Enzymuria as a marker of occupational nephrotoxicity
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Routine renal function tests are insensitive for detection of subclinical renal impairment. A marker of early renal affection is needed for screening of workers at risk. In this study the activity of urinary N-acetyl-B-Dglucosatninidase (NAG) was measured to detect early renal changes in healthy and ill groups of workers exposed to nephrotoxic chemicals. The efficacy of NAG was compared with that of urinary B2-microglobulin. The studied groups included 132 subjects: 37 chemical laboratory workers exposed to aliphatic hydrocarbon solvents, 33 car painters exposed to aromatic hydrocarbon solvents and 26 plumbers exposed mostly to lead fumes and a control group of 36 clerks, matched the exposed groups in age, sex' and residence. Exposure indices included lifetime hydrocarbon exposure score (HES), Lead in blood (Ug/dL) and lifetime exposure score for lead (LES-Pb). Levels of urinary NAG differed significantly in all groups compared to controls. Unlike B2- microglobulin, NAG levels showed a strong and consistent correlation with cumulative exposure indices (HES and LES-Pb). Furthermore, an exposure-effect relationship existed between NAG and HES in solvent-exposed normotensive subjects. NAG levels were higher in solventexposed hypertensives than normotensives. These results support the use of urinary NAG in periodic screening of workers at risk, especially hypertensives and those with renal disease.