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 functional overload and the process of hyperfiltration, urinary excretion of ET-1-like immunoreactivity (U-ET-1) and urinary excretion of other parameters [beta 2-microglobulin (beta 2-MG), N-acetyl-beta-D-glucosaminidase (NAG), albumin (Alb) and 24-hour creatinine clearance (Ccr24)] were measured before, 1, 2 and 7 days after unilateral nephrectomy in 15 patients with unilateral renal lesions (renal cell cancer, renal pelvic cancer, ureteral cancer and renal tuberculosis) and after unilateral adrenalectomy in 5 patients with adrenal lesions. In the nephrectomy group (NX), Ccr24 significantly decreased at 1 and 2 days after the operation, but the other 4 parameters significantly increased after the operation as compared to preoperative values. In the adrenalectomy 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 after the operation. On the other hand, neither NAG/Cr nor Alb/Cr in NX differed from values in ADX. Comparing ET-1/Cr and other parameters, only 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.