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Evaluation of renal tubular damage in liver cirrhosis by urinary enzymes and beta‐2‐microglobulin excretions
Author(s) -
GATTA A.,
AMODIO P.,
FRIGO A.,
MERKEL C.,
MILANI L.,
ZUIN R.,
RUOL A.
Publication year - 1981
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.1981.tb01847.x
Subject(s) - cirrhosis , renal function , medicine , endocrinology , beta 2 microglobulin , urinary system , chemistry
. To assess the renal tubular damage in liver cirrhosis the fractional clearances of beta‐2‐micro‐globulin (B2m‐fr. cl) and malate‐dehydrogenase (MDH‐fr. cl) were measured respectively in sixty‐four and in forty‐six out of seventy‐nine patients with liver cirrhosis of different aetiology; furthermore the fractional excretions of gammaglutamyl‐transpeptidase (fr‐GGT) and of alpha‐glucosidase (fr‐AGL) were determined in fifty‐three and in forty of them respectively. In all patients glomerular filtration rate (GFR) and renal plasma flow (RPF) were also measured. Twenty‐five subjects were studied as a control group for the enzyme excretions, sixteen for B2m‐fr. cl. B2m‐fr. cl and MDH‐fr. cl—indexes of tubular functions—on the average were normal and only slightly increased respectively in cirrhotics compared to controls. Nevertheless fr‐GGT and fr‐AGL—indexes of cytolysis of tubular cells—on the average were massively increased in cirrhotics compared to controls, particularly in those with reduced RPF and/or GFR. No clear relationship between the indexes of tubular damage studied and the indexes of liver function was found. Our results show that: (1) A renal tubular anatomical damage was found by means of an increase in the release of enzyme from tubular cells in patients with liver cirrhosis, particularly in those with a significant reduction of RPF and/or GFR; even so renal reab‐sorbtion of low molecular weight proteins is generally maintained. (2) The tubular damage does not seem to be related to the degree of liver impairment.