title: Relationship between clinical predictors and tubulointerstitial damage in adult-onset primary nephrotic syndrome.
abstract: BACKGROUND
  Tubulointerstitial damage (TID) is an important mediator in the progression of chronic proteinuric nephropathies. Our aim in this study was to evaluate the relationship between several clinical predictors and TID in adult-onset primary nephrotic syndrome in China.
  
  
  METHODS
  One hundred ninety-five adult inpatients who were diagnosed with primary nephrotic syndrome based on clinical presentation and biopsy results were enrolled in this study from March 2003 to September 2005. The degree of TID was graded by a semiquantitative method including <2 score and >or=2 score.
  
  
  RESULTS
  In all patients, the rate of glomerulosclerosis was correlated with the severity of TID. Serum creatinine and uric acid (r = 0.183, p = 0.012 and r = 0.377, p = 0.00001, respectively) but not serum lipid or total 24-h urinary protein were related with TID. In 64 patients, urinary excretion of IgG (r = 0.443, p = 0.00001) but not of albumin, transferrin, retinal-binding protein, or alpha1-microglobulin were significantly associated with the extent of TID. Proteinuria selectivity index based upon IgG also correlated significantly with the extent of TID (p = 0.0001) (score 0-1 vs. score >or=2).
  
  
  CONCLUSIONS
  These results showed that serum creatinine and uric acid, the excretion of urinary IgG and proteinuria selectivity index based upon IgG, were highly correlated with the severity of TID in adult-onset primary nephrotic syndrome. These clinical parameters might be useful for predicting the development and progression of proteinuric nephropathy as independent risk factors.
authors.affiliation: Division of Nephrology, The Second Xiangya Hospital, Central-South University, Changsha, China.
authors.forename: Fu You
authors.initials: FY
authors.lastname: Liu
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.forename: You Ming
authors.initials: YM
authors.lastname: Peng
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.forename: Shao Bin
authors.initials: SB
authors.lastname: Duan
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Xing
authors.initials: X
authors.lastname: Chen
authors.forename: Yun Cheng
authors.initials: YC
authors.lastname: Xia
authors.forename: Ning
authors.initials: N
authors.lastname: Guo
authors.forename: Xiang Qing
authors.initials: XQ
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D018450:Disease Progression; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000175:diagnosis; D006801:Humans; D007074:Immunoglobulin G / Q000652:urine; D007678:Kidney Glomerulus / Q000473:pathology; D007684:Kidney Tubules / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000175:diagnosis* / Q000473:pathology; D011379:Prognosis; D011507:Proteinuria / Q000175:diagnosis; D012720:Severity of Illness Index
chemical_list: D007074:Immunoglobulin G