Selective protein index and clinical features of childhood nephrotic syndrome in Kampala

A cross sectional study was carried out to determine Selective Protein Index (SPI) and relate it to some clinical features that might be useful in deciding on the treatment of children with the nephrotic syndrome in four hospitals in Kampala, Uganda. Radial immunodiffusion technique in commercially prepared plates was used for the determination of SPI. High selective protein index was found in 23 out of 60(38%) and low selective protein index was found in 37 out of 60(62%) of the patients studied. In patients who were not on antihypertensive or diuretic therapy, the clinical features found to be significantly associated with high Selective Protein Index (SPI) were: normal blood pressure and generalised oedema. When these features occurred together in a patient, their positive predictive value for high SPI was found to be 71%. Normal blood pressure and generalised oedema appear to be the clinical features that may be used in combination to select children with nephrotic syndrome who are likely to have high Selective Protein Index and therefore to respond to steroid therapy.