There is almost complete unanimity of opinion that chronic glomerular nephritis is the outcome of an acute phase which fails to heal completely. When the acute attack is over, which usually occurs within a period of two to six weeks, a fundamental question arises as to whether the renal lesion has completely healed or subsided temporarily, only to progress into transitional nephritis followed by a progressive degeneration terminating eventually in death from uremia or heart failure.
Often there is failure to diagnosis the acute phase of nephritis because there are mild forms in which the typical picture of hematuria, albuminuria, hypertension, and edema is lacking. It is these cases which are unrecognized, undiagnosed, and untreated that pass insidiously into the chronic form of the disease without the patient being aware of the presence of an illness. When the chronic phase sets in, there is such a variability of symptoms that
MURPHY FD, SCHULZ EG. natural History of Glomerular nephritis: A Report of Patients Treated From Ten to Twenty-Five Years After the Acute Stage. AMA Arch Intern Med. 1956;98(6):783–800. doi:10.1001/archinte.1956.00250300101012
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