TIME RELATED RESPONSE OF URINARY CYCLIC ADENOSINE-MONOPHOSPHATE TO TRAUMA

  • 1 January 1976
    • journal article
    • research article
    • Vol. 143  (6) , 901-905
Abstract
Urinary cyclic[c]AMP levels were measured in 150 patients with accidental injury of varying causes. Healthy adults (38) of both sexes serving as controls excreted 2.21-6.85 .mu.mol of cAMP/g of creatinine, mean 4.34 .+-. 1.25. In 120 patients with trauma on admission, the excretion was increased by 15.7%, P < 0.05, and the changes showed a time related pattern. In patients admitted within the first 30, 60 and 120 min after trauma, the mean excretion was changed by 19, 10 and minus 2.8%, respectively, and in those admitted between 2 and 24 h, by 30%. Patients (12) with differing types of trauma showed a mean 24 h excretion reaching its peak on the 1st day, 44%, and declining to its nadir of 2.25 .mu.mol/g of creatinine on the 3rd day, minus 47%, P < 0.01. A 2nd rise reached its peak on the 5th day, P < 0.05. Thereafter the excretion fluctuated widely with peaks significantly above and below the control range, without correlation to any specific factors. In post-traumatic acute renal failure, the nucleotide excretion fell within several hours and usually reached low values, i.e., below 0.25 .mu.mol/l per 24 h within 1-3 days. In general, the excretory pattern for cAMP followed that of creatinine clearance, but in the diuretic phase of the recovering kidney, the cAMP levels remained more depressed than those of creatinine. The high sensitivity of urinary cAMP to abnormalities in renal function suggests its potential as a clinical indicator.

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