178: 'Urinary Enzymes in Neonates after Asphyxia and during Gentamycin therapy'

Two β-Glycosidases, N-Acetyl-β-Glucosaminidase (N.A.G.), and β-Galactosidase (G.A.L.), and Acid Phosphatase (A.P.) have been estimated fluorimetrically in the urine of neonates to detect renal damage and the results expressed per m.mole urinary creatinine. Bag urines were collected, but to minimise contamination were discarded if faeces were passed simultaneously. A.P. is less affected by contamination than are G.A.L. or N.A.G.. There is no sex difference in the excretion of A.P. N.A.G. and G.A.L. can be stored ae 4°C before estimation for more than one month;A.P. should be estimated within four days. N.A.G. levels were raised in three cases of perinatal asphyxia and normal in one. Acute asphyxia in two cases did not cause any elevated enzyme levels. G.A.L. was raised in only one of the three cases while A.P. was raised once only in the same case. These results support the theory that acute asphyxia does not damage the renal tubules, while more prolonged asphyxia may. Two neonates have been studied during treatment with Gentamycin. N.A.G. levels are markedly raised during treatment - in one case eight times higher than pre-treatment levels within 24 hours. G.A.L. was intermittently raised and A.P. was not raised during treatment. The consistently raised levels of N.A.G. during Gentamycin therapy in neonates is suggestive of renal tubular cell dysfunction. We gratefully acknowledge the financial assistance of the Research Endowments Fund of St.Thomas' Hospital.