Proteinuria has been thought of as the first sign of serious renal disease. However, in some patients proteinuria may last for years without other evidence of kidney damage, and in other patients it may only be an insignificant and transient laboratory finding. The nature and severity of renal involvement in a particular patient are often suggested by the clinical picture, and the pattern and amount of proteinuria. The physician should use this information in evaluating the severity of the patient's disease. An approach for such evaluations is offered by briefly reviewing the causes and prognosis of the various types of proteinuria and by suggesting steps to take in treating patients with increased protein excretion.

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The platelet aggregation test was used to measure circulating immune complexes in patients who had glomerulonephritis and autoimmune disease, and in unselected hospitalized patients. Titers higher than those for the control group were found for groups with acute glomerulonephritis, Berger's disease, renal transplants, lupus nephritis, and polyarteritis nodosa. Hospitalized patients had titers that were higher than normal in more than one out of five cases. This preliminary study showed that the platelet aggregation test detects immune complexes in many conditions previously reported to give positive results with other assays. The test seemed suitable for use in most hospital laboratories, since it was simple, reliable, and inexpensive. The observation of detectable circulating immune complexes in 23% of the general hospital population suggests that this phenomenon may be more common than was previously suspected.