Abstract
Urinary glycoprotein of Tamm and Horsfall (T & H) is a renal substance found in the ascending limb of the loop of Henle and the distal convoluted tubule. Excretion can be measured by 0.58 M NaCl precipitation. Normal excretion = (1.7–2.1 mg/hr/1.73 sq. m. body surface area). Increased excretion occurs with dichromate-induced renal tubular damage in rats. This observation suggested that monitoring T & H excretion might provide an early index of kidney damage in human allograft rejection. Eight patients (4 males, 4 females. Age 9–49 years) were studied during the first 37–120 days post-transplantation. Seven rejection episodes in 5 patients were diagnosed clinically. In each instance T & H excretion exceeded 25 mg/24 hours (½ upper limit of normal adult excretion = normal excretion of one kidney) prior to the onset of clinical rejection. The interval between onset of increased excretion and clinical rejection was between 4 and 14 days (mean = 9 days). Peak excretion rates up to 110 mg/24 hours occurred. High excretion rates in chronic rejection (1 patient) and in glomerulonephritis of the transplanted kidney (1 patient) were also observed. In these instances T & H was primarily in the form of insoluble urinary casts. Since anti-rejection measures are likely to be more effective when the diagnosis of a rejection episode is early, T & H measurement has a practical clinical value.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Schwartz, R., May, A., Schenk, E. et al. Tamm-Horsfall glycoproteinuria: An early index of human renal allograft rejection. Pediatr Res 5, 385 (1971). https://doi.org/10.1203/00006450-197108000-00062
Issue Date:
DOI: https://doi.org/10.1203/00006450-197108000-00062