During the follow-up period, significantly more patients with detectable PLA2R-Ab developed
nephrotic range proteinuria (13 out of 16 patients) compared to those that tested negative (five out of 17).
The efficacy of glucocorticoids has been tested in 80 children with MPGN, nephrotic range proteinuria, and preserved renal function.
Two patients showed improvement in serum creatinine, one patient had a remission of nephrotic range proteinuria, and one patient showed less endocapillary proliferation on a repeat kidney biopsy.
Nephrotic range proteinuria was defined as UPCR more than 2000mg/mg [11].
Twenty-four patients (55.8%) had nephrotic range proteinuria. As expected, nephrotic subjects had higher degrees of proteinuria ([UPCR.sub.1]: nephrotic, 3.57 (2.14-9.23) versus subnephrotic, 1.02, (0.54-1.95, p < 0.001)), but GFR was not different ([GFR.sub.1]: nephrotic, 59 (25-143) versus subnephrotic, 71 (12-143), p = 0.56).
Similarly
nephrotic range proteinuria has been shown to be the most common presentation in India as well by Chacko and Siddapa2425.
Nephrotic syndrome is a manifestation of glomerular disease characterized by
nephrotic range proteinuria and the triad of clinical findings associated with large urinary losses of protein: hypoalbuminemia, edema and hyperlipidemia.
1 shows a patient with marked generalised oedema and
nephrotic range proteinuria (3.3 g/d), yet the serum albumin level was relatively high at 28 g/l.
Due to disease-specific changes of glomerular permeability [47], different patterns of plasma proteins including transferrin, [[alpha].sub.1] antitrypsin (A1AT), and antithrombin III would be lost in urine of patients with nephrotic syndrome and might not be specific for FSGS as they could be detected in
nephrotic range proteinuria secondary to any etiology [54].
D-allele is also implicated in the cause of diabetic nephropathy, MI and VUR, as our patient had LV dysfunction, VUR, and
nephrotic range proteinuria.
