Hyperproteinemic proteinuria induced by plasma infusion.

Abstract

Extract: Five of seven children receiving plasma for correction of coagulation disorders developed transient proteinuria during 10 of 21 infusions. Frozen plasma with a mean protein and cholesterol cocentration of 6.0 g/100 ml and 174 mg/ml, respectively, was In patients developing proteinuria, the mean volume of plasme infused per kiligram of body weight was 203.5 to ml as compared with 93.4 ml in patients without proteinuria (p < 0.001). The mean concentration of serum protein at onset of proteinuria was 9.6 g/100 ml. The quantity of proteinuria raged from 0.05 to 3.7 g/12 h exceeding 0.5 g/12 h in 7 of 10 study periods and 1.8 g/12 h in four of five patients. Excretion of protein in the urine returned to normal values 2–7 days following termination of the plasma infusion in three of five patients; in two patients who were discharged before proteinuria disappeared no evidence of proteinuria appeared upon subsequent relation was observed betwee the serum cholesterol concentration and the corresponding serum protein level. With serum protein levels of 6.5–8.0 g/100 ml the mean cholesterol level was 209 mg/100 ml; wiht levels from 8.1 to 10.4 g/100 ml the mean cholesterol levels was 300 mg/100 (p < 0.001). Prolonged plasma infusion may result in significant transient proteinuria.Speculation: Elevation of serum protein concentration followng plasma infusion renders the glomerular capillary basement membrance more permeable to proteins, paritcular those protein of low molecular weight, and proteinuria results. Changes in bloof volume, however, hormonal, allergic or other metabolic responses to the nonautologous protein may also be operative. Induction of hyperproteinemia may lead to increased cholesterol synthesis mobilzation with result hypercholesterolemia; conversely, the hypercholesteroemia may be a reflection of an elevated lipoprotein concentration following plasma infusion.