Proteinuria after burn injury.

Qualitative and quantitative aspects of the excretion of protein after burn injury have been investigated. The excretion of total protein and of albumin have been measured nephelometrically while the excretion of proteins of both serum and non-serum origin have been measured by immunoelectrophoresis using antiserum against serum proteins or against a pool of urine from burned patients. Comparison of the patterns of proteins observed in urine using these two different antisera showed the presence of at least three major proteins that did not originate from the plasma. The excretion of two of these three proteins followed closely the pattern of total protein excretion which reached a maximum at five to seven days after injury. The excretion of albumin was greatest in the first 48 hours after injury. Examination of the original burn patients' urine antigen by sodium dodecyl sulphate polyacrylamide gel electrophoresis showed that this urine pool contained greater amounts of lower molecular weight proteins than were observed in a pool of normal urines. The observations suggest that a biphasic renal pathophysiology is observed after burn injury. Initially, there develops a mild transient glomerular lesion which progresses to a different state which shows at least some of the features of a tubular proteinuria.