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Erschienen in: Clinical and Experimental Nephrology 10/2019

06.06.2019 | Original article

New selectivity index calculated using protein fraction as a substitute for the conventional selectivity index

verfasst von: Jun Nakamura, Katsuyuki Nagatoya, Naohiko Fujii, Aki Warada, Atsuyuki Tokuyama, Satoshi Masuyama, Sachio Kajimoto, Ryota Haga, Atsushi Yamauchi

Erschienen in: Clinical and Experimental Nephrology | Ausgabe 10/2019

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Abstract

Background

Selectivity index (SI) of proteinuria, calculated using the clearance ratio of immunoglobulin G to transferrin, predicts the response to glucocorticoids in patients with nephrotic syndrome. However, there is disagreement regarding the suitability of SI. Therefore, alternate indices should be considered. This study investigated whether or not selectivity index protein fraction (SIPF) was inferior to SI for the prediction of the response to glucocorticoids.

Methods

Forty-nine patients with nephrotic syndrome were evaluated. On the basis of molecular weight and protein fraction, as an inexpensive substitute for SI, the clearance ratio of the albumin to γ fractions measured in serum and urine protein fractions was defined as SIPF. The quality of SIPF was examined. Moreover, the best cutoff value of SIPF was determined; and SIPF distribution, according to histopathological diagnosis by renal biopsy, was examined.

Results

SIPF was strongly correlated with SI (r = 0.79, P < 0.001). The area under the receiver operating characteristic (ROC) curve of SIPF and SI was not significantly different (P = 0.18). The best cutoff value of SIPF was 0.45. In the group with SIPF > 0.45, only two patients with minimal change disease (MCD) achieved complete remission. In the group with SIPF ≤ 0.45, all patients with MCD achieved complete remission, although eight patients with other histopathological diagnoses did not achieve complete remission.

Conclusions

Analysis of protein fractions as a substitute for SI may be useful for predicting response to glucocorticoids in patients with nephrotic syndrome.
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Literatur
1.
Zurück zum Zitat Cameron JS, White RH. Selectivity of proteinuria in children with the nephrotic syndrome. Lancet. 1965;1:463–5.CrossRefPubMed Cameron JS, White RH. Selectivity of proteinuria in children with the nephrotic syndrome. Lancet. 1965;1:463–5.CrossRefPubMed
2.
Zurück zum Zitat Cameron JS, Blandford G. The simple assessment of selectivity in heavy proteinuria. Lancet. 1966;2:242–7.CrossRefPubMed Cameron JS, Blandford G. The simple assessment of selectivity in heavy proteinuria. Lancet. 1966;2:242–7.CrossRefPubMed
3.
Zurück zum Zitat Blainey JD, Brewer DB, Hardwicke J, Soothill JF. The nephrotic syndrome. Diagnosis by renal biopsy and biochemical and immunological analyses related to the response to steroid therapy. QJM. 1960;29:235–56.PubMed Blainey JD, Brewer DB, Hardwicke J, Soothill JF. The nephrotic syndrome. Diagnosis by renal biopsy and biochemical and immunological analyses related to the response to steroid therapy. QJM. 1960;29:235–56.PubMed
4.
Zurück zum Zitat Soothill JF. Estimation of eight serum proteins by a gel diffusion precipitin technique. J Lab Clin Med. 1962;59:859–70.PubMed Soothill JF. Estimation of eight serum proteins by a gel diffusion precipitin technique. J Lab Clin Med. 1962;59:859–70.PubMed
5.
Zurück zum Zitat Joachim GR, Cameron JS, Schwartz M, Becker EL. Selectivity of protein excretion in patients with the nephrotic syndrome. J Clin Invest. 1964;43:2332–466.CrossRefPubMedPubMedCentral Joachim GR, Cameron JS, Schwartz M, Becker EL. Selectivity of protein excretion in patients with the nephrotic syndrome. J Clin Invest. 1964;43:2332–466.CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Abdurrahman MB, El Sheikh OK, Elidrissy AT, Al Kahtani WM, Lambourne A. Proteinuria selectivity index in Saudi children with nephrotic syndrome. Ann Clin Biochem. 1989;26:492–5.CrossRefPubMed Abdurrahman MB, El Sheikh OK, Elidrissy AT, Al Kahtani WM, Lambourne A. Proteinuria selectivity index in Saudi children with nephrotic syndrome. Ann Clin Biochem. 1989;26:492–5.CrossRefPubMed
7.
Zurück zum Zitat Philippon C, Laurent J, Vivien P, Weil B, Lagrue G. Proteinuria selectivity: description of a new index. Pathol Biol (Paris). 1990;38:723–6.PubMed Philippon C, Laurent J, Vivien P, Weil B, Lagrue G. Proteinuria selectivity: description of a new index. Pathol Biol (Paris). 1990;38:723–6.PubMed
8.
Zurück zum Zitat Shoji H, Kimura S, Matsui M, Suehisa E, Hidaka Y. Evaluation of fully automated capillary zone electrophoresis with the Sebia Capillarys 2 System. Japanese Journal of Clinical Laboratory Automation. 2014;39:378–85 [in Japanese]. Shoji H, Kimura S, Matsui M, Suehisa E, Hidaka Y. Evaluation of fully automated capillary zone electrophoresis with the Sebia Capillarys 2 System. Japanese Journal of Clinical Laboratory Automation. 2014;39:378–85 [in Japanese].
9.
Zurück zum Zitat Fujimoto S, Hara S, Sato Y, Yamada K, Hisanaga S, Eto T. Nephrotic syndrome caused by membranous nephropathy: response to a short course of cyclophosphamide alternating with prednisolone. Intern Med. 2004;43:30–4.CrossRefPubMed Fujimoto S, Hara S, Sato Y, Yamada K, Hisanaga S, Eto T. Nephrotic syndrome caused by membranous nephropathy: response to a short course of cyclophosphamide alternating with prednisolone. Intern Med. 2004;43:30–4.CrossRefPubMed
10.
Zurück zum Zitat Hasegawa T, Suzuki K, Kaneko Y, Takeuchi T. Proteinuria selectivity index as a prognostic biomarker in lupus nephritis. Lupus. 2017;26:656–60.CrossRefPubMed Hasegawa T, Suzuki K, Kaneko Y, Takeuchi T. Proteinuria selectivity index as a prognostic biomarker in lupus nephritis. Lupus. 2017;26:656–60.CrossRefPubMed
11.
Zurück zum Zitat Ellis D, Buffone GJ. Protein clearances and selectivity determinations in childhood nephrosis: a reappraisal. Clin Chem. 1981;27:1397–400.PubMed Ellis D, Buffone GJ. Protein clearances and selectivity determinations in childhood nephrosis: a reappraisal. Clin Chem. 1981;27:1397–400.PubMed
12.
Zurück zum Zitat Lagrue G, Laurent J, Robeva R, Laurent G, Philippon C. Proteinuria selectivity index: prognostic value in idiopathic nephrotic syndromes. Ann Med Interne. 1991;142:249–53. Lagrue G, Laurent J, Robeva R, Laurent G, Philippon C. Proteinuria selectivity index: prognostic value in idiopathic nephrotic syndromes. Ann Med Interne. 1991;142:249–53.
13.
Zurück zum Zitat Laurent J, Philippon C, Lagrue G, Laurent G, Weil B, Rostoker G. Proteinuria selectivity index-prognostic value in lipoid nephrosis and related diseases. Nephron. 1993;65:185–9.CrossRefPubMed Laurent J, Philippon C, Lagrue G, Laurent G, Weil B, Rostoker G. Proteinuria selectivity index-prognostic value in lipoid nephrosis and related diseases. Nephron. 1993;65:185–9.CrossRefPubMed
14.
Zurück zum Zitat Nakayama M, Katafuchi R, Yanase T, Ikeda K, Tanaka H, Fujimi S. Steroid responsiveness and frequency of relapse in adult-onset minimal change nephrotic syndrome. Am J Kidney Dis. 2002;39:503–12.CrossRefPubMed Nakayama M, Katafuchi R, Yanase T, Ikeda K, Tanaka H, Fujimi S. Steroid responsiveness and frequency of relapse in adult-onset minimal change nephrotic syndrome. Am J Kidney Dis. 2002;39:503–12.CrossRefPubMed
15.
Zurück zum Zitat Hosogaya S, Kume S, Fujita K, Sakurabayashi I. Quality control in electrophoretic determination of protein fractions with cellulose acetate membrane. Physico-chemical Biology. 1997;41:127 [in Japanese]. Hosogaya S, Kume S, Fujita K, Sakurabayashi I. Quality control in electrophoretic determination of protein fractions with cellulose acetate membrane. Physico-chemical Biology. 1997;41:127 [in Japanese].
Metadaten
Titel
New selectivity index calculated using protein fraction as a substitute for the conventional selectivity index
verfasst von
Jun Nakamura
Katsuyuki Nagatoya
Naohiko Fujii
Aki Warada
Atsuyuki Tokuyama
Satoshi Masuyama
Sachio Kajimoto
Ryota Haga
Atsushi Yamauchi
Publikationsdatum
06.06.2019
Verlag
Springer Singapore
Erschienen in
Clinical and Experimental Nephrology / Ausgabe 10/2019
Print ISSN: 1342-1751
Elektronische ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-019-01753-2

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