Nephrotic syndrome complicated by tubular dysfunction .

Introduction Abnormalities of proximal renal tubular function in the nephrotic syndrome are rare but well documented (Bruck, Rapoport and Rubin, 1954; Kovnat and Lin, 1974; Pabico et al., 1976), particularly in children. The mechanisms underlying this combination remain obscure; a number have been proposed (Vitacco et al., 1970) including the recent speculation that a common mechanism linked by immune-mediated processes could be at work in some cases (Shwayder et al., 1976). In addition, little is known about the effect of steroid or other therapy in this mixed syndrome. A case is now reported of an adult with nephrotic syndrome due to mesangiocapillary glomerulonephritis (MCGN) who subsequently developed a potassium-losing state, generalized amino aciduria and glycosuria. His course and response to steroids are described and the possible mechanisms underlying his disease are considered.