Familial renal insufficiency.

The picture of chronic renal insufficiency in childhood is not common, and instances of more than one member of a family with this picture are comparatively rare. Mitchell (1930), in an exhaustive review of the literature of chronic interstitial nephritis in childhood, quotes 14 instances in which more than one child in the family was affected. Graham and Hutchinson (1941) have described a family in which three or probably four out of eight children suffered from this condition. Rinkoff, Stem, and Schumer (1939) reported the death from renal failure in early adult life of three brothers: necropsy on two of them confirmed the presence of chronic glomerulo-nephritis, but death apparently occurred in all three cases soon after the symptoms appeared, and there is no evidence indicating the time of onset. Hawkins (1950) has recently described the occurrence of chronic nephritis in association with a variety of congenital defects in two brothers and in one daughter of each of them. In this family the renal lesion appears to have been relatively benign, as two of the affected members were over 40 years of age, and all of them were alive. In view of the comparative rarity of reports on familial nephro-sclerosis, it may be of interest to report the histories of a family of six children, of whom one was found at necropsy to have a hypoplastic horseshoe kidney, and two others subsequently died of chronic renal failure.