Nephrotic syndrome with mesangial hyperplasia and an unfavorable outcome

: In a group of 109 children with the nephrotic syndrome caused by mesangial hyperplasia 5 cases with unfavourable outcome were observed. The follow-up was from 3 years to 11 years. In all children no remissions of the syndromes were obtained after treatment with prednisone, methylprednisolone pulses, immunosuppressants. They had hypertension poorly responding to hypotensive drugs, and chronic renal failure developed with early progression to terminal renal failure. In three children subjected to renal transplantation the signs of the nephrotic syndrome returned, in two of them biopsy of the renal graft demonstrated evidence of mesangial hyperplasia, and in one case vascular rejection and extracapillary proliferation of cells with presence of semilunar hyperplasia.