title: Renal tubular dysfunction after urinary diversion.
abstract: 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.
authors.affiliation: Department of Urology, University Hospital, Lund, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Kristjansson
authors.forename: A
authors.initials: A
authors.lastname: Grubb
authors.forename: W
authors.initials: W
authors.lastname: Månsson
mesh_terms: 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
chemical_list: D000510:Alpha-Globulins; D011480:Protease Inhibitors; C016001:alpha-1-microglobulin