CHANGES IN URINARY-EXCRETION OF ENDOTHELIN-1-LIKE IMMUNOREACTIVITY BEFORE AND AFTER UNILATERAL NEPHRECTOMY IN HUMANS - COMPARISON WITH OTHER URINARY PARAMETERS AND UNILATERAL ADRENALECTOMY

To assess the value of endothelin-1 (ET-1) as a parameter of renal fun ctional overload and the process of hyperfiltration, urinary excretion of ET-l-like immunoreactivity (U-ET-1) and urinary excretion of other parameters [beta(2)-microglobulin (beta(2)-MG), N-acetyl-beta-D-gluco saminidase (NAG), albumin (Alb) and 24-hour creatinine clearance (Ccr2 4)] were measured before, 1, 2 and 7 days after unilateral nephrectomy in 15 patients with unilateral renal lesions (renal cell cancer, rena l pelvic cancer, ureteral cancer and renal tuberculosis) and after uni lateral adrenalectomy in 5 patients with adrenal lesions. In the nephr ectomy group (NX), Ccr24 significantly decreased at 1 and 2 days after the operation, but the other 4 parameters significantly increased aft er the operation as compared to preoperative values. In the adrenalect omy group (ADX), neither Ccr24 nor ET-1/Cr showed any change after the operation, but the other 3 parameters (beta(2)-MG/Cr, NAG/Cr and Alb/ Cr) significantly increased. Comparing the NX and ADX groups, both ET- 1/Cr and beta(2)-MG/Cr in NX were significantly higher than in ADX aft er the operation. On the other hand, neither NAG/Cr nor Alb/Cr in NX d iffered from values in ADX. Comparing ET-1/Cr and other parameters, on ly beta(2)-MG showed a positive significant correlation. These results suggest that U-ET-1 may be an indicator of functional overload of the kidney.