Urinary beta-glucuronidase in renal cell carcinoma.

The aim of the paper was to study the urinary beta-glucuronidase activity in 30 patients with renal cell carcinoma (RCC), histopathologically proven after surgery, and 32 healthy subjects taken as controls. Classification of patients was done using the TNM system. A statistically significant increase (p < 0.01) in this enzyme was found in RCC patients, without relation to the changes in the urinary sediment (hematuria, pyuria, bacteriuria) or tumor dissemination. Urinary beta-glucuronidase is a useful marker in the diagnosis of malignant renal tumors.

Urinary N-acetyl-beta-glucosaminidase in the prediction of preeclampsia.

The urinary excretion of N-acetyl-beta-glucosaminidase (NAG), a lysosomal enzyme of the renal tubular cells was analyzed in 177 women divided into nonpregnant healthy controls (n = 46), normal pregnant women in their third trimester (n = 49), pregnant women with transient hypertension (n = 43), and women with preeclampsia (n = 39). Urinary activity of NAG was increased in normal pregnant women and in patients with transient hypertension in pregnancy compared to nonpregnant healthy controls. In preeclamptic women, this increase was found to be much higher than that corresponding to their gestational age; this fact is due to the tissue ischemia that precedes glomerular endotheliosis, but also tubular lesions caused by arteriolar vasoconstriction may have an important role.

[Study of serum C3 and C4 fractions in patients with glucose-6-phosphate dehydrogenase deficiency (author's transl)]. / Estudio del C3 y C4 en el déficit en glucosa-6-fosfato deshidrogenasa.

Activity of serum C3 and C4 fractions have been measured in 35 individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency and various clinical manifestations. Determination of serum complement was carried out in six cases during an abrupt hemolytic phase; the remaining 29 patients were asymptomatic at the time of laboratory test, but the past history revealed acute hemolytic syndroe in 11 cases. There were no statistical significant differences between C3 and C4 fraction levels of patients with G6PD deficiency and those corresponding to a group of 30 normal controls. Immunoallergic theories causing hemolytic episodes in patients with G6PD deficiency are discussed.

[Microalbuminuria in arterial hypertension]. / Microalbuminuria en la hipertensión arterial.

Microalbuminuria is a considerable good indicator of atherogenic disease and cardiovascular risk. In the arterial hypertension, the main centre organ is the kidney. Structural and functional changes that happen in the hypertensive nephropathy are going to cause alterations m the albumin urinary excretion. The authors have done a revision of the main factors which can origin the existence of microalbuminuria in patients with arterial hypertension, and they conclude that this is an useful biochemist indicator in order to evaluate the degree of renal disease in these patients.

[Allergic granulomatosis as a systemic disease]. / Granulomatosis alérgica como enfermedad sistémica.

The Churg-Strauss's allergic granulomatosis is an entity considered by some authors as a simple clinical problem within the context of vasculitis, but that given its anatomopathological and clinical characteristics (different from other vasculitis), must be studied as a separate syndrome. Its incidence depends on the strictness in the application of the diagnosis criteria and its pathogenic is unknown. Although the most frequent pathology is respiratory, we review the affectation of other organs and systems (circulatory, digestive, urogenital, locomotive, nervous system, skin, etc.), stressing the relevance of its knowledge for a correct diagnosis. The current therapy is based in seeking an useful drug, which added of the patients. of the patients.

[Idiopathic hemochromatosis, analysis of 19 cases]. / Hemocromatosis idiopática (análisis de 19 casos).

We studied 19 patients with idiopathic haemochromatosis between 12,000 patients by the Department of Internal Medicine. By 17 the diagnosis was made very late with severe state of chronic liver disease, only two went to consult because transaminases were increased without exploration in routinary examination. Hepatomegalie was constant exploratory feature (100%) followed by impaired hydrocarbonated metabolism (52%). The biochemical usual pattern was: hipersideremie, decreased transferrin and increased transaminases activities in all the patients. Increased iron urinary excretion (more than 8 g/24 h) with desferroxiamine administration is a useful biochemical feature if because severe liver disease the biopsy punction was not indicated due to impaired hemostasia. Because the serious illness with late diagnosis and the normal survival if the diagnosis is early the iron metabolism would be useful screening as in another countries.

[The treatment of incipient diabetic nephropathy (2nd of 2 parts)]. / Consideraciones sobre el tratamiento de la nefropatía diabética incipiente (segunda de dos partes).

Besides diabetic patients are controlled with glycosylated hemoglobins not exceeding 7% and the normalization of blood pressure with some hypotensive drugs, it has been noted the important role of protein restriction in diet in order to retard nephropathy progression. For some years, various aldose reductase inhibitors (ARIs) have been used, which avoid the accumulation of sorbitol in tissues as well as complications. Platelet antiaggregants are also used for the treatment of diabetic nephropathy, but at a lower level.

[Considerations on the treatment of incipient diabetic nephropathy (lst of 2 parts)]. / Consideraciones sobre tratamiento de la nefropatía diabética incipiente (Primera de dos partes).

Diabetic nephropathy is the third cause of renal failure after pyelonephritis and glomerulonephritis. Lately, many efforts have been made for the early identification (on the silent stage) of patients with a high risk of developing this disease. On these initial stages, therapeutic attitude has changed very much, emphasizing nowadays the importance of glucose levels control, avoiding maintained conditions of hyperglycemia and maintaining blood pressure within the limits, by using the therapeutic store available, basically calcium antagonists and angiotensin-converting enzyme inhibitors.

[Early biochemical indicators of renal damage in arterial hypertension]. / Indicadores bioquímicos precoces de daño renal en la hipertensión arterial.

Hypertensive nephropathy is an important complication of arterial hypertension, being a cause of chronic renal insufficiency in a considerable number of patients. For years it has been attempted to find an useful marker of nephropathy in the incipient phases of the disease. We revised the main biochemical indicators of renal damage, paying special attention to hyperuricemia, microalbuminuria, and urinary excretion of beta-2-microglobulin and N-acetyl-beta-glucosaminidase. Each one of them expresses alterations in the glomerular filtrate, lesion of capillary endothelium or anomalies of the tubular function. None of them demonstrated to be specific to nephroangiosclerosis, but they guide us on the structural and functional alterations occurring in the first stages of hypertensive nephropathy.