Parenchymatous enzymuria
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parenchymatous enzymuria definition urinary enzymes renal tubular injury
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Parenchymatous enzymuria means increased excretion of enzymes into urine because of injury to, or increased turnover of, cells in the renal parenchyma, particularly renal tubular epithelial cells.
- It is therefore a marker of renal tubular damage, often proximal tubular injury.
- Enzymes may leak from damaged cells into tubular fluid, or impaired tubular handling may raise their urinary concentration.
- Examples include N-acetyl-beta-D-glucosaminidase (NAG), gamma-glutamyl transferase, alanine aminopeptidase, alkaline phosphatase, and glutathione-S-transferases.
- It can occur early in acute tubular injury, nephrotoxic exposure such as heavy metals or aminoglycosides, ischemia, and some tubulointerstitial disorders.
- It is sensitive but generally not specific enough to diagnose a particular renal disease alone. Urine concentration, collection conditions, and non-renal urinary tract sources may affect results.
In contrast, non-parenchymatous enzymuria can arise from the lower urinary tract, inflammation, infection, or contamination rather than the renal tissue itself.
- Tietz Textbook of Laboratory Medicine, 7th ed., p. 1076
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