Diagnostic and prognostic significance of proteinuria selectivity index in glomerular diseases.

Original article


Tencer J, Bakoush O, Torffvit O.

Department of Nephrology, Lund University Hospital, S-221 85, Lund, Sweden. jan.tencer@njur.lu.se

Clin Chim Acta. 2000 Jul;297(1-2):73-83.


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 (