The purpose of´ this study is to evaluate the selectivity of proteinuria in nephrotic patients and its correlation with the different pathologic types of glomerulonephritis and the response to steroid therapy. The selectivity of proteinuria was measured by means of the IgG/transferrin clearance ratio using the clearances of the proteins, which were derived from the method of radial immunodiffusion.
The selectivity indices were obtained from 27 nephrotic syndrome patients who were confirmed by laboratory findings and renal biopsy.
The results obtained were as follows.
I) The mean selectivity indices in various types of nephrotic syndrome; ie, minimal change (1 case), mesangial proliferative type (8cases), diffuse proliferative type (4cases), membranoproliferative type (3cases), membranopathy (6cases), chronic glomerulonephritis (2cases), focal glomerulosclerosis (1 case) and Kimmeistiel-Wilson´s syndrome (2cases) were 0. 07, 0. 27 (0.1~0.55), 0.65 (0.4~0.96), 0. 44 (0.35~0.59), 0.49 (0.20~0.80), 0.86 (0.63~1.01), 0. 61 and 0.36 (0.32~0.39) respectively.
It could be found that selectivity indices have close relationship with microscopic findings in renal biopsy.
2) The selectivity of proteinuria was not correlated with daily amount of proteinuria, BUN, serum creatinine and cholesterol.
3) The selectivity indices of various response groups to steroid therapy were 0. 22 (0.07~0. 30) in excellent response group, 0.33 (0.10~0.55) in good response group, 0.59 (0.20~0.96) in fair response group and 0.43 (0.24~0.61) in poor response group.
4) Eight out of 10 patients with the selectivity index below 0.3 had good response to steroid therapy while 3 out of 12 patients with that above 0. 3 had poor response.
Summarizing the above data, measurement of the selectivity indices in nephrotic patients is relatively simple and reliable for the observation of severity of histological change, response to steroid and prognosis in nephrotic syndrome patients.
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