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Diagnostic and prognostic significance of proteinuria selectivity index in glomerular diseases

Tencer, Jan LU ; Bakoush, Omran LU and Torffvit, Ole LU (2000) In Clinica Chimica Acta 297(1-2). p.73-83
Abstract
The proteinuria selectivity index (SI) describes changes of the glomerular permeability for macromolecules. In the present study, we examine the implications of SI as a diagnostic (199 patients) and a prognostic (49 patients) marker in glomerular diseases. Using SI based on alpha(2)-macroglobulin (alpha(2)-M-SI) or on IgM (IgM-SI) we found that minimal change nephropathy could be discriminated by low SI values and crescentic necrotizing glomerulonephritis by high SI values compared to other diseases. SI based on IgG (IgG-SI) was less useful in determining specific diagnoses. During a follow-up of 46 months creatinine clearance (Cr cl) decreased 36% in a group of patients with high IgG-SI (>0.2) and 38% in a group of patients with high... (More)
The proteinuria selectivity index (SI) describes changes of the glomerular permeability for macromolecules. In the present study, we examine the implications of SI as a diagnostic (199 patients) and a prognostic (49 patients) marker in glomerular diseases. Using SI based on alpha(2)-macroglobulin (alpha(2)-M-SI) or on IgM (IgM-SI) we found that minimal change nephropathy could be discriminated by low SI values and crescentic necrotizing glomerulonephritis by high SI values compared to other diseases. SI based on IgG (IgG-SI) was less useful in determining specific diagnoses. During a follow-up of 46 months creatinine clearance (Cr cl) decreased 36% in a group of patients with high IgG-SI (>0.2) and 38% in a group of patients with high IgM-SI (>1.5(-3)) compared to only 8% in patients with low IgG-SI (</=0.2) or low IgM-SI (</=1.5(-3)). Furthermore, Cr cl decreased more than 30% in 12 (92%) out of thirteen patients with high baseline levels of both IgG-SI and IgM-SI compared to three out of thirteen patients with low baseline values of both the indexes. The decline rate of Cr cl correlated significantly to the SI levels but not to the degree of albuminuria. The findings of the study indicate that urinary excretion of high-molecular-weight proteins, and not of albumin, is a potential prognostic marker in proteinuric glomerulopathies and it may also serve as valuable diagnostic aid in these disorders. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Clinica Chimica Acta
volume
297
issue
1-2
pages
73 - 83
publisher
Elsevier
external identifiers
  • pmid:10841910
  • scopus:0034074667
ISSN
0009-8981
DOI
10.1016/S0009-8981(00)00235-7
language
English
LU publication?
yes
id
46757f7b-23be-4c9b-be17-6ad86d9d5bc0 (old id 1118137)
date added to LUP
2008-06-19 09:29:32
date last changed
2017-05-21 03:28:04
@article{46757f7b-23be-4c9b-be17-6ad86d9d5bc0,
  abstract     = {The proteinuria selectivity index (SI) describes changes of the glomerular permeability for macromolecules. In the present study, we examine the implications of SI as a diagnostic (199 patients) and a prognostic (49 patients) marker in glomerular diseases. Using SI based on alpha(2)-macroglobulin (alpha(2)-M-SI) or on IgM (IgM-SI) we found that minimal change nephropathy could be discriminated by low SI values and crescentic necrotizing glomerulonephritis by high SI values compared to other diseases. SI based on IgG (IgG-SI) was less useful in determining specific diagnoses. During a follow-up of 46 months creatinine clearance (Cr cl) decreased 36% in a group of patients with high IgG-SI (&gt;0.2) and 38% in a group of patients with high IgM-SI (&gt;1.5(-3)) compared to only 8% in patients with low IgG-SI (&lt;/=0.2) or low IgM-SI (&lt;/=1.5(-3)). Furthermore, Cr cl decreased more than 30% in 12 (92%) out of thirteen patients with high baseline levels of both IgG-SI and IgM-SI compared to three out of thirteen patients with low baseline values of both the indexes. The decline rate of Cr cl correlated significantly to the SI levels but not to the degree of albuminuria. The findings of the study indicate that urinary excretion of high-molecular-weight proteins, and not of albumin, is a potential prognostic marker in proteinuric glomerulopathies and it may also serve as valuable diagnostic aid in these disorders.},
  author       = {Tencer, Jan and Bakoush, Omran and Torffvit, Ole},
  issn         = {0009-8981},
  language     = {eng},
  number       = {1-2},
  pages        = {73--83},
  publisher    = {Elsevier},
  series       = {Clinica Chimica Acta},
  title        = {Diagnostic and prognostic significance of proteinuria selectivity index in glomerular diseases},
  url          = {http://dx.doi.org/10.1016/S0009-8981(00)00235-7},
  volume       = {297},
  year         = {2000},
}