Selective Protein Index and Response to Treatment in the Childhood Nephrotic Syndrome

ABSTRACT

In a group of 59 children with nephrotic syndrome who had been admitted to Severance Ho-spital, during the period of 2 years from July of 1978 till June of 1980, the histological picture seen on renal biopsy, the selective protein index, and the response to the steroid therapy were studied. The degree of selective protein index is not related to the total daily amount of urinary protein excretion and selective protein index remains relatively constant over months in the minimal lesion nephrotic syndrom. Those patients with primary renal disease and the nephrotic syndrome who displayed high selectivity types of proteinuria usually responds initially to steroid therapy within 8 weeks. Studies of selective protein index allow the pediatrician to avoid renal biopsy with safety in nephrotic children aged 1 to 5 years, but distinguish any given renal disease with certainty. The mesangial proliferative glomerulonephritis with immune deposits has relatively poor selectivity of proteinuria and without immune deposits, it has high or moder-ate selectivity of proteinuria. Response to treatment of steroid in the Henoch-Sch?lein Purpura was poor and not related with selective protein index.