PROTEINURIA SELECTIVITY INDEX - PROGNOSTIC VALUE IN LIPOID NEPHROSIS AND RELATED DISEASES

In order to predict the steroid response in lipoid nephrosis(LN), we s tudied age, sex, proteinuria level, histological features and proteinu ria selectivity index (SI; ratio between IgG and transferrin clearance s) in 52 LN cases (minimal-change disease: n = 39; focal glomeruloscle rosis + IgM nephropathy: n = 13). The multivariate analysis showed tha t age, sex and proteinuria level were not contributive, whereas histol ogy and SI were. The predictive value of SI was much higher than that of histological type (Mc Fadden's r2: 47% vs. 22%, p < 0.001). Thus, S I should be systemically assessed in idopathic nephrotic syndrome for reviewing the pathologic classification obtained by histology. However , if its prognostic value is lower than that of selectivity, initial r enal biopsy remains necessary for diagnosis in adults.