Tubular dysfunction in the deeply jaundiced patient with hepatorenal syndrome

✍ Scribed by William G. Rector Jr; Gary C. Kanel; Jorge Rakela; Telfer B. Reynolds

• Publisher: John Wiley and Sons
• Year: 1985
• Tongue: English
• Weight: 608 KB
• Volume: 5
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.1840050229

✦ Synopsis

We examined &-microglobulin (BZMG) excretion, an index of tubular function, in patients with hepatorenal syndrome, in whom tubular function is generally regarded as normal. Urine BBMG was significantly higher in these patients than in control patients with normal serum creatinine concentration. Patients with high urine BBMG concentration had markedly higher serum bilirubin than did patients with normal values (31 f 3 vs. 10 f 8 mg%, p < 0.001), whereas prothrombin activity, serum albumin and serum BZMG concentration were similar. A "threshold" serum bilirubin concentration of about 23 mg% differentiated patients with normal and high urine BBMG values. Renal morphology at autopsy was unremarkable in both groups. Tubular dysfunction, manifested by increased urinary excretion of BBMG, occurs in patients with hepatorenal syndrome and deep jaundice. This measurement cannot, therefore, be used to make a diagnosis of acute tubular injury, as due t,o aminoglycosides, in such patients.