[Beta 2-microglobulinuria and lysozyme-uria. Their role as diagnostic and therapeutic indicators in dilatation of the upper urinary tract during pregnancy].

In a prospective clinical trial the diagnostic and therapeutic validity of beta 2-microglobulinuria (as an indicator of tubulointerstitial damage) and lyzozymuria (as an indicator of granulomonocytic activity in urinary tract) was studied in pregnant women with dilatation of the upper urinary tract and its possible complications (urinary tract infections, acute pyelonephritic episodes). A pathologically increased beta 2-microglobulinuria (greater than 300 micrograms/l) was found in all of the infectious episodes of upper urinary tract: pyelonephritis (PN) with concomitant tubulointerstitial lesions. Asymptomatic PN-episodes could also be recognized by increased beta 2-microglobulinuria. A normal beta 2-microglobulinuria (less than 300 g/l) in pregnant women can--inspite of dilatation of the pyelon--be considered as primary or secondary (after chemotherapy) absence of infection of the upper urinary tract. Furthermore, any functional damage of the tubulointerstitial tissue, possibly caused by the pyelondilatation during pregnancy, can be excluded. A positive lysozymuria (less than 0.3 mg/dl) indicates the infection of the lower and/or upper urinary tract; also asymptomatic infectious episodes may be detected. A negative lysozymuria (less than 0.3 mg/dl) proves the absence of any infection in the lower and upper urinary tract. Pseudo-infections, caused by contamination, can also be revealed. The determination of beta 2-microglobulinuria and lysozymuria increases the diagnostic and therapeutic potency in the evaluation of dilatation of upper urinary tract and its complications during pregnancy.