ackground : The idiopathic nephrotic syndrome is classified into minimal change nephrotic
syndrome, focal glomerulosclerosis, membianous glomerulonephritis and membranoproliferative
glomerulonephritis. They have different histological features and different capillary wall
permeability to serum protein. The difference of capillary wall permeability to serum protein
may leads to changes of serum and urinary protein composition. But there has been no report
about that. Thereby we had carried out the electrophoresis of the serum and urinary protein
obtained from the patient with idiopathic nephrotic syndrome.
Methods : To investigate the change in serum proteins and patterns of proteinuria in 42
patients with idiopathic nephrotic syndrome(13 minimal change nephrotic syndrome-MCNS
group, 7 focal glomerulosclerosis-FGS group, 12 membranous glomerulonphritis-MGN group
and 10 patients with membranoproliferative glomerulonephritis Type I-MPGN group) celluclose
acetate protein electrophoresis was done.
Results :
1) In the percent composition of serum protein. The albumin and gama-globulin fraction of
all the patient groups investigated decreased more significantly than those of the normal
control group, but the alpha1-, alpha2-, gamma-grobulin fraction increased(p<0.001, but that
of alpha1-globulin of MGN group was p>0.05).
2) In the amount composition of serum proteins, the albumin and gama-globulin fraction of
all the patient groups decreased more than those of the normal control group(p<0.001). The
alpha2-globulin fraction of MCNS group increased(p<0.01), but the beta-globulin
decreased(p<0.05). The alpha1-globulin fraction of FGS group decreased(p<0.001), but the
alpha2-globulin increased(p<0.001). The alpha2-globulin fracton of MGN group
increased(p<0.001). The beta-globulin fraction of MPGN group decreased(p<0.01).
3) In the percent composition of urine protein, the albumin fraction of FGS group showed
the lowest value in comparison of the other groups, but the alpha1-, beta-globulin fraction
showed higher value. And the value of the alpha2-globulin fractiion of MGN group was
higher. A similar pattern appered in the MCNS and the MPGN group.
4) In the amount composition of urine protein, the alpha1-, alpha2-, beta-globulin fractiion
of FGS group, compared with the others, showed the highest value.
Conclusion : The albumin fraction and the gamma-globulin fraction in the percent
composition of serum protein in patients with idiopathic neophrotic syndrome decreased and
the fractions of alpha1-, alpha2-, beta-globulin increased more than those of the normal
control group. The alpha1-globulin fraction showed increased value regardless the level of
serum albumin or proteinuria, but the alpha2, beta-globulin showed and increased value
according to decreases of serum albumin and increases of proteinuria.There were some
differences in each disease group in serum protein composition, but that was insufficient when
used as one of the criteria for differential diagnosis. A more sensitive mrthod is needed in the
evaluation of urine protein in idiopathic nephrotic syndrome.
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