Abstract: FR-PO753

A Significance of Urine-Gravidity in Nephrotic Syndrome

Session Information

Category: Glomerular

  • 1004 Clinical/Diagnostic Renal Pathology and Lab Medicine

Authors

  • Nishi, Shinichi, Kobe University Graduate School of Medicine, Kobe, Japan
  • Fujii, Hideki, Kobe University Graduate School of Medicine, Kobe, Japan
  • Goto, Shunsuke, Kobe University Graduate School of Medicne, Kobe, Japan
  • Kono, Keiji, Kobe University Graduate School of Medicine, Kobe, Japan
  • Yoshikawa, Mikiko, Kobe University Graduate School of Medicine, Kobe, Japan
  • Watanabe, Shuhei, Kobe University Graduate School of Medicine, Kobe, Japan
  • Watanabe, Kentaro, Kobe University Graduate School of Medicine, Kobe, Japan
Background

Selectivity index (SI) has been used in the differentiation of nephrotic syndrome (NS), while the sensitivity of SI is not so high. We studied the significance of urine gravidity (UG) as an available differentiative marker for NS.

Methods

We selected 45 consecutive patients with primary NS that were admitted in Kobe University Hospital from 2012 to 2014. Secondary renal diseases associated with collagen diseases and diabetes were excluded. The cases already treated by glucocorticoid or diuretics were also excluded. We studied the relationship between histological and clinical findings and clarified the availability of UG in the point of differentiation of NS due to MCNS, FSGS, MN.

Results

The subjective cases were comprised of 23 MCNS, 18 MN (stage 1=4), and 3 FSGS. The average age was 52.7±27.7 years-old. The means of amount of urine protein (AUP) and albumin were 8.1±3.7 g/gCr and 1.7±0.7 g/dL, respectively. Those of UG and SI were 1.032±0.013 and 0.340±0.563, respectively. We divided all cases into two groups; MCNS (n=23) and non-MCNS (n=22). In the comparison of two groups, UG was significantly higher in MCNS, 1.039±0.008 and 1.024±0.013 (p<0.001). SI did not show a significant difference; 0.216±0.476 in MCNS and 0.476±0.662 in non-MCNS (p=0.9314). In ROC analysis UG-AUC of MCNS was 0.831 and SI-AUC of MCNS was 0.796, respectively. We divided into all cases into other two groups; MCD (MCNS+stage1 MN+FSGS) and non-MCD groups. In the comparison of two groups, UG was significantly higher in MCD, 1.039±0.008 and 1.017±0.009, respectively (p<0.001). SI did not show significant difference in MCD and non-MCD, 0.222±0.384 and 0.574±0.787 (p=0.943). In ROC analysis UG-AUC of MCD was 0.978 and SI-AUC of MCD was 0.770.

Conclusion

UG was an available differentiative marker for MCNS vs. non-MCNS or MCD vs. non-MCD. When we combinate UG and SI, we can effectively differentiate three groups MCNS, MN, and FSGS.

The mean parameters of NS cases
 AUP(g/gCr)Alb(g/dL)UGSI
MCNS8.4(3.7)1.6(0.7)1.039(0.003)0.216(0.434)
MN stage17.0(3.0)1.5(0.4)1.037(0.006)0.187(0.160)
MN stage2-47.1(3.5)1.9(1.9)1.017(0.009)0.594(0.787)
FSGS 12.9(3.1)1.7(0.8)1.041(0.007)0.311(0.065)

Mean(SD)