All issues > Volume 32(10); 1989

Original Article

J Korean Pediatr Soc. 1989;32(10):1384-1390. Published online October 31, 1989.

Selectivity Index of Proteinuria in Childhood Minimal Change Nephrotic Syndrome.

Cheol Ho Lee¹, Young Seo Park¹, Kwang Wook Ko¹

¹Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea

Received: March 6, 1989;  Accepted: May 11, 1989.

Abstract

The selectivity indices (S.I.) of proteinuria in 120 biopsy proven minimal change nephrotic syn- drome (MCNS) children who were admitted to Seoul National University Childern’s Hospital from January 1976 to June 1988 and followed up for more than 1 year from onset of disease, were analyzed in relation to clinical findings, histopathologic features and steroid responsiveness. The results were as follows: 1) The mean age at the onset of nephrotic syndrome was 6.98 ±3.58 years and the male to female ratio was 3.14:1. 2) All patients were classified into 3 groups according to S.I.; 51 cases (42.5%) with high S.I. (^0. 1), 29 cases (24.2%) with moderate S.I.(>0.1—<0.2) and 40 cases (33.3%) with poor S.I.(>0.2). 3) Mean age of onset, sex ratio and presence of nephritic findings such as hematuria, hypertension and renal insufficiency revealed no significant difference among the 3 groups with different S.I.. 4) No significant difference in the distribution of histopathologic variants was noted among the 3 groups either. 5) Initial response to steroid therapy and frequency of relapse were not different among the 3 groups, however, subsequent nonresponders and continuing nonresponders were more frequent in those with poor S.I. than in those with high S.I. during later follow up (p<0.05). In conclusion, S.I. of proteinuria in childhood MCNS can be used as a predictive indicator for late response to steroid therapy.

Keywords :Minimal change nephrotic syndrome, Selectivity index