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Proteins, Enzymes and Cells in Urine as Indicators of the Site of Renal Damage

  • Chapter
Nephrotoxicity in the experimental and clinical situation

Part of the book series: Developments in Nephrology ((DINE,volume 19-20))

Abstract

A comparison of the composition of fluid entering and leaving the kidney shows that many of the normal plasma constituents are handled individually — some are eliminated, some are conserved. For example, we have to account for the near absence of glucose and protein and for the appearance of high concentrations of creatinine and urea. To fulfil its role in maintaining a relatively constant internal environment the kidney is able to perform many complex and diverse functions simultaneously. These major functions include filtration, reabsorption, secretion and excretion. Changes in any of these functions will be reflected by a change in the composition of the urine. It is widely accepted that a variety of chemical substances can alter renal function, and the ability to produce a mild and reversible change is important from a pharmacological viewpoint, e.g. diuresis. However, in some instances irreversible effects may occur following incidental exposure to toxic substances. There are several reasons why the kidney may be particularly susceptible to injury. Firstly, renal blood flow is approximately 25% of cardiac output and as such delivers large quantities of blood and contents to the kidney. Secondly, the anatomical and functional properties of the kidney ensure that ample and often unwanted exposure to chemicals occurs by virtue of the blood supply to peritubular membranes and by virtue of tubular fluid at the brush-border membranes in the proximal tubule. Thirdly, the ability to concentrate the glomerular fluid may mean an increase in concentration of 100–1000 fold of certain chemical substances at critical regions of the nephron, e.g. the proximal tubule.

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  1. M. D. Stonard
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  1. The Robens Institute, University of Surrey, Guildford, Surrey, GU2 5XH, England

    P. H. Bach

  2. Biochemical Toxicology Section, Imperial Chemical Industries plc, Alderley Park, Macclesfield, Cheshire, SKI0 4TJ, England

    E. A. Lock

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Stonard, M.D. (1987). Proteins, Enzymes and Cells in Urine as Indicators of the Site of Renal Damage. In: Bach, P.H., Lock, E.A. (eds) Nephrotoxicity in the experimental and clinical situation. Developments in Nephrology, vol 19-20. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-3371-2_4

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