Clinical implication of microproteinuria and urine enzyme in the detection of early renal damage by antibiotics

Abstract

Objective To analyze the clinical significance of serial microproteinuria and urease detection in early diagnosis of antibiotics damage to kidney by observing the changes of urine microalbumin/creatinine ratio(mAlb/Cr), transferrin(TRF), IgG, α1-microglobulin(α1-MG), β2-microglobulin(β2-MG), retinol-binding protein(RBP) and N-acetyl-β-D-glucosaminidase(NAG). Methods A total of 161 children with pneumonia whose test results were normal of urine protein, blood urea nitrogen(BUN) and serum creatinine(Scr), and had no related history of kidney diseases were selected.All the patients were divided into three groups according to antibiotics for the treatment, the penicillins(penicillin G, amoxicillin and potassium clavulanate, ticarcillin and potassium clavulanate) group, the cephalosporins (cefazolin, cefuroxime, ceftriaxone, cefoperazone, ceftazidime) group and the macrolides(erythromycin, azithromycin)group.Changes of mAlb/Cr, TRF, IgG, α1-MG, β2-MG, RBP, NAG, BUN, Scr levels of the patients one week before and after use the antibiotics were observed, and statistically analyzed. Results In the penicillins group and macrolides group, the results showed that none of the serial microproteinuria and urease changed(all P>0.05). In the cephalosporins group, the urine mAlb/Cr, TRF, β2-MG and NAG were higher than before using the antibiotics[(15.56±5.98)mg/g vs.(21.08±10.88)mg/g, (1.61±0.14)mg/L vs.(1.66±0.14)mg/L, (0.25±0.09)mg/L vs.(0.28±0.11)mg/L, (4.62±3.80)U/L vs.(4.98±3.97)U/L, t=-5.11, -3.24, -2.29, -2.04, P 0.05). Conclusion Combined detection of serial microproteinuria and urease has great clinical significance in judgment and warning of early renal damage by antibiotics. Key words: Anti-bacterial agents; Renal damage; Kidney function tests; Drug monitoring; Child