{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:03:04Z","timestamp":1779235384020,"version":"3.51.4"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2013,1,1]],"date-time":"2013-01-01T00:00:00Z","timestamp":1356998400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2013]]},"abstract":"<jats:p><jats:italic>Objective.<\/jats:italic>To assess whether high-molecular-weight proteins excretion predicts outcome and therapy-responsiveness in patients with FSGS and nephrotic syndrome.<jats:italic>Research Design and Methods<\/jats:italic>. Thirty-eight patients measured at biopsy fractional excretion of IgG (FEIgG) and urinary<jats:italic>\u03b1<\/jats:italic>2-macroglobulin\/creatinine ratio (<jats:italic>\u03b1<\/jats:italic>2m\/C). Low and high risk groups were defined by cutoffs assessed by ROC analysis. In all patients first-line therapy was with steroids alone or in combination with cyclophosphamide.<jats:italic>Results.<\/jats:italic><jats:italic>\u03b1<\/jats:italic>2m\/C and FEIgG were correlated with segmental sclerosis (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>r<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.546<\/mml:mn><\/mml:math>;<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mi>r<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.522<\/mml:mn><\/mml:math>). Twenty-three patients (61%) entered Remission and 9 (24%) progressed to ESRD. Comparing low and high risk groups, by univariate analysis remission was predicted by FEIgG (77% versus 25%,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.016<\/mml:mn><\/mml:math>) and<jats:italic>\u03b1<\/jats:italic>2m\/C (81% versus 17%,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.007<\/mml:mn><\/mml:math>) and ESRD at best by FEIgG (0% versus 75%,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.0001<\/mml:mn><\/mml:math>) and<jats:italic>\u03b1<\/jats:italic>2m\/C (4% versus 67%,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\"><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.0001<\/mml:mn><\/mml:math>). By multivariate analysis FEIgG was the only independent predictor of remission and<jats:italic>\u03b1<\/jats:italic>2m\/C the most powerful predictor of ESRD. Low and high risk groups of FEIgG and<jats:italic>\u03b1<\/jats:italic>2m\/C in combination had very high predictive value of sustained remission and ESRD in response to therapy.<jats:italic>Conclusions.<\/jats:italic>FEIgG and<jats:italic>\u03b1<\/jats:italic>2m\/C are powerful predictors of outcome and responsiveness to steroids and cyclophosphamide; their predictive value, if validated in prospective studies, may be useful in clinical practice suggesting first-line alternative treatments in high risk patients.<\/jats:p>","DOI":"10.1155\/2013\/941831","type":"journal-article","created":{"date-parts":[[2013,9,4]],"date-time":"2013-09-04T17:05:07Z","timestamp":1378314307000},"page":"1-8","source":"Crossref","is-referenced-by-count":15,"title":["Urinary IgG and<b><i>\u03b1<\/i><\/b>2-Macroglobulin Are Powerful Predictors of Outcome and Responsiveness to Steroids and Cyclophosphamide in Idiopathic Focal Segmental Glomerulosclerosis with Nephrotic 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