This two-part work is based on a symposium held in Melbourne, Australia, and is an extremely elegant presentation of the current overall knowledge about glomerulonephritis. International authorities present their experiences in a systematic fashion. A good classification of glomerular disease is proposed by Renee Habib, MD, who is working on the well-recognized fact that histological patterns rather than causative factors and symptoms determine the outcome.
The symposium obviously raises important questions about therapeutic maneuvers in various glomerular disorders. Of special interest are the results of treatment by the Melbourne group of mesangiocapillary glomerulonephritis. In patients with nephrotic syndrome, malignant hypertension, and crescents, a "cocktail" containing cyclophosphamide, dipyridamole, and warfarin sodium is employed. Impressive reduction or disappearance of proteinuria and hematuria is demonstrated in some patients. What is even more striking (and heartening) is the histological improvement in some of these "poor prognosis" patients with disappearance of crescents and the double-contour.