| Abstract: | Urinary splitting enzymes and proteins including N-acetyl-b-D-glucosanimidase (NAG), beta 2 microglobulin (beta 2MG), and alpha 1 microglobulin: (alpha 1MG), which are established to be useful in the evaluation of renal dysfunction, especially renal tubular impairment, were measured to determine the extent of renal tubular impairment in relation to the degree of glomerular dysfunction in patients with renal deterioration. In healthy volunteers, urinary NAG, alpha 1MG and beta 2MG levels were 3.5 +/- 1.4 (mean +/- SD) U/g creatinine, 2.5 +/- 2.0 mg/l and 88 +/- 75 micrograms/l, respectively. While serum beta 2MG level (SBMG; microgram/ml) was between 2.0 and 2.9, among the patients with renal dysfunction, NAG, alpha 1MG and BMG levels showed 8.6 +/- 5.5, 9.8 +/- 5.8 and 785 +/- 1,264, respectively, and further elevated to 10.1 +/- 5.0, 16.5 +/- 0.7 and 525 +/- 440, respectively with a SBMG level over 3.0. Thus glomerular function was deteriorated, urinary alpha 1MG level elevated to significantly higher with a parallel to renal dysfunction. In patients with more severe renal dysfunction, the corresponding urinary NAG and alpha 1MG levels became significantly higher. However, urinary beta 2MG level was significantly higher in patients with moderate renal dysfunction compared to healthy volunteers only when SBMG level was more than 2.0. Therefore, it was more valuable to measure urinary alpha 1MG with NAG or beta 2MG at SBMG level of less than 1.9 and to determine urinary NAG and alpha 1MG at greater than 2.0. These results indicated that the measurement of the levels of urinary splitting enzymes and proteins is valuable in the evaluation of proximal tubular impairment, even when the degree of glomerular impairment is minimal.(ABSTRACT TRUNCATED AT 250 WORDS) |
