSH deficiecy.
  • 湯村 和子, 新田 孝作, 内田 啓子, 村井 克尚, 堀田 茂, 筒井 貴朗, 二瓶 宏
    1994 年 36 巻 10 号 p. 1090-1094
    発行日: 1994年
    公開日: 2011/03/01
    ジャーナル フリー
    We conducted a study to investigate whether expression of the contractile proteins in cultured rat mesangial cells (MC) was associated with the cell cycle and protein kinase C (PKC). When growth-arrested MC were stimulated with 100 nM phorbol myristate acetate (PMA) for 24 hours, an increased expression of smooth muscle α-actin and vimentin was detected by immunocytochemistry. A proportion of the S- and G2/M-phase in MC was increased in accordance with the enhanced expression of contractile proteins on flow cytometry. Immunoblot analysis revealed that 100 nM PMA stimulated expression of α-actin and vimentin as a single band. These results indicate that expression of contractile proteins, such as α-actin and vimentin, is dependent on the cell cycle and PKC, suggesting a phenotypic change in which MC assume smooth muscle cell characteristics.
  • 柳沢 康敏
    1994 年 36 巻 10 号 p. 1095-1102
    発行日: 1994年
    公開日: 2011/03/01
    ジャーナル フリー
    Temocapril is a novel angiotensin-converting enzyme (ACE) inhibitor which is preferentially eliminated via the biliary tract. To examine whether it has a protective effect in diabetic nephropathy like conventional ACE inhibitors which are eliminated via the kidney, a study was performed in streptozotocin-induced diabetic rats for 8 months. Male Wistar rats were divided into 4 groups (control rats, diabetic rats treated with temocapril at the doses of 5 mg/l or 15 mg/l of drinking water, and untreated diabetic rats). There was no significant difference in the blood glucose levels of the 3 diabetic groups. Administration of temocapril at both doses of 5 mg/l and 15 mg/l significantly reduced the blood pressure as well as the urinary excretion of albumin and N-acetyl-β-D-glucosaminidase. However, significant suppression of glomerular basement membrane hypertrophy was only induced by treatment with temocapril at the dose of 15 mg/l. Elevated glomerular filtration rate and filtration fraction in diabetic rats were decreased by temocapril at the dose of 15 mg/l, but not significantly. These results indicate that temocapril has a protective effect on diabetic nephropathy like conventional ACE inhibitors.
  • ―ループス腎炎患者における抗DNA抗体とその親和性の検討―
    斉藤 元章, 植地 泰之, 中林 公正, 長澤 俊彦
    1994 年 36 巻 10 号 p. 1103-1112
    発行日: 1994年
    公開日: 2011/07/04
    ジャーナル フリー
    IgG-class antibodies to double-stranded (ds) and single-stranded (ss) DNA in patients with collagen disease were measured by enzyme-linked immunosorbent assay (ELISA) using bacteriophage λ DNA as the antigen. Moreover, avidity of IgG-class antibodies to both dsDNA and ssDNA in patients with systemic lupus erythematosus (SLE) was evaluated by ELISA as salt-dependent binding activities. The results are as follows:1) Elevated IgG-class antibodies to dsDNA were largely restricted to patients with active SLE. Furthermore, the levels of IgG-class antibodies to dsDNA correlated with the disease activity of SLE. 2) Lupus nephritis (LN) patients with nephrotic syndrome (NS) or diffuse proliferative LN as determined by renal biopsy had high levels of IgG-class antibodies to both dsDNA and ssDNA. 3) LN patients with NS showed the highest means of avidity index of IgG-class antibodies to both dsDNA and ssDNA. These findings suggest that the present method of measuring IgG-class antibodies to dsDNA is useful for the diagnosis and management of patients with active SLE and that IgG-class antibodies to both dsDNA and ssDNA with high avidity may be an important factor in the pathogenesis of LN with NS.
  • 内藤 隆
    1994 年 36 巻 10 号 p. 1113-1122
    発行日: 1994年
    公開日: 2011/03/01
    ジャーナル フリー
    This study was designed to investigate whether expression of platelet-derived growth factor (PDGF) and its receptor in the glomeruli is correlated with clinicopathological parameters in 42 patients with primary IgA nephropathy. Immunohistochemical studies were conducted using frozen sections from biopsy specimens. The intensity of PDGF β receptor expression in the glomeruli was correlated with the mesangial cell count, but not with clinical parameters, such as daily excretion of urinary protein and creatinine clearance. Moreover, overexpression of PDGF β receptor in the glomeruli was observed in the patients who were responsive to corticosteroid therapy. These data suggest that PDGF β receptor expression in the glomeruli of IgA nephropathy could be a useful marker for predicing the prognosis and effectiveness of corticosteroid therapy.
  • 石原 俊二, 稲場 進, 岡田 敏夫
    1994 年 36 巻 10 号 p. 1123-1129
    発行日: 1994年
    公開日: 2011/03/01
    ジャーナル フリー
    We studied the contributions of glomerular hypertrophy in renal disease. The patients were 20 cases of IgA nephropathy with prolonged proteinuria, 13 cases of Alport syndrome and 12 cases of focal glomerular sclerosis (FGS). All patients had a normal creatinie level on renal biopsy. We determined the mean glomerular tuft area in the equatorial region of five glomeruli that showed no sclerotic change in each patient using an image analyzer and compared the value with the mean value in normal controls. Glomerular hypertrophy was defined as a value over the mean glomerulartuft area +1SD of normal controls. Glomerular hypertrophy was found in 14 IgA nephropathy cases (70.0%), 4 Alport syndrome cases (30.7%) and 8 FGS cases (66.7%). The incidence of glomerular hypertrophy was significa ntly higher in IgA nephropathy than in Alport syndrome and FGS showed a higher tendency compared with Alport syndrome. Of the patients with renal insufficiency, 4 of 6 IgA nephropathy cases (66.6%), 0 of 5 Alport syndrome cases (0%) and 1 of 3 FGS cases (33.3%) showed glomerular hypertrophy, IgA nephropathy patients showed the highest incidence of glomerular hypertrophy. The interval between the final biopsy and renal insufficiency showed no significant difference in this study. In IgA nephropathy, obsolescent glomeruli were significantly increased in the group in which the glomerular tuft area was over the the mean +2SD compared with the group with an area less than the mean +2SD. FGS cases showed no relationship between the ratio of obsolescent glomeruli to whole glomeruli and glomerular hypertrophy. This study suggested that glomerular hypertrophy may cause declining renal function in IgA nephropathy, but not in Alport syndrome. Since FGS showed increased obsolescent glomeruli irrespective of the degree of glomerular hypertrophy, its pathogenesis was distinct from that in IgA nephropathy.
  • 酒井 由紀, 稲場 進, 松倉 裕喜, 岡田 敏夫
    1994 年 36 巻 10 号 p. 1130-1136
    発行日: 1994年
    公開日: 2011/03/01
    ジャーナル フリー
    IgA-Fibronectin complex (IgA-FN) has been found in the circulation of patients with IgA nephropathy (IgAN). It has been suggested that circulating IgA-FN is related to IgA deposits in the mesangial area following mesangial marrix expansion in IgAN . We investigated serum IgA-FN in patients with various renal diseases, and examined the relationship between IgA-FN and the clinico-pathological findings. Serum IgA-FN level was measured by enzyme linked immunosorbent assay (ELISA) in 35 patients with IgAN, 20 patients with Henoch-Schonlein purpura nephritis (HSPN), and other various renal diseases in children. IgA-FN in patients with IgAN was significantly higher than in healthy subjects and patients with minimal change nephrotic syndrome. However some patients with membranoproliferative glomerulonephritis and lupus nephritis had a high level of IgA-FN. The increase in IgA-FN was correlated with macroscopic hematuria and the degree of proteinuria and mesangial matrix expansion in IgAN. Thus, we concluded that the level of IgA-FN is associated with mesangial matrix expansion.
  • ―体位性蛋白尿と腎炎寛解例との比較―
    大嶋 忠幸
    1994 年 36 巻 10 号 p. 1137-1144
    発行日: 1994年
    公開日: 2011/03/01
    ジャーナル フリー
    The urinary protein components of 14 children with orthostatic albuminuria (group OA) and also that of 9 children with remission of IgA nephropathy or Henoch-Schönlein purpura nephritis (group GN) after forced lordosis were analyzed. The results were as follows; (1) Urinary total protein excretions after forced lordosis were greater than 30mg/dl in 50% of 26 children with remission of glomerulonephritis, therefore a high percentage of children with remission of glomerulonephritis were complicated with orthostatic albuminuria. (2) Urinary total protein excretions after forced lordosis were 150±9lmg/dl in the group of OA and 149±88mg/dl in GN (p<0.05). (3) In the urinary protein components, the percentage of urinary albumin and α1-antichymotrypsin excretions were significantly higher in the OA group than the GN group (p<0.01, p<0.001 respectively), while the percentage of urinary transf errin, IgA and IgG excretions were significantly higher in the GN group than the OA group (p<0.01, p<0.001 and p<0.05 respectively). (4) The ratio of urinary IgG/IgA and serum IgG/IgA was significantly lower in the GN group than the OA group (p<0.05), suggesting that serum IgA tended to be excreted in urine in the GN group.
  • 佐藤 隆
    1994 年 36 巻 10 号 p. 1145-1158
    発行日: 1994年
    公開日: 2010/07/05
    ジャーナル フリー
    We studied the relationship between the histomorphometric parameters of bone structure in biopsied illiac crest bone specimens and the serum biochemical parameters in 62 chronic renal failure (CRF) patients at the time of starting hemodialysis. These patients were classified into 4 groups according to Coburn's definition: 4 patients with osteomalacia, 1 with osteitis fibrosa, and 57 with mild type. Serum corrected Ca levels were significantly lower in cases with osteomalacia than those of mild type, which suggested that hypocalcemia was related to Calcification disturbance in end-stage renal failure. The bone histomorphometry revealed that in CRF patients, osteoid and bone resorption parameters were significantly higher and calcification parameters were significantly lower than those of normal controls. Osteoclast and osteoblast surfaces were significantly correlated with osteoid and bone formation parameters. In diabetic nephropathy patients, serum C-PTH levels were significantly lower than those of patients with non-diabetic nephropaties. Bone mass, osteoid and bone formation parameters were also significantly lower in diabetic nephropathy patients, which showed that low turnover bone mass decrement has already appeared at the time of starting hemodialysis. There was a significant negative correlation between serum corrected Ca levels and osteoid parameters. A significant relationship was also found between serum alkaline phosphatase levels and both osteoid and bone formation parameters. Serum C-PTH levels were significantly related to osteoid, bone resorption and bone formation parameters, demonstrating the presence of high turnover bone in secondary hyperparathyroidism. This study clarifies that morphological changes of bone structure are present at the time of starting hemodialysis in CRF patients.
  • 田辺 享史
    1994 年 36 巻 10 号 p. 1159-1168
    発行日: 1994年
    公開日: 2010/07/05
    ジャーナル フリー
    Recombinant human erythropoietin(r-HuEPO) is recognized to be effective in the treatment of anemia in patients on chronic dialysis. However, studies on the influence of r-HuEPO on the immune system are currently limited and inconsistent. In order to clarify the alteration of T and B lymphocyte subpopulations in patients on CAPD following administration of r-HuEPO, the changes in the expression of HLA-DR, IL2R and CD4/CD8 ratio in the peripheral blood of CAPD patients were evaluated using flow cytometry. In addition, the production of immunoglobulins in peripheral lymphocytes by enzyme immunoassays in 30 CAPD outpatients with anemia, who were treated with r-HuEPO in Tokai University Hospital, was also studied. The dose of r-HuEPO was 6, 000 IU in 13 patients in group I and 9, 000 IU in 17 patients in group II. The r-HuEPO was given subcutaneously once a week for up to 9 weeks. The level of hematocrit increasee significantly following treatment with r-HuEPO. The numbers of lymphocytes and their CD4/CD8 ratios in peripheral blood showed no significant changes after administration of r-HuEPO. The count of HLA-DR-positive T lymphocytes increased significantly and the count of IL2R-positive T lymphocytes decreased and normalized after administration of r-HuEPO. In comparison with healthy controls, basal formation of IgG, IgA and IgM was decreased significantly in PBMC from patients on CAPD. Following treatment with r-HuEPO, the production of IgG, IgA and 1gM in PBMC from CAPD patients did not show any significant changes. In conclusion, this study suggested that the administration of r-HuEPO altered T lymphocyte function and also corrected anemia in CAPD patients.
  • 藤沢 佳代子, 丸山 泰幸, 中村 一路, 長瀬 光昌
    1994 年 36 巻 10 号 p. 1169-1174
    発行日: 1994年
    公開日: 2011/03/01
    ジャーナル フリー
    A schizophrenic woman, aged 45, was admitted complaining of high fever, oliguria, blackish urine, muscle swelling and pain. She had been treated for the past 3 years with haloperidol (8 mg), levomepromazine (150 mg), chlorpromazine (75 mg), lithium carbonate (600 mg), bromocriptine mesilate (7.5 mg), etizolam (1 mg), and flunitrazepam (2 mg), Physical examination revealed her to be an obese and uncommunicatable woman with swelling and weakness of the extremities and abdominal distension without borborygmus. Urine was dark brown and (+) for protein and occult blood. Blood chemistry analysis revealed BUN 71 mg/dl, creatinine 6.8 mg/dl, CPK 143, 850 IU and myoglobin 3, 980 ng/ml. PRA on the 11th hospital day was 96 ng/ml/hour. This patient fulfilled the Levenson's diagnostic criteria for manifestations of neuroleptic malignant syndrome (NMS). High PRA did not decrease after cessation of the diuretics. After treatment with dantrolene sodium and 10 treatments with hemodialysis, azotemia disappeared with the start of diuresis. The PRA also decreased to the normal level. Characteristic acceleration of the central sympathetic stimuli in NMS seemed to have induced hyperreninemia, which together with rhabdomyolysis, might have contributed to the development of acute renal failure.
  • 若林 良則
    1994 年 36 巻 10 号 p. 1175-1183
    発行日: 1994年
    公開日: 2010/07/05
    ジャーナル フリー
    Solute permeability of the peritoneum accelerates considerably in continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis. Residual dextrose (RD) (g/bag) and the amount of total protein loss (LP) (g/bag) in the effluent of dialysate were measured during the clinical course of 21 cases of CAPD-related peritonitis as markers of deranged peritoneal permeability. The following were the results obtained: 1) In 15 cases of intraluminal infection (simple peritonitis by microorganism contamination through the lumen of a peritoneal catheter), RD decreased on day 1 (p< 0.001) and day 3 (p< 0.001) after the onset of peritonitis, and LP increased on day 1 (p< 0.001) and day 3 (p< 0.01), compared to the values of the non-infected phase. Both parameters were restored on day 7 and day 14 by adequate therapeutic maneuver. 2) In 6 cases of periluminal infection (peritonitis caused by an organic lesion of infection along the peritoneal catheter), RD and LP persisted even on day 7 (p<0.01), and recovered 10 days after surgical removal of the peritoneal catheter with simultaneous catheter replacement. It is concluded that both RD and LP are valuable markers in the evaluation of the clinical course of CAPD-related peritonitis, and are useful in deciding on therapeutic intervention.
  • 大田 聡, 横山 仁, 松田 一郎, 瀬沢 英幸, 久田 幸正, 和田 隆志, 高枝 正芳, 荻 真, 内藤 毅郎, 高沢 和也, 友杉 直 ...
    1994 年 36 巻 10 号 p. 1184-1190
    発行日: 1994年
    公開日: 2010/07/05
    ジャーナル フリー
    We reported a case of a 22-year old female with a microscopic form of polyarteritis nodosa (PN) who initially manifested Behcet's disease-like symptoms, such as fever, arthralgia, oral aphtha and erythema nodosum, and rapidly progressive glomerulonephritis (RPGN). On admission, her urinalysis showed active nephritic syndrome and her renal function rapidly deteriorated; serum creatinine levels elevated from 1.2 to 3.9 mg/dl within 2 weeks. Skin biopsy specimens from erythema showed panniculitis. Accordingly, she was treated with daily 30 mg of oral prednisolone and three-day intravenous pulse therapy of 1000 mg of methylprednisolone twice. After treatment, skin eruption and oral aphtha disappeared, and the serum creatinine level improved to 1.2 mg/dl. Percutaneous renal biopsy performed on the 28th day showed focal necrotizing glomerulonephritis and hyalinosis of small arteries. Immunofluorescence studies showed only trace stainings for IgG, IgA and $lc. Electron microscopic findings revealed fusion of the foot process and swelling of endothelial cells, but no dense deposits. Anti-neutrophil cytoplasmic antibody (ANCA) was positive for IgG class with a 40 fold titer by indirect immunofluorescence test and showed a cytoplasmic pattern combined with high urinary IL-8 level (280.1 pg/ml). We diagnosed this case as a microscopic form of PN. ANCA titer and urinary IL-8 correlated positively with the disease activity, and were finally below 8-fold and 58.6 pg/ml, respectively after resolution of RPGN for 42 months. In this case, ANCA was useful not only for differential diagnosis of the patients with systemic vasculitis and crescentic glomerulonephritis, but also for evaluation of the disease activity.
  • 小西 憲子, 武下 清隆, 安井 浩
    1994 年 36 巻 10 号 p. 1191-1195
    発行日: 1994年
    公開日: 2010/07/05
    ジャーナル フリー
    APRT deficiency is an enzyme disorder which is inherited as an autosomal recessive trait. The use of adenine in purine metabolism is disturbed and it accumulates in the body, where it is oxidised by xanthine oxidaee to poorly insoluble 2, 8-dihydroxyadenine (DHA). The dihydroxyadenine forms stones which cause recurrent urolithiasis, frequent episodes of urinary tract infection or interstitial nephritis, and finally renal insufficiency in some cases.We report a case of APRT deficiency discovered by urine examination. The patient was a 33-year-old man who had never had any episodes of urolithiasis. He was admitted to our hospital because of pseudoarthrosis of his left arm caused by a traffic accident. His urinalysis revealed no proteinuria nor hematuria, but disclosed numerous round brown crystals in the sediment. These crystals had the characteristics of 2, 8-DHA. The enzyme activity of APRT in his blood was completely deficient. He was diagnosed as an APRT* QO homozygote. In addition, diagnostic imaging revealed that his right kidney was poorly hypoplastic and the pelvis of his left kdney was extra-renal. The renal function was slightly disturbed. In Japan 6 cases of 2, 8-DHA urolithiasis associated with hypoplastic kidney had been reported by 1989. Theoretically, the incidence of hypoplastic kidney is around 20% of all 2, 8-DHA urolithiasis cases. We suspect a genetic correlation between hypoplastic kidney and APRT deficiency. This patient was treated with Allopurinol, which inhibits the process of xanthine oxidation, after which crystals were no longer detected in his urine.
  • 森田 宗孝, 岡田 司郎, 吉田 寛, 坂井 誠, 岩谷 逸平, 松岡 彰, 老籾 宗忠, 三村 恵子
    1994 年 36 巻 10 号 p. 1196-1202
    発行日: 1994年
    公開日: 2011/07/04
    ジャーナル フリー
    A 48-year-old female who had general fatigue was admitted to our hospital. She had swelling of the axillary, inguinal, and paraaortic lymph nodes and mediastinal lesions. Laboratory examinations showed anemia, polyclonal hyperimmunoglobulinemia with IgG 5570 mg/dl, renal dysfunction and interstitial changes of the lungs. Microscopic findings of hematoxylin-eosin staining in biopsy specimens of the left inguinal and axillar lymph nodes revealed increased levels of infiltration of mature plasma cells without evidence of malignancy. Immunoperoxidase staining showed intracytoplasmic polyclonal immunoglobulin. These findings were identical to those of idiopathic plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia (IPL) described by Mori et ally. (1980). The specimens also showed evidence of chronic nephritis with infiltration of lymph cells and a slight invasion of plasma cells. Accordingly this case was diagnosed as IPL with renal involvement, which is associated with chronic nephritis. Recently, five cases of IPL with renal dysfunction have been reported. In particular, two cases of IPL with renal dysfunction, which included our case, revealed an increased level of IL6. These findings suggest that the occurrence of renal involvement with IPL may be related to changes in IL6, which is an important factor in the pathogenesis of IPL.
  • 滝下 佳寛, 石川 聖子, 岡田 要
    1994 年 36 巻 10 号 p. 1203-1208
    発行日: 1994年
    公開日: 2011/03/01
    ジャーナル フリー
    Although the occasional occurrence of glomerulonephritis associated with hepatitis C virus (HCV) infection has been reported recently in the literature, the type described has been mainly membranoproliferative glomerulonephritis (MPGN); membranous glomerulonephritis (MGN) is very rare. In this paper, two cases of MGN associated with HCV infection are reported. Case 1 was a 56-year-old male who had positive HCV Ab and HCV RNA. The diagnosis of chronic active hepatitis was verified by liver biopsy. Laboratory data showed proteinuria (5g per day), hematuria and hypocomplementemia by hemolytic assay. Renal biopsy led to the diagnosis of MGN in stage II. The patient was treated with interferon a for 6 months, resulting in improvement of hypocomplementemia, transient reduction of GOT and GPT during the course of treatment. The GOT and GPT were aggravated again after the completion of therapy. No improvement was seen in proteinuria and hematuria, and HCV Ab remained positive. Case 2 was a 69-year-old male who had positive HCV Ab and HCV RNA, and had normal liver function. Subsequently, his GOT value was slightly elevated. Proteinuria (2g per day) was demonstrated. The diagnosis of MGN in stage II was made on the basis of renal biopsy. The clinical characteristics of these two cases suggest that MGN is a type of glomerulonephritis associated with HCV infection.
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