INCREASED ENZYMURIA IN DIABETIC CHILDREN WITHOUT PERSISTENT MINIMAL ALBUMINURIA

The urinary activity of the enzyme N-acetyl-beta-glucosaminidase is a useful, early marker of renal tubular damage in various conditions. Co nsequently, it is tempting to presume that the excretion of this enzym e might recognize subclinical renal damage long before elevation of ur inary albumin excretion. The urinary N-acetyl-beta-glucosaminidase act ivity was therefore assessed in a group of 77 diabetic patients (37 gi rls and 40 boys, aged 2.9-20 years) without persisting minimal albumin uria. Circulating glycosylated haemoglobin and fructosamine were signi ficantly higher in the 24 patients with persistently increased urinary N-acetyl-beta-glucosaminidase compared with the remaining patients. I t is concluded that raised urinary N-acetyl-beta-glucosaminidase might be the earliest detectable abnormality of renal damage in chronic dia betes mellitus.