Variability of kidney tubular interstitial distortions in glomerulonephritis as measured by 1H-NMR urinalysis

1H-NMR urinalysis is used for reliable non-invasive diagnostics of tubular and papillary distortions in glomerulonephritis. The study of urine from 52 patients with various clinical forms of the disease shows that these dysfunctions can manifest and develop independently of the degree of glomerular lesions at any stage of the glomerulonephritis. Tubular and papillary changes can be negligible even in terminal uremia and drastic in cases of clinically preserved kidney function. In addition, the results indicate that not only tubular interstitial changes, but also isolated tubular or papillary distortions can develop at any stage of the disease. Thus 1H-NMR urinalysis is suitable for diagnosing latent tubular interstitial changes which are not readily detected by traditional techniques. This is important since early tubular intervention worsens the prognosis of the glomerulonephritis progression. Thus an approach enables identification of a group at risk of rapid deterioration of the disease among patients whose serum has normal creatinine levels. This additional information is valuable for the proper treatment of patients, and makes 1H-NMR urinalysis a prospective method for screening urine in glomerulonephritis. Further studies are required to decide whether the technique can be recommended for clinical practice.