During the past 7 year period from 1986 to 1993, 40 patients were found to have reflux nephropathy. Of them, patients progressed to chronic renal failure. 5 of 7 patients underwent renal biopsy studies. We therefore have udied clinical
characteristics and pathologic features of them.
1) Those 7 patients who progressed to end stage renal failure showed marked proteinuria(75~39mg/hr/M2) with normal blood pressure at the time of diagnosis.
2) There were no refluxes in 2 of 5 patients who underwent renal biopsy studies. However, there were severe renal scarrings bilaterally in the remainders.
3) Three of 5 patients showed normal renal function at the initial evaluation but progressed to chronic renal failure during the period of follow-up 1~4yrs.
4) The most prominent pathologic findings of 5 patients with reflux nephropathy was focal segmental glomerulosclerosis. Segmental glomerulosclerosis ranged 9 to 565 among glomeruli examined. Globally sclerotic lesions accounted
for 13
to 40% of glomeruli examined.
5) There was no correlation between the extent of glomerular involvement and the amount proteinuria.
Even in patients with normal renal function, extensive loss of renal substance and massive proteinuria could be und and also, we could find that massive proteinuria in patients with reflux nephropathy denoted glomerular sion, focal
glomerulosclerosis(FSGS), and progression to end stage renal failure. We therefore elieve that proteinuria, particularly
microalbuminuria, is the earlies clinical manifestation of FSGS, and should e sought routinely in all patients with reflux nephropathy.
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