The estimation of intraoperative renal function with urinary enzyme
1987 Volume 7 Issue 1 Pages 100-105
Details
1987 Volume 7 Issue 1 Pages 100-105
In 46 patients, renal function was studied mainly with the excretion of urinary enzymes during surgery.
We chosed N-acetyl-β-D-glucosaminidase (NAG) and γ-glutamyl-transpeptidase (γ-GTP) as urinary excretory enzyme from proximal tubules. Creatinine clearance (Ccr) and free water clearence (CH2O), fractional sodium excretion (FENa) were measured simultaneously. The urinary excretion of NAG and γ-GTP were 0.36+0.058U/hr, 0.71+0.069U/hr, respectively. The mean excretory values of urinary enzymes in these operative patients were almost equal to normal values of healthy subjects.
It was suggested that the renal proximal tubular would not be impaired during surgery. In the five patients below 70mmHg in systolic blood pressure, the excretion of NAG and γ-GTP were elevated, compared with the patient induced hypotensive anesthesia.
The damage of the renal proximal tubular cells seemed to be existed in these hypotensive patients.
γ-GTP could be affected by other factors as well as by proximal injuries. These factors seemed to be included diuretics, urine volume, Ccr and soon. As NAG would not be affected by these factors, NAG seemed to be more reliable index than γ-GTP.
