多元线性回归法分析PSA的影响因素

目的:用多元线性回归的方法分析各个影响因素对于PSA的影响大小。方法:对6个自变量X1年龄、X2前列腺体积、X3剩余尿多少、X4血胆固醇、X5泌尿系感染程度、X6影像学占位赋值后,用多元线性回归的方法计算自变量对应变量Y:TPSA的偏回归系数。结果:泌尿系感染、前列腺大小、年龄与PSA之间存在线性关系,影响大小依次为泌尿系感染前列腺大小年龄,其中泌尿系感染、前列腺体积对于PSA为正影响,年龄则为负影响。剩余尿多少及患者是否有尿潴留对于F/T比值有着正影响。结论:泌尿系感染加重、前列腺体积增大一定程度可以增大PSA,年龄增加可以减小PSA。剩余尿增加及患者发生尿潴留可以增大F/T比值。     

经皮肾镜碎石术后患者尿源性脓毒血症的影响因素分析

目的:研究分析经皮肾镜碎石术(PCNL)后患者尿源性脓毒血症的影响因素。方法:选取2016年1月至2019年1月在本院接受PCNL治疗的患者700例作为研究对象。将所有研究对象按照术后是否发生尿源性脓毒血症分为尿源性脓毒血症组(46例)和非尿源性脓毒血症组(654例)。比较两组患者的基本资料(包括年龄、性别、糖尿病、高...     

Renal ammoniagenesis in humans with chronic potassium depletion.

Renal ammonia production and distribution and ammonia precursor utilization were evaluated in eight patients with chronic potassium depletion (CPD) and aldosterone-producing adenoma and in 20 controls. In CPD, urinary ammonia excretion and ammonia added to renal venous blood were about twofold higher than in controls; thus, total ammonia production was significantly augmented (88.0 +/- 10.3 mumol/min.1.73 m2 vs. 45.0 +/- 2.6 in controls). Total ammonia production was inversely correlated with serum potassium and directly correlated with urine flow. Stepwise multiple regression analysis showed that both factors, mainly serum potassium, significantly influence ammonia production and account for 61.4% of variations in ammonia production. Renal extraction of glutamine was significantly increased (56.6 +/- 5.9 mumol/min.1.73 m2 vs. 34.6 +/- 3.1 in controls), and this could account for ammonia production. The ratio of urinary ammonia excretion to total ammonia production, an index of the intrarenal ammonia distribution, was similar in patients and controls, and was significantly correlated with urine pH and true renal blood flow (RBF). Stepwise multiple regression analysis showed that RBF, urine pH and urine flow also significantly affected ammonia distribution. However, these factors accounted for only 41.7% of variations in intrarenal ammonia partition, urine pH having a minor role. We conclude that in patients with CPD other factors besides urine pH, urine flow and RBF intervene in the ammonia partition between urine and blood.     

Effects of an intravenous bolus calcium injection on glomerular filtration rate and electrolyte excretion in the kidney in conscious pigs

This paper reports the changes observed in the concentration of various constituents of plasma and in their excretion in the urine after a bolus intravenous injection of 2,2 mM calcium gluconate into conscious pigs weighing 20 kg. In the plasma, both ionic and total calcium concentrations increased but returned to normal within 35 minutes, while sodium, potassium and inorganic phosphate did not change significantly. In the kidney, the urine volume, glomerular filtration rate (GFR) and fractional sodium excretion increased slightly during the first 10 minutes but became significantly depressed later. Potassium and phosphate levels decreased, the latter significantly, while the calcium concentration increased significantly and only returned to normal after 70 minutes. These results suggest that since the disturbances in urinary volume, GFR and fractional phosphate excretion persist after both the plasma calcium and urinary calcium levels have returned to normal, factors other than these calcium values may be responsible for changes in the former measurements.     

Proton-pump inhibitors associated with decreased urinary citrate excretion

Introduction

Proton-pump inhibitors (PPIs) may increase the risk of kidney stone formation, but the mechanism has not been elucidated. There is a paucity of literature evaluating the effects of PPIs on urinary metabolites and urine pH.

Methods

We performed a retrospective review of nephrolithiasis patients treated at our institution and compared patients who were taking PPIs to those who were not at the time of their 24-h urine collections. Hierarchical multivariate linear regression was used to evaluate the independent relationship between PPI use and urinary mineral composition.

Results

We identified 301 consecutive patients, 88 (29%) of whom were taking PPIs at the time of their 24-h urine collections. Patients taking PPIs were older and more likely to have medical comorbidities associated with metabolic syndrome such as hypertension, diabetes, and dyslipidemia (p?<?0.01). Controlling for these factors, patients taking PPIs were found to have 12% lower 24-h urine citrate excretion (β?=????0.12, ΔF?=?4.24, p?=?0.04). There were no other differences in urinary mineral composition between the groups.

Conclusion

Our findings suggest that patients who take PPIs regularly may be at risk for decreased urinary citrate excretion. The consequent decrease in urinary citrate may become clinically significant for patients with other predisposing factors for hypocitraturia.

     

广东东江流域泌尿系结石患者中尿酸结石的比例和代谢特点

目的 分析广东东江流域泌尿系结石患者中尿酸结石的比例及其代谢特点.方法 对东江流域290例泌尿系结石患者的结石样本进行红外光谱定性分析,调查尿酸结石所占比例.对尿酸结石患者进行1∶1配对病例对照研究,通过条件logistic回归处理资料,分析饮食危险因素.对尿酸结石患者、草酸钙患者和正常人进行广泛式代谢评估并行组间比较,分析尿酸结石形成的代谢性因素.结果 290例泌尿系结石中含尿酸结石有53例,占18.3%.多因素的条件logistic回归显示饮水量少、口味咸、喜食肉和少食蔬菜是尿酸结石形成的主要饮食危险因素.尿酸结石组尿量、尿pH值、尿钙、尿草酸,血钙浓度显著低于草酸钙组;尿尿酸和血尿酸浓度显著高于草酸钙组;尿量、尿pH值、尿草酸、尿枸橼酸均显著低于正常对照组;尿尿酸、尿钙和血钠、钙、尿酸显著高于正常对照组,血钾、镁显著低于正常对照组.结论 广东东江流域泌尿系结石患者尿酸结石的比例较高,其饮食危险因素为饮水少、口味咸、海鲜摄入多;低尿量、低pH尿、高尿酸、高钙尿、低枸橼酸尿、高血钠、低血钾、高血钙、高尿酸、低血镁是尿酸结石形成的重要代谢因素.     

逆行上尿路腔内碎石术后并发急性尿源性感染的相关危险因素分析

目的探讨上尿路腔内碎石术后并发急性尿源性感染的危险因素。方法选取2013年2月至2014年11月在本院进行逆行上尿路腔内碎石术患者843例,按照术后是否发生急性尿源性感染进行分组,不发生感染的为A组(747例),发生感染的为B组(96例),收集并整理两组患者临床资料,采用单因素分析和logistic回归分析法分析逆行腔内碎石术后并发急性尿源性感染的危险因素。结果单因素结果显示年龄、性别、结石直径、手术时间、糖尿病、手术方式选择、术前是否应用抗生素为术后发生急性尿源性感染影响因素。Logistic回归分析结果显示女性、结石直径>2 cm、手术时间>90 min、糖尿病、尿白细胞>10个/HP、尿培养阳性为术后发生急性尿源性感染独立危险因素(P<0.05)。结论女性患者、结石直径>2 cm、手术时间>90 min、糖尿病、尿白细胞>10个/HP、尿培养阳性为患者术后并发急性尿源性感染的危险因素,此类患者术后应警惕急性尿源性感染的发生。     

经皮肾镜致尿源性脓毒血症的危险因素及最佳干预时机的初步探讨

目的探讨经皮肾镜碎石取石术（PCNL）所致尿脓毒血症的危险因素,及脓毒血症最佳干预时机。 方法回顾性分析2016年1月至2020年2月在郁南县人民医院及南方医科大学第三附属医院进行PCNL治疗的497例患者临床资料,利用Fisher精确检验和二元Logistic回归分析尿脓毒血症相关危险因素,构建预测模型,通过ROC曲线验证该模型的预测效能。 结果在这497例行PCNL术的患者中19例发生尿源性脓毒血症（3.82%）;Fisher精确检验和二元logistic回归分析显示女性、术前尿培养阳性、结石直径>2.5 cm,手术时间>90 min、术者经验（<100例）、合并糖尿病为PCNL术后脓毒血症的独立危险因素。ROC曲线分析显示这些危险因素可以很好的预测尿脓毒血症的发生（AUC=0.926）。在这19例患者中,8例出现感染性休克（42.1%）,3例死亡（15.8%）。其中12例早期应用亚胺培南抗感染只有1例进展为感染性休克阶段,余7例则均进展为感染性休克,其中3例死亡。 结论女性、术前尿培养阳性、结石直径>2.5 cm、手术时间>90 min、术者经验<100例、合并糖尿病为PCNL术后尿脓毒血症的危险因素,且这些危险因素对PCNL所致尿脓毒血症具有良好预测效率。早期应用广谱抗生素是降低尿脓毒血症风险的有效方案。     

A study on the cause of urolithiasis of the upper urinary tract--clinical study of risk factors in the formation of stones in the upper urinary tract

Various risk factors and inhibitors of the stone formation of the upper urinary tract have been pointed out in urine. We examined the amount of daily excretion of several important risk factors (calcium, phosphorus, urate and oxalate) and inhibitors (magnesium and citrate) in the urine of 21 healthy males, 13 male single stone formeks and recurrent and/or multiple stone formers before and after taking the regular diet which contains 500 mg of calcium and 1,000 mg of phosphorus a day. The daily excretion of calcium, phosphorus and magnesium indicated no significant differences among the 3 groups. The excretion of oxalate in urine for 24 hours was significantly decreased in the stone formers after taking the regular diet. The urinary excretion of the urate per body surface area in the stone formers was significantly higher than that in the healthy control. The amount of the excretion of the citrate in urine in the recurrent and/or multiple stone formers was significantly lower than that in the other 2 groups. Many patients of the recurrent and/or multiple urinary stones had more than two abnormal values of above-mentioned risk factors and inhibitors. These results suggest that the causes of the formation of the upper urinary stone were not single but multiple and that the dietary advice to these patients was important against the recurrence of the urolithiasis.     

Absorption of drugs from continent caecal reservoir for urine

The possibility of drug absorption from a continent caecal reservoir for urine was studied in 3 men with well functioning reservoirs. Saline solutions of digoxin, theophylline or terbutaline were instilled into the reservoir, each on a separate occasion, and drug concentrations in plasma and urine were measured for 24 h thereafter. Theophylline, but not terbutaline or digoxin, was absorbed from the reservoir. Estimated from an intravenous reference dose, the uptake of theophylline from the reservoir was approximately 50%. In patients with this type of urinary diversion, therefore, reabsorption from the continent caecal reservoir may complicate drug therapy.     

Urinary excretion of liver fatty acid-binding protein in health-check participants

Background Messenger RNA of liver fatty acid-binding protein (L-FABP) is expressed in proximal tubules of the kidney, and a certain amount is excreted into urine. We analyzed factors relating to the urinary L-FABP excretion in health-check participants.Methods We measured L-FABP in the first morning urine by ELISA in 715 men and 193 women 30–79 years of age who entered a 2-day hospitalized health checkup program. In addition to the routine physical examination and laboratory tests, plasma high-sensitivity C-reactive protein (HSCRP) was assayed.Results In 150 healthy subjects, urinary L-FABP averaged 3.6 ± 0.2µg/g creatinine, whereas the values were significantly increased in patients with hypertension (5.2 ± 0.4, P = 0.010), diabetes mellitus (5.5 ± 0.5, P < 0.001), and chronic hepatitis (5.8 ± 1.0, P = 0.022). Urinary L-FABP excretion was significantly greater in women than in men when the value was related to creatinine. In regression analysis in men, urinary L-FABP was positively correlated with fasting plasma glucose (r = 0.103, P = 0.033) and plasma HSCRP (r = 0.135, P = 0.006).Conclusions It is suggested that renal production and urinary excretion of L-FABP are increased in situations in which arteriosclerosis is promoted, such as hypertension, diabetes mellitus, and cardiovascular inflammation.     

Comparison of the Equil2 Program and Other Methods for Estimating the Ion-Activity Product of Urinary Calcium Oxalate: A New Simplified Method Is Proposed

Background: We aimed to develop a new simplified method to determine the urinary calcium-oxalate saturation.
Methods: The ion-activity product (AP) of urinary calcium oxalate was estimated in 345 clinical urine specimens (all 2.5 hour collections) using the Equil2 computer program and several other methods, and the results were compared. A new index using 4 parameters was created using multiple regression analysis.
Results: Our new simplified method (the AP(CaOx) index EQ2) provided a better approximation to the Equil2 method ( r = 0.9897) than other conventional methods.
Conclusion: This new method requiring 4 factors (urinary calcium, magnesium, oxalate, and citrate concentrations) is simple and clinically usable.     

Urgency is the core symptom of female overactive bladder syndrome, as demonstrated by a statistical analysis

PURPOSE: We determined overactive bladder symptoms in combination with other lower urinary tract symptoms and illustrated their relationships using a statistical analysis. Furthermore, we also describe the potential contributory factors and adaptation strategies in patients that are associated with overactive bladder subtypes. MATERIALS AND METHODS: A total of 1,930 women with a mean age +/- SD of 46 +/- 15 years (range 15 to 91) with troubling lower urinary tract symptoms were successfully interviewed with a validated questionnaire at the urology and urogynecology clinics at 14 medical centers in Taiwan. The questionnaire was constructed to evaluate 6 lower urinary tract symptoms and 7 adaptation strategies. A log linear statistical model and multiple logistic regression analysis were used to assess the associations among lower urinary tract symptoms and the potential overactive bladder contributory factors, respectively. RESULTS: No single or isolated symptom presented in patients with overactive bladder. Most patients reported a combination with other lower urinary tract symptoms. These female patients can be categorized into 3 groups, including 1 is associated with dry symptoms (urgency, frequency and nocturia), 1 associated with wet symptoms (urgency, urge incontinence and mixed stress incontinence) and a small group that may have overactive bladder symptoms combined with voiding difficulty symptoms. in contrast to patients with dry overactive bladder (urgency associated with frequency and/or nocturia without urge incontinence), after multiple logistic regression analysis patients with wet overactive bladder (urgency with urge incontinence) had a greater average age and higher body mass index, and made more adaptation efforts (p <0.05). CONCLUSIONS: We used statistical analysis to determine and suggest that urgency is the core symptom of female overactive bladder syndrome and there are 3 distinctive overactive bladder subtypes, which differ in their symptom combinations. Different symptom combinations and patient characteristics affect female adaptation to overactive bladder syndrome.     

A multicenter case–control study of diagnostic tests for urinary tract infection in the presence of urolithiasis

Urinary stone disease (USD) alone can cause much morbidity, but when present in conjunction with urinary tract infection, complications and morbidity increase even more. This study investigated the clinical and laboratory findings in patients who had USD with and without infection and evaluated the most suitable diagnostic value for urinary tract infection parameters before urine culture results were available. In a prospective fashion, patients who presented to the emergency department with a complaint of colicky flank pain (with or without hematuria) and who were diagnosed as having urolithiasis with ultrasound were evaluated for 1 year. The gold standard for the diagnosis of urinary tract infection was urine culture. The most suitable diagnostic value for urinary tract infection parameters was determined by receiver operating characteristic (ROC) curves. Logistic regression was used to identify independent variables that predicted a positive urine culture. Of the 192 eligible patients, 177 agreed to participate in the study. Of the clinical and laboratory characteristics analyzed, urine WBC, blood WBC, and fever were significantly different between culture positive and negative patients (p < 0.001, p = 0.04 p = 0.012, respectively). Using ROC curve analysis, pyuria (over 10 WBCs per HPF), fever over 37.9°C, and leucocytosis over 11,300 were the best predictors of a positive culture result. The logistic regression model for leukocytosis >11,300 (OR 2.1), pyuria (OR 2.8), and temperature >37.9°C (OR 3.1) showed a significantly increased risk of having a positive urine culture (correct class 87.9%). While a single physical examination or laboratory finding cannot predict urinary tract infection in USD patients with complete reliability, the presence of pyruria, fever, and leukocytosis significantly increases the odds of a positive urine culture.     

The prevalence of hyperlipidemia in renal transplant recipients. Associations with immunosuppressive and antihypertensive therapy

To determine the extent of persisting hyperlipidemia in renal transplant recipients receiving modern maintenance immunosuppressive and antihypertensive therapy we compared plasma levels of total and high-density lipoprotein and triglyceride in 275 renal transplant recipients with stable graft function with age- and sex-matched groups from the local general population (n = 4055). Total cholesterol and triglyceride were higher in transplanted patients in all age groups, but the difference was much more striking in women. Plasma levels of HDL cholesterol were similar or slightly lower in transplanted patients. Association with parameters of graft function, immunosuppressive therapy, and antihypertensive therapy were studied within the transplanted population using multiple regression. Total cholesterol was significantly and independently associated with age, sex, diuretic therapy, and urinary protein. In 127/134 (95%) of patients the diuretic was a loop diuretic. None of the other classes of antihypertensive drug was independently associated with serum cholesterol. The only variables significantly associated with HDL cholesterol were sex and the plasma creatinine. Plasma triglyceride was significantly and independently associated with both diuretic therapy and beta-blocker therapy and with age, urinary protein excretion, and plasma albumin. Plasma cholesterol, HDL cholesterol, and triglyceride levels were almost identical in patients receiving triple therapy (cyclosporine 3-5 mg/kg; prednisolone 7-10 mg o.d.; azathioprine 1-1.5 mg/kg) to those in patients receiving conventional immunosuppression (prednisolone 7-10 mg o.d.; azathioprine 2-2.5 mg/kg). Thus these results do not support the existence of a persisting long-term effect of cyclosporine on plasma cholesterol and triglyceride at these doses of the drug. The more striking abnormality of plasma cholesterol and triglyceride in females is unexplained but might be connected with greater sensitivity to low doses of corticosteroids.     

Effect of captopril on urinary cystine excretion in homozygous cystinuria

We determined if captopril could reduce urinary cystine excretion in homozygous cystinuric patients. Seven patients were treated with 150 mg. captopril daily after determination of baseline 24-hour urine cystine excretion. All patients had a history of multiple cystine stones, and were on chronic fluid and alkalization therapy. Five patients had previously been on D-penicillamine. Cystine excretion studies were repeated 1 to 5 months after institution of captopril. Baseline 24-hour urinary cystine excretion ranged from 580 to 970 mg. per gm. creatinine (mean 744). After institution of captopril these levels decreased to a range of 113 to 581 mg. per gm. creatinine (mean 371). These values on treatment represented a statistically significant decrease to between 18 and 89% of baseline levels (p equals 0.0045). We conclude that captopril can significantly, and at times profoundly, decrease urinary cystine excretion in patients with homozygous cystinuria. Further studies are required to elucidate fully the mechanism of urinary cystine reduction and to help define a possible role for this drug in routine maintenance or dissolution therapy.     

Estrogen replacement increased the citrate and calcium excretion rates in postmenopausal women with recurrent urolithiasis.

PURPOSE: Epidemiological data indicate a sharp increase in urinary calcium stone formation after menopause. We investigated the role of menopausal estrogen replacement therapy on the urinary constituents and characteristics that may influence recurrent calcium oxalate stone disease. MATERIALS AND METHODS: Urinary constituents in 28 postmenopausal women on estrogen replacement therapy for more than 6 months were compared with those in 41 women who had never been exposed to estrogen after menopause. These 2 groups had a history of recurrent calcium oxalate urolithiasis. A group of age matched, nonstone forming volunteers who were and were not on estrogen served as controls. RESULTS: The 24-hour urine collection revealed significantly higher mean calcium plus or minus standard deviation (188.8 +/- 101.5 versus 129.2 +/- 80.9 mg./24 hours, p <0.01), citrate (576.6 +/- 237.9 versus 306.2 +/- 209.9 mg./24 hours, p <0.001) and agglomeration inhibition (203 +/- 106 versus 159 +/- 81 minutes, p <0.05) in stone forming women who were versus were not on estrogen. CONCLUSIONS: Higher urinary citrate and higher agglomeration inhibition in women exposed to estrogen may decrease the risk of subsequent calcium stone formation.     

A substrate inhibitor analysis of the urinary excretion of tissue and plasma kallikreins in patients with chronic glomerulonephritis

The usage of substrate inhibitor analysis made it possible to estimate the levels of excretion of plasma proteinases, including plasma kallikrein in the urinary DValLeuArgpNA (S-2266)- and DProPheArgpNA (S-2302)-amidase activity in patients with latent and nephrotic types of chronic glomerulonephritis (CGN). The soya bean trypsin inhibitor, an inhibitor of plasma kallikrein and other plasma proteinases, such as that of the blood coagulative factors XIa and XIIa, and the high selective plasma kallikrein inhibitor DPhePheArgCH2Cl were used as those differentiating kallikreins of tissue and plasma origin. The S-2266 and S-2302-amidase activity of the urine from healthy subjects was shown to be determined by only tissue (renal) kallikrein. The urine from the patients with a latent CGN type displayed the activity of plasma proteinases, but plasma kallikrein made no significant contribution to the urine amidase activity in these patients. With a nephrotic CGN type, great quantities of trypsin-like proteinases were secreted from the plasma through the glomerular filter into the urine, the proportion of plasma kallikrein in the urinary S-2266 and S-2302-amidase activities being approximately 27%. The compensatory and pathogenetic role of plasma kallikrein is discussed if there is lower excretion of tissue (renal) kallikrein in CGN with the nephrotic syndrome.     

Dramatic suppression of plasma and urinary prostate specific antigen and human glandular kallikrein by antiandrogens in male-to-female transsexuals

PURPOSE: Prostate specific antigen (PSA) and human glandular kallikrein (hK2) are mainly produced by the prostate and their genes are regulated by androgens through the androgen receptor. We determine whether PSA and hK2 change significantly in plasma and urine after antiandrogen treatment in male-to-female transsexuals. MATERIALS AND METHODS: Plasma and urine PSA and hK2 were measured with highly sensitive immunofluorometric procedures capable of detecting within 1 or 6 ng./l. PSA or hK2, respectively. Study groups consisted of 10 men treated with cyproterone acetate only (group 1), 15 transdermal estradiol plus cyproterone acetate (group 2) and 31 ethinyl estradiol plus cyproterone acetate (group 3). Plasma and urine samples were collected before initiation of treatment as well as after 4 months of hormonal therapy. For a subset of group 3 patients blood and urine samples were also obtained after 12 months of treatment. RESULTS: Cyproterone acetate, a steroidal antiandrogen, alone or with estradiol was able to suppress greater than 90% of plasma and urinary PSA and hK2 concentration after 4 or 12 months of therapy. CONCLUSIONS: Cyproterone acetate therapy causes dramatic suppression of plasma and urinary PSA and hK2 in men without prostate cancer. Since cyproterone acetate is used for prostate cancer treatment, suppression of PSA after hormonal therapy may not accurately reflect therapy success in reducing tumor burden.     

Urine excretion of protein HC in proteinuric glomerular diseases correlates to urine IgG but not to albuminuria.

BACKGROUND: Proteinuric glomerular diseases often are associated with tubulointerstitial injury, which imposes on the progression of renal failure. Tubular damage is partly referable to toxic effects on the tubular epithelial cells induced by filtered plasma proteins. Patients with nonselective proteinuria, that is, increased urine excretion of high-molecular-weight plasma proteins such as IgG in comparison to albumin, often have poor renal outcome. The present observational study examined correlations between the degree of tubular damage, measured by urine concentration of protein HC, and the levels of urine IgG and albuminuria. METHODS: Measurements of urine concentrations of IgG, albumin, and protein HC were performed in 56 proteinuric patients (33 males and 23 females) with nondiabetic glomerular diseases at the time of the diagnostic renal biopsy and at a mean of 49 follow-up months. RESULTS: A highly significant correlation between the urine IgG excretion and the urine protein HC concentration was found both at the start and at the end of the observational time (r = 0.74 and 0.65, respectively, P < 0.001). Furthermore, alterations in the urinary excretion of the two proteins in single patients correlated significantly to each other (r = 0.84, P < 0.001). The correlation between the degree of albuminuria and the protein HC excretion was significant at the time of kidney biopsy, but ceased to exist during the follow-up time. Stepwise linear regression analysis showed that in comparison with the creatinine clearance and albuminuria, only the changes in urinary IgG excretion were related to the corresponding changes in urinary protein HC excretion (r = 0.84 and r2 = 0.7, P < 0.001). CONCLUSION: The findings of the study suggest that the urinary protein HC concentration correlates to the degree of IgG-uria but not to the degree of albuminuria during the course of proteinuric glomerular disease. Whether this correlation is to be explained by an intrinsic toxic effect on tubular cells executed by IgG or perhaps by some other high molecular weight proteins, needs to be investigated further. However, the results contribute to the understanding of the poor renal survival in patients with glomerular diseases and nonselective proteinuria.