Bradwell
AR, Delamere JP. The effect
of acetazolamide on proteinuria at altitude
Aviation, Space & Environmental Medicine. 1982 53(1): 40-43
Albumin
was measured by dipstick tests and immunologically in 24-h and early morning
urine (EMU) samples collected from 20 subjects during a high-altitude trek.
Each was given acetazolamide (Diamox sustets) or placebo as part of a
double-blind trial on the prophylactic use of acetazolamide in acute mountain
sickness (AMS). At the highest altitudes, albuminuria was six times greater
in those on placebo (p<0.001) and was related to the clinical features of AMS
(p<0.01) and arterial oxygen tension (p<0.001). Urine dipsticks tests for proteinuria were also an index of
AMS, but were inaccurate. The
proteinuria is probably due renal hypoxia, which causes increased glomerular
permeability, reduced tubular readsorption, or both.
The reduction in the clinical features of AMS achieved with acetazolamide
therapy is also associated with improved renal function.