[Renal tubular impairment in traumatized patients]

Urinary beta 2-microglobulin (beta 2M) and N-acetyl-beta-D-glucosaminidase (NAG) in addition to conventional renal parameters such as creatinine clearance (Ccr), free water clearance (CH2O) and fractional excretion of sodium (FENa) were measured in 79 traumatized patients. These patients were separated into two groups, one with shock on admission (N = 43). In patients with shock, CH2O, FENa and urinary excretion of Beta 2M and NAG indicated abnormal levels correlating with impairment of Ccr, inspite of adequate urine output, on the day of trauma. Even in patients without shock, urinary Beta 2M and/or NAG increased without impairment of urine output, Ccr, CH2O and FENa, and did not return to normal level during the following 7 days. The results suggest a liability to damage and the delayed improvement of renal tubulus in traumatized patients.