Urinary Enzymes and Microalbuminuria as Indicators of Renal Nephropathy in Saudi Patients

In the current work we tried to investigate some newbiochemical markers in the urine of kidney patients, kidney transplantrecipients and control subjects of the Saudi population, such markers areN-acetyl-β-D-glucosaminidase (NAG), Alkaline Phosphatase (ALP),Alanine Aminopeptidase (AAP) as well as microalbuminuria. Kidneypatients, males and females, age ranged from 16-85 years, and kidneytransplant recipients, male and female, age ranged from 18-75 years.Results from control subjects showed a slight elevation of totalurinary protein and NAG in females. This may be due to the higherlevel of creatinine concentration in male subjects, that would result inlower protein concentration and NAG activity when expressed interms of creatinine. Microalbuminuria, glucose and pH results were inclose agreement with the published data and no sex differences wererecorded when compared with the males. There were statisticallysignificant differences in most of parameters investigated betweenkidney patients and the normal population except for glucose leveland pH value. The reduction in creatinine concentration may reflectchanges in the glomerular filtration rate (GRF). Higher levels ofurinary NAG activity were associated with high microalbuminuriaand raised AAP levels.Increase urinary NAG predominantly reflects decreased renal functionand tubular damage. ALP increased levels reflect a lesion of theproximal convoluted tubules and/or intensive degeneration of thetubular epithelial cells. The increase in NAG activity correlates wellwith urinary protein and may indicate an increase in activity of renaltubular cells. Kidney transplant recipients showed a significantincrease in NAG, ALP and AAP enzymes compared to controlsubjects. The marked increase in most parameters may indicate thatpatients are in an immediate functioning graft.