[Skip to Navigation]
February 21, 1959


JAMA. 1959;169(8):846. doi:10.1001/jama.1959.03000250064014

ACCORDING to Kark and co-workers1 "the metabolic, nutritional and clinical consequences of continued massive albuminuria constitute the nephrotic syndrome." Far from being a single entity, as once thought, it can be produced by a variety of causes which may be grouped as (1) heredofamilial diseases, (2) infections, (3) toxins, (4) allergens, (5) mechanical disturbances, (6) generalized diseases, and (7) intrinsic renal diseases. Pathologically the characteristic lesion is necrosis of the tubules. Clinically the disease is characterized by oliguria, edema, and anorexia, although in many persons it may exist in a subclinical form and be discovered only by a routine urinalysis. In microscopic section the glomeruli may appear to be ischemic, but no change in their structure is seen with the ordinary microscope.2 Folli and co-workers3 studied renal biopsy specimens from patients with the nephrotic syndrome by means of an electron microscope. When their first specimen was taken