Intrarenal Vascular Changes in Adult Patients with Recurrent Haematuria and Loin Pain--A Clinical, Histological and Angiographic Study

Clinical features have been correlated with renal function,histology and selective renal angiography in 19 patients withrecurrent painless haematuria, recurrent loin pain, or bothhaematuria and loin pain in whom urinary infection, calculiand anatomical abnormalities of the urinary tract had been excluded.No deterioration in renal function was observed in any patientover periods of up to nine years. Although all patients showedsimilar glomerular changes histologically, consisting of focaland segmental mesangial thickening and proliferation and periglomerularfibrosis, mild tubular damage was more common in those withloin pain. All patients with loin pain whether or not they hadhaematuria, had abnormal renal angiograms consisting of focalor generalized vascular lesions sometimes associated with corticalinfarcts. The possible aetiological factors are discussed withparticular reference to oestrogen-containing compounds. ¹Present address: Wessex Regional Renal Unit, St. Mary's GeneralHospital, Portsmouth.²Present address: Renal Unit, Walsgrave Hospital, Coventry.