Urine Protein Selectivity in Human Renal Allografts1

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Abstract
SummaryUrine protein selectivity was determined by the radial diffusion immunoassay method on normal urines and 119 specimens from 32 renal transplant patients. In the 19 patients studied serially normal selectivity (Θ = 60° C or more) was not seen before 3 weeks post transplantation even in the presence of excellent renal function. Eight patients achieved normal selectivity within 12 weeks after transplantation and 7 more after 12 weeks. By chisquare analysis there was a significant relationship between normal selectivity and 1) serum creatinine of 1.5 mg/100 ml or less (P < 0.005); 2) creatinine clearance of 70 ml/mm n or more (P < 0.005). The relationship of a normal selectivity to a daily protein excretion of 400 mg or less was of doubtful significance (P < 0.05). In all 13 rejection episodes a normal selectivity was never seen. During these rejections there were 5 instances of a sharp decline in selectivity, 3 with poor selectivity and further deterioration, 1 with a subnormal but rising selectivity, and, where no earlier specimens were available, 4 grossly subnormal selectivities. The subnormal selectivity existing in 7 of 9 patients on the last determination before a rejection suggests that it is a sensitive indicator of glomerular damage with possibly a predictive capability. This is strikingly apparent in 2 patients whose course for over 8 weeks after transplantation was marked by grossly subnormal selectivities but excellent renal function until an overt rejection occurred. After rejection the selectivity increased by 11° C to 50° C in the 8 instances in which subsequent specimens were available. Donor source and total ischemia time did not significantly affect the development of normal selectivity.

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