Endogenous albumin as a marker of renal selectivity in steroid-unresponsive nephrotic syndrome.

Albumin electrical charge, conformation and hydrophobicity taken as indexes of renal selectivity were evaluated in 8 children affected by steroid-unresponsive nephrotic syndrome associated with glomerulosclerosis or mesangial hypercellularity. These characteristics related to urinary albumin have already been reported to vary markedly in steroid-responsive nephrotic syndrome of minimal-change nephropathy giving rise to new pathogenetic possibilities in this disease. In the steroid-unresponsive nephrotic children albumin was found to be more microheterogenous and cationic in urine than in serum and at the same time it was conformationally altered. Regarding these characteristics, the selectivity properties of the renal filter are similar in steroid-unresponsive nephrotic syndrome, suggesting a pathogenetic connection between these two renal disorders.