Urinary excretion of beta-hexosaminidase in patients with vesico-ureteric reflux

Urinary excretion of beta-hexosaminidase was studied in 50 patients with vesico-ureteric reflux (VUR) in order to obtain information on the renal injury in this disease. There was no correlation between urinary enzyme excretion and the degree of VUR. Patients without pyelonephritis changes and with normal serum creatinine values showed normal excretion of beta-hexosaminidase. Patients with pyelonephritic changes but normal serum creatinine had enzyme activity towards the upper limit of the normal range whilst patients with pyelonephritic changes and decreased renal function (high serum creatinine) showed increased excretion of urinary beta-hexosaminidase. Some of the patients with VUR and asymptomatic bacteriuria exhibited increased excretion of urinary beta-hexosaminidase and six with acute pyelonephritis had very high levels. These findings indicate that the infective process plays an essential role, besides VUR, in the development of kidney damage.