The changes of proteinuria originated from serum in renal homotransplantation, renal insufficiency due to chronic glomerulonephritis and other urinary tract diseases

Abstract

The fractions of urinary protein originated from serum were studied in renal homotransplantation, renal insufficiency due to chronic glomerulonephritis and other urinary tract diseases. Among fractions of urinary protein, α1-Lp, α2-Lp, α2-M, βIC/IA, Tr, Ig-M and Ig-G were investigated. The urine was dialyzed for 24hrs. In visking tube and concentrated to 33 times with polyethylene glycol. The concentration of each fraction was determined by means of the antibody absorption method.A patient who underwent renal homotransplantation from cadaver is still surviving 38 months after the operation. The rejection crisis was not apparent, however renal damage developed gradually later because of the chronic rejection. The changes of proteinuria with clinical course of this case were as follows: α1-Lp, Tr, Ig-G were increased significantly immediately after the transplantation and returned to normal after 3 weeks. The higher molecular weight fractions, α2-M and α2-Lp, did not appear in this period. It is considered that this proteinuria may be related with tubular proteinuria due to ischemia. From the 330th day after transplantation when chronic rejection developed, βIC/IA appeared continuously, which was never seen previously. The Ig-M was also increased but α2-Lp and α2-M was not seen. This proteinuria may be regarded as the intermediate type of proteinuria. In this period the BUN is correlative with Tr (p<0.05) and Ig-G (p<0.001), but not with α1-Lp (p>0.05).In 28 cases of renal insufficiency due to chronic glomerulonephritis, α2-Lp, α2-M and βIC/IA were noted in the urine. In 10 cases of chyluria, urinary protein was significantly increased and the pattern of protein fraction was the same as that of serum. In 36 cases of upper and lower urinary tract diseases the urinary protein level was very low and α2-Lp and βIC/IA did not appear. It is thought that the pattern of urinary protein fraction in chronic rejection may develop in to the non-selective proteinuria in chronic glomerulonephritis with the progress of rejection.