Diagnostic value of urinary enzyme determination in renal transplantation

Abstract

The measurement of enzyme activity in urine provides a sensitive assessment for renal tubular cell damage. The present study was undertaken to evaluate the clinical value of the determination of tubular brush-border-associated enzymes, alkaline phosphatase (AP), gamma-glutamyl transferase (GGT), leucine aminopeptidase (LAP), and dipeptidyl peptidase IV (DPP), of patients with normal graft function (NOR, n = 20), with acute tubular necrosis (ATN, n = ll), with an acute rejection episode (ARE, n = 17) after transplantation, and of healthy persons (n =20). The second urine of the morning was collected daily during the patients' stay in hospital. The enzyme activities were measured at 25 "C and were expressed as Uimmol creatinine. The enzymuria in NOR is higher than in healthy controls, but is still in the normal range. By 5 days after transplantation the initial increased excretion declines as the graft function

Biomarkers of Acute Kidney Injury

“…Enzymuria was increased with both acute rejection and ATN. Successful treatment of rejection resulted in a decrease in the enzymuria 66. In a prospective pilot study of 26 consecutive critically ill adult patients admitted to the ICU, urinary levels of γGT, AP, NAG, and alpha- and pi-glutathione S-transferase (alpha- and pi-GST) but not lactate dehydrogenase were higher in the AKI group on admission and were useful in predicting AKI 67…”

Enzyme Biomarkers of Renal Tubular Injury in Arterial Surgery Patients

“…2,7,16,17 The main finding of this study is that factors, which chronically alter renal function, such as diabetes and hypertension, probably influence the detection of these enzymes after surgery, and therefore influence their use as markers of tubular dysfunction.…”

Untitled

“…[9][10][11][12][13][14] Thus, such enzymes as N-acetyl-β-D-hexosaminidase (NAG), [15][16][17][18] γ-glutamyl transpeptidase (GGT), 16,[19][20][21] and alkaline phosphatase (AP) 19,20 have been proposed for in-depth assessment of the KAG state. However, most published studies on these biomarkers in KAG recipients were limited to the early posttransplant period 16,18,20,22,23 and focused on the diagnosis of acute tubular necrosis, 16,18,20,22,23 acute graft rejection, 16,20,23 or nephrotoxicity. 17,23 Only a few studies were dedicated to the problem of chronic graft injury.…”