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Background: Proteinuria is an established marker of activity, severity, and progression in glomerular diseases. In addition to reflecting damage to the glomerular filtration barrier, it also plays a pathogenetic role in the development of tubulointerstitial inflammation and fibrosis. Objectives: To assess the dynamics of proteinuria in patients with chronic glomerulonephritis and its significance as an indicator of therapeutic response. Methods: A retrospective study of a total of 57 patients with different morphological forms of chronic glomerulonephritis, treated at the Clinic of Nephrology and Dialysis, St. Marina University Hospital – Varna, were followed for a period of 24 months. Twenty-four-hour proteinuria and the protein-to-creatinine ratio (Pr/Cr) in a spot urine sample were analyzed. All patients received optimal nephroprotective therapy, and immunosuppressive treatment was administered when indicated. Results: The mean baseline 24-hour proteinuria was 5.94 g/24 h. By the third month, a statistically significant decrease to 3.65 g/24 h was observed (p≈0.008), followed by a further reduction to 2.7 g/24 h at month 6 and to 1.72 g/24 h at month 12. The observed reduction indicates an early and sustained therapeutic response in the studied patient population. Analysis of the protein-to-creatinine ratio confirmed the same favorable trend and supports its applicability as a reliable marker for monitoring proteinuria in clinical practice. Conclusion: Early and sustained reduction of proteinuria is a reliable indicator of therapeutic efficacy in chronic glomerular diseases and is associated with a more favorable renal prognosis. Proteinuria has substantial value both as a prognostic marker and as a surrogate endpoint in clinical follow-up.
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Copyright (c) 2026 Dr. Miroslava Stancheva Benkova-Petrova, Dr. Simona Bogdanova-Petrova (Author)