Urinary Protein Electrophoresis Patterns in Patients with Nephrotic Syndrome at a Tertiary Hospital in Enugu State

Urinary protein electrophoresis provides valuable diagnostic information about the nature and origin of proteinuria in nephrotic syndrome, enabling differentiation of glomerular from tubular patterns and characterization of protein classes lost in urine. This study investigates urinary protein electrophoresis patterns in patients with nephrotic syndrome attending the University of Nigeria Teaching Hospital, Enugu State. Fifty confirmed nephrotic syndrome patients, diagnosed by proteinuria above 3.5 grams per day, hypoalbuminaemia, oedema, and hypercholesterolaemia, and thirty apparently healthy controls were enrolled. Twenty-four-hour urine samples were collected for quantitative protein measurement by the benzethonium chloride turbidimetric method. Urinary protein electrophoresis was performed on concentrated urine samples using sodium dodecyl sulphate polyacrylamide gel electrophoresis. Serum albumin, total protein, cholesterol, and triglycerides were measured concurrently. Results show a predominantly glomerular high-molecular-weight proteinuria pattern in 74 percent of patients, characterized by the prominence of albumin and transferrin bands. A mixed tubular-glomerular pattern was observed in 18 percent, while selective albuminuria consistent with minimal change disease was seen in 8 percent. All patients showed significant hypoalbuminaemia (mean 18.4 g/L) and hypercholesterolaemia. Urinary albumin loss correlated significantly with the degree of serum albumin reduction. Protein electrophoresis patterns correlated with clinical outcomes, with selective proteinuria patients showing the best response to steroid therapy. The study supports routine urinary protein electrophoresis in the diagnostic evaluation of nephrotic syndrome. Keywords: urinary protein electrophoresis, nephrotic syndrome, proteinuria, hypoalbuminaemia, Enugu State.