Clinical value of urinary alpha 1-microglobulin and N-acetyl beta-D-glucosaminidase in pediatric renal diseases

ABSTRACT

Measuring urinary alpha[1]-microglobulin [alpha1 MG] and acetyl beta-D-glucosa-minidase [NAG] excretion is widely used as a valuable clinical tool in assessing renal glomerular and tubular lesion in adult, However few data are on values for urinary alpha[1]MG and NAG in pediatrics. The aim of this study was to measure urinary alpha[1]MG and NAG in children in health and diseases and if these might reflect disease activity. We studied 31 children with some clinical renal diseases during active disease and remission over follow-up period of 3 years and 10 healthy children were included as a control group. 10 children with nephritic syndrome [group I], 11 children with nephrotic syndrome [group II] and 10 children with lupus nephritis [group III]. Urinary alpha[1]MG and NAG was measured by radial immunodiffusion technique assay and colorimetric assay respectively. Our results showed significantly higher levels of urinary alpha[1]MG in children with active disease versus controls. The urinary alpha[1]IMG level was in the control [19.67 +/- 8.481, in group 1[53.61 +/- 2.95, p<0.05]. In group 11[91.29 +/- 31.91 p<0.01] in group III [81.27 +/- 15.09, p<0.001] compared to control. Urinary alpha[1] MG level showed no significant difference in patients in remission period versus control [p>0.05]. Urinary level of alpha[1] MG showed significant correlation to proteinuria in group I [r=0.783<0.01] and group 11 [r=0.925, p<0.001] only. On the other hand urinary NAG level showed significantly higher levels in all patients groups [group I, group II, group III], compared to controls [p<0.001] and there was no significant difference in all patients in remission phase compared to controls [p >0, 5]. There was a significant positive correlation between urinary alpha[1]MG and NAG