[Renal tubular impairment after surgery].

It is well known that acute renal failure (ARF) after surgery has a high mortality rate. The purpose of this paper is to clarify the renal tubular damage following surgery. Urinary beta 2 microglobulin (u-BMG) and urinary N-acetyl-beta-D-glucosaminidase (u-NAG) activities, thought to be the sensitive indicators of renal tubular impairment, were measured in 48 patients treated surgically in our clinic. Three out of 48 patients developed ARF. Remaining 45 showed normal values in conventional renal function tests, while u-BMG and u-NAG revealed abnormally high levels in many cases. Bleeding amount during surgery, operative time, postoperative complications, especially circulatory shock, and preoperative hypotention were the factors which correlated closely to the elevation of u-BMG and u-NAG. Administration of urinastatin prevented the u-NAG elevation postoperatively, while it had no effect on u-BMG.