Proteinuria and enzymuria in vesicoureteric reflux

Vesicoureteric reflux is a common abnormality of the urinary tract leading to significant renal morbidity and premature mortality. No reliable non-invasive method exists for its diagnosis. This study investigated the presence of urinary proteins and enzymes in healthy children and those with reflux. A log normal distribution was found for all analyte/creatinine ratios. Significantly higher tubular protein/creatinine ratios were found in patients with reflux nephropathy. Three enzyme/creatinine ratios (n-acetyl-B-D-glucosaminidase, gamma-glutamyl transferase and lactate dehydrogenase) were higher in children with reflux who had no renal scarring, but the degree of overlap with the normal range was such that it is doubtful whether any will be of use as a urinary marker.