Selectivity of Protein Excretion in Patients with the Nephrotic Syndrome*

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Abstract
This study, utilizing a gel diffusion precipitin technique, and commercially prepared antisera was performed to determine the urine/plasma ratios of specific proteins by a clearance technique. By this method the selectivity of the glomerular membrane to various proteins was determined. Those with high selectivity types of protein-uria usually respond to steroid therapy regardless of the glomerular changes as seen on renal biopsy. Those patients with chronic renal disease and nephrotic syndrome display an average and frequently low selectivity type of proteinuria. There appears to be no characteristic type of selectivity for a given pathologic group of patients with the nephrotic syndrome. A statistically significant correlation exists between the initial blood urea nitrogen or inulin clearance and the selectivity type of protein excretion. Those patients who were not azotemic and had initially near normal inulin clearances had an average selectivity type or better. Those adult patients who were initially azotemic had a very poor response to therapy whereas those with normal blood urea nitrogen respond well to therapy.