Renal tubular dysfunction after urinary diversion.
Renal tubular function can be assessed by measuring low molecular weight proteins in urine. In the present study, urinary levels of protein HC, also called alpha 1-microglobulin, were determined in 84 patients, 3-17 years after conduit diversion or continent urinary reconstruction. Increased excretion of protein HC, indicating tubular dysfunction, was found in 30 patients (36%), but was slight in most cases. Among patients with GFR > 45 ml/min/1.73 m2 at latest follow-up, the fall from preoperative GFR was greater in those with elevated levels of protein HC than in those with normal levels (p < 0.01). No permeation of protein HC through the intestinal mucosa in contact with urine could be demonstrated. Urinary protein HC may be a suitable marker for detecting early renal impairment after urinary diversion.
Kristjansson
A
A
Department of Urology, University Hospital, Lund, Sweden.
Grubb
A
A
Månsson
W
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000510:Alpha-Globulins / Q000652:urine; D002648:Child; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007677:Kidney Function Tests; D007684:Kidney Tubules / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000503:physiopathology; D011480:Protease Inhibitors / Q000652:urine; D011507:Proteinuria / Q000175:diagnosis* / Q000503:physiopathology; D012016:Reference Values; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000601:surgery*; D014547:Urinary Diversion; D016476:Urinary Reservoirs, Continent
D000510:Alpha-Globulins; D011480:Protease Inhibitors; C016001:alpha-1-microglobulin