SERUM LEVELS OF IGG ANTIBODIES AGAINST TAMM-HORSFALL PROTEIN AND URINARY-EXCRETION OF NAG AND ALPHA-1-MICROGLOBULIN AS POSSIBLE MARKERS FORTUBULAR DAMAGE IN PATIENTS WITH A CONTINENT ILEAL RESERVOIR FOR URINARY-DIVERSION

Serum IgG antibodies against Tamm-Horsfall protein and urinary excreti on of NAG and alpha-1-microglobulin were measured in 26 patients with a Kock reservoir for continent urinary diversion or orthotopic bladder reconstruction in order to detect any signs of tubular damage. None o f these markers for tubular damage was correlated to the postoperative observation time ranging between 2 and 16 years. No correlation was f ound between these markers and signs of renal scarring or upper urinar y tract dilatation as judged from urographies. A positive correlation was demonstrated between NAG excretion and antibodies against Tamm-Hor sfall protein. The annual reduction in GFR was increased in patients w ith elevated alpha-1-microglobulin excretion but not in patients with elevated titres of antibodies against Tamm-Horsfall protein or increas ed NAG excretion. Patients with previous or present reflux nipple prob lems had elevated excretion of alpha-l-microglobulin. Regular determin ations of alpha-l-microglobulin excretion appear to be of value in the follow-up of these patients.