A change of urinary proteins from a glomerular pattern to a tubular pattern during a late diuretic phase of acute renal failure

Abstract

The proteinuria on admission, on the 3rd day of the disease, of a 15-year-old male patient with acute renal failure (vasomotor nephropathy) showed a glomerular proteinuria-predominant pattern, and had a normal activity of N-acetyl-beta-D-glucosaminidase, indicating little proximal tubular damage. During a late diuretic phase, the excretion of N-acetyl-beta-D-glucosaminidase in the urine increased in accordance with increases of sodium excretion and urine flow, and then decreased to the normal range on the 20th day of the disease. Urine during the late diuretic phase showed a tubular proteinuria pattern and finally returned to a normal pattern on the 47th day of the disease. Thus, transient proximal tubular damage was evidenced in the late diuretic phase of the patient.