Nephrosis serum proteins

PEM is frequently associated with changes in serum markers such as protein, lipid, and nitrogen (Hendrickse, 1991). Decreased serum albumin levels have been used as a standard PEM indicator. Since albumin has a long half-life of 18 days in the plasma and a large pool size that decreases in various illnesses (such as hepatic insufficiency and nephrosis), it is not a specific marker for recent nutritional inadequacies. Prealbumin (or transthyretin), by virtue of its higher catabolic rate (half-life = 1.9 days) and small pool size, is a very sensitive and fairly specific indicator of acute malnutrition and shortterm responses to nutritional replacements in patients of all ages (Bernstein and Ingenbleek, 2002). 

Except in genetic disorders such as Menkes Syndrome, caused by abnormalities in protein metabolism in children (62), hypocupremia has not been demonstrated to occur in man (49), Two other disorders, nephrosis and iron deficiency, are known to have low serum copper concentrations. 

The hypocupremia in nephrosis where the albumin globulin ratio is reversed and total protein levels are low remains to be explained. In these cases, however, there is a considerable loss by kidney excretion, as has been described by Markowitz et al. (1955). The ceruloplasmin excretion has been determined in 4 of his 7 nephrosis patients. The loss proved to be as high as 46-75 mg. ceruloplasmin a day. The serum copper values of these 7 patients were between 36 and 129 fig. %, with corresponding decreases in ceruloplasmin values. 

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