Differentiation of proteinurias with electrophoresis

Ehrich, J. H. H.; Wurster, Ulrich

doi:10.1007/bf01453655

Cited by 16 publications

(10 citation statements)

References 32 publications

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“…The dried agarose film is durable and shows little or no deterioration upon storage. Quantification was easily accomplished with densitometry due to the clarity of the finished electrophoretogram [13,14].…”

Section: Study Populationmentioning

confidence: 99%

Enalapril and prednisone in children with nephrotic-range proteinuria

Delucchi

Cano

Rodríguez

et al. 2000

Pediatric Nephrology

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The effect of enalapril and low prednisone doses on the urinary protein electrophoretic pattern was studied in 13 pediatric patients with glomerular diseases and steroid-resistant nephrotic syndrome. Enalapril was administered at doses of 0.2-0.6 mg/kg per day for 24-84 months, and prednisone was introduced 2 months later in 11 patients at doses of 30 mg/m2 on alternate days. The urine protein electrophoretic pattern showed a reduction of 80% and 70% in the total protein and albumin, respectively, after enalapril. Total urinary protein decreased from 5.46 to 1.1 g/m2 per day (P<0.001). A marked change from a pattern of non-selective urinary protein loss to an albumin-selective proteinuria was observed. Mean total plasma proteins increased from 4.7 to 5.43 g/dl (P<0.001). Four patients became free of proteinuria 24 months after enalapril was started, but only 2 remained free of proteinuria at 48 months of follow-up. The other 11 patients had persistent albuminuria of between 0.5 and 2.6 g/m2 per day with a selective urinary electrophoretic pattern. No additional decrease was observed after steroids were introduced. A clinical improvement in edema was observed in all children. Three patients developed transient acute renal failure, during the course of an infectious disease; 2 developed peritonitis and 1 pneumopathy. In these patients withdrawal of enalapril was necessary until a complete recovery of renal function was observed. Four patients were hypertensive on admission, achieving normal blood pressure 1 month after enalapril was started. No episodes of systemic arterial hypotension were seen. Creatinine clearance and serum potassium showed no statistically significant change.

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Section: Study Populationmentioning

confidence: 99%

Enalapril and prednisone in children with nephrotic-range proteinuria

Delucchi

Cano

Rodríguez

et al. 2000

Pediatric Nephrology

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“…Nephrotic-range proteinuria caused by any glomerulopathy usually has different fractions of protein, including transferrin and less frequently immunoglobulins [1,2]. The absence of transferrin (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed IgA nephropathy or other glomerular pathology may be suspected but can be diagnosed by kidney biopsy. In patients with massive proteinuria the albumin fraction is rarely over 75% of the total urine protein [1,2]. In the patient described urinary protein electrophoresis revealed almost pure (99.4%) albumin without a transferrin fraction, suggesting factitious proteinuria.…”

Section: Introductionmentioning

confidence: 98%

Munchausen syndrome by proxy with massive proteinuria and gastrointestinal hemorrhage

Ulinski

Lhopital

Cloppet³

et al. 2004

Pediatric Nephrology

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A 5-year-old boy presented with acute abdominal pain. Massive proteinuria of 10 g/1.73 m(2) per day was detected on standard urinalysis. There was no peripheral edema. Serum concentrations of total proteins, lipids, and creatinine and immunological investigations were normal. Two kidney biopsies revealed no abnormalities. Several weeks later he was admitted for intestinal hemorrhage with significant anemia. Endoscopy of the esophagus, stomach, colon, and small bowel (via laparotomy) were normal. Electrophoresis of urine proteins revealed the unusual finding of an albumin fraction of 99.4%. During a routine check-up in the outpatient clinic fresh urine samples were obtained while the boy's mother was absent. These were all negative for protein. The mother, who was a nurse, finally confessed to adding human albumin to the urine samples.

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“…The accepted range of variation included the 2 SD band for the parameters of tubular reabsorption, and the 95th percentile for parameters of proteinuria. In addition, proteinuria was further differentiated using sodium dodecyl sulphate-polyacrylamide gel electrophoresis with silver staining [6]. …”

mentioning

confidence: 99%

Partial and complete de Toni-Debr�-Fanconi syndrome after ifosfamide chemotherapy of childhood malignancy

Rossi

Ehrich

1993

Eur J Clin Pharmacol

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Ten out of 79 patients treated with ifosfamide (IFO) developed a complete (n = 2) or partial (n = 8) de Toni-Debré-Fanconi syndrome (RFS). All but one of these patients had been treated in addition with cisplatinum (CPL) or had undergone radiotherapy to the abdomen or nephrectomy as part of the overall treatment for malignancy. A detailed nephrological work-up of proximal tubular function showed decreased fractional phosphate and percent aminoacid reabsorption in 37.1 and 56.7% of cases, respectively, and the excretion of alpha 1-microglobulin and N-acetyl-beta-D-glucosaminidase was elevated in 44.4 and 23.5%. Glomerular function was well preserved in the majority of patients. Tubular dysfunction was confirmed by silver-stained SDS PAGE of urine which showed mostly low molecular weight proteinuria. CPL has been shown to result in renal magnesium loss and reduced glomerular filtration rate, and its toxicity clearly differs from IFO-mediated tubulopathy. Our data suggest that subclinical impairment of proximal tubular function was significantly increased by additional CPL therapy. We conclude that CPL may enhance IFO-mediated nephrotoxicity and that a substantial number of patients is at risk of developing persistent tubular dysfunction leading to metabolic bone disease.

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Differentiation of proteinurias with electrophoresis

Cited by 16 publications

References 32 publications

Enalapril and prednisone in children with nephrotic-range proteinuria

Enalapril and prednisone in children with nephrotic-range proteinuria

Munchausen syndrome by proxy with massive proteinuria and gastrointestinal hemorrhage

Partial and complete de Toni-Debr�-Fanconi syndrome after ifosfamide chemotherapy of childhood malignancy

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