PARENCHYMATOUS NEPHRITIS: I. AS A GENERAL SYSTEMIC DISORDER

Nephritis in children can be divided into two main classes: hemorrhagic, or glomerular, and parenchymatous, or tubular. This paper attempts to characterize the group termed "parenchymatous," to indicate the etiology and nature of the disorder, to present the differential diagnosis from hemorrhagic nephritis, and to outline the therapy. The chief clinical features of parenchymatous nephritis are: marked edema and albuminuria, and the absence of hematuria, hypertension and retention of nonprotein nitrogen. The microscopic changes in the kidney in early cases are confined to degeneration of the tubules; in later cases, one may also observe interstitial infiltration with round cells. The hemorrhagic lesions typical of glomerular nephritis are not found. These features serve to differentiate the disorder from glomerular nephritis, as well as from other types of tubular degeneration, such as the febrile, that due to intoxication with mercury or with diphtheria toxin, and in the case of adults the nephritis