URINE PROTEIN SELECTIVITY IN HUMAN RENAL ALLOGRAFTS

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Abstract
Urine protein selectivity was determined by the radial diffusion immunoassay method in 32 renal transplant patients. In the 19 patients studied serially normal selectivity (θ = 60° 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 seven more between the 12th and 40th weeks. There was a highly significant correlation between selectivity and both serum creatinine (P < 0.001) and creatinine clearance (P < 0.001). No significant correlation was found between selectivity and the 24-hr urine protein excretion (0.1 > P > 0.05). In all 13 rejection episodes the selectivity was subnormal. During these rejections there were five cases of a sharp decline in selectivity, three with poor selectivity and further deterioration, one with a subnormal but rising selectivity, and, where no earlier specimens were available, four grossly subnormal selectivities. The subnormal selectivity occurring in seven of nine patients on the last determination before a rejection suggested that it was a sensitive indicator of glomerular damage with possibly a predictive capacity. After rejection the selectivity increased by 11–50° in the eight 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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