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Monitoring of Urinary Proteins by SDS Electrophoresis in Kidney Transplant Patients

Sodium dodecyl sulphate (SDS) electrophoresis of urinary proteins was used routinely for monitoring more than 80 kidney transplant recipients as out-patients during one year. Special attention was paid to the question of whether this method can help the clinician to differentiate between a graft rejection reaction and Cyclosporin A-induced nephrotoxic damage. Two cases are presented showing the time course of proteinuric patterns together with serum creatinine, total urinary protein and, in one case, the blood level of Cyclosporin A. Changes of proteinuric patterns signalled the start of rejection and/or nephrotoxicity. A homogeneous collective of 33 kidney recipients (first transplantation) with chronic glomerulonephritis as a basic disease was specially selected. In this collective, the distribution of proteinuric patterns among patients and its dependence on immunosuppressive therapy was investigated. During the observation period of 7 months, two proteinuric patterns, "tubular" and "mixed weak", were found exclusively in Cyclosporin A-treated patients. We ascribe this finding to nephrotoxic effect of Cyclosporin A. We found the SDS electrophoresis of urinary proteins to be a useful, non-invasive method for monitoring Cyclosporin A-treated kidney transplant patients.