Evaluation of renal tubular damage in liver cirrhosis by urinary enzymes and beta-2-microglobulin excretions
Article first published online: 20 MAR 2008
European Journal of Clinical Investigation
Volume 11, Issue 3, pages 239–243, June 1981
How to Cite
GATTA, A., AMODIO, P., FRIGO, A., MERKEL, C., MILANI, L., ZUIN, R. and RUOL, A. (1981), Evaluation of renal tubular damage in liver cirrhosis by urinary enzymes and beta-2-microglobulin excretions. European Journal of Clinical Investigation, 11: 239–243. doi: 10.1111/j.1365-2362.1981.tb01847.x
- Issue published online: 20 MAR 2008
- Article first published online: 20 MAR 2008
- Received 18 February 1980and in revised from 11 November 1980
- Liver cirrhosis;
- renal pathophysiology;
- urinary enzymes
Abstract. 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.