Urinary biomarkers in assessing the nephrotoxic potential of gentamicin in solitary kidney patients after 7 days of therapy

Gluhovschi, Gheorghe; Gădălean, Florica; Gluhovschi, Cristina; Velciov, Silvia; Petrică, Ligia; Bob, Flaviu; Bozdog, Gheorghe; Kaycsa, Adriana

doi:10.3109/0886022x.2013.876349

Cited by 4 publications

(2 citation statements)

References 33 publications

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“…Initially fine apical vesicles become large by fusion and dislocate the nucleus at advanced stages, which can be accompanied by functional deterioration. N-Acetyl- β -D-glucosaminidase (NAG) and lactate dehydrogenase (LDH) are damage markers of proximal tubular epithelial cells [133–135]. RCM injection induced a dose-dependent vacuolization with an increase in urinary NAG and LDH excretion that correlated with vacuolization suggesting a pathophysiological role for vacuoles in CI-AKI [106].…”

Section: Characteristic Histopathological Changes In Ci-akimentioning

confidence: 99%

Histopathological Evaluation of Contrast-Induced Acute Kidney Injury Rodent Models

Kiss

Hamar

2016

BioMed Research International

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Contrast-induced acute kidney injury (CI-AKI) can occur in 3–25% of patients receiving radiocontrast material (RCM) despite appropriate preventive measures. Often patients with an atherosclerotic vasculature have to receive large doses of RCM. Thus, animal studies to uncover the exact pathomechanism of CI-AKI are needed. Sensitive and specific histologic end-points are lacking; thus in the present review we summarize the histologic appearance of different rodent models of CI-AKI. Single injection of RCM causes overt renal damage only in rabbits. Rats and mice need an additional insult to the kidney to establish a clinically manifest CI-AKI. In this review we demonstrate that the concentrating ability of the kidney may be responsible for species differences in sensitivity to CI-AKI. The most commonly held theory about the pathomechanism of CI-AKI is tubular cell injury due to medullary hypoxia. Thus, the most common additional insult in rats and mice is some kind of ischemia. The histologic appearance is tubular epithelial cell (TEC) damage; however severe TEC damage is only seen if RCM is combined by additional ischemia. TEC vacuolization is the first sign of CI-AKI, as it is a consequence of RCM pinocytosis and lysosomal fusion; however it is not sensitive as it does not correlate with renal function and is not specific as other forms of TEC damage also cause vacuolization. In conclusion, histopathology alone is insufficient and functional parameters and molecular biomarkers are needed to closely monitor CI-AKI in rodent experiments.

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Section: Characteristic Histopathological Changes In Ci-akimentioning

confidence: 99%

Histopathological Evaluation of Contrast-Induced Acute Kidney Injury Rodent Models

Kiss

Hamar

2016

BioMed Research International

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“…16,23 In recent literature for humans and animals, it is not uncommon for samples to be frozen at −80°C until urine NAG measurement. 9,11,18,19,23,33 Thus, variation in storage times and conditions between samples in our study was not expected to affect urine NAG results. The effect of storage time and conditions should be evaluated prior to routine use of this assay for diagnostic samples.…”

Section: Discussionmentioning

confidence: 82%

Equine urinary N-acetyl-β-D-glucosaminidase assay validation and correlation with other markers of kidney injury

et al. 2019

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Detection of equine acute kidney injury (AKI) is hindered by limited markers of early renal damage in horses. N-acetyl-β-D-glucosaminidase (NAG), a lysosomal enzyme in renal tubular epithelium released into urine during tubular insult, has shown promise for early identification of AKI in humans and other species. We validated an assay for NAG in equine urine and measured urinary NAG in 7 azotemic and 7 non-azotemic client-owned adult horses. The enzymatic NAG assay was validated using within- and between-run coefficients of variation (CVs), recovery following standard addition, and linearity of dilution. Intra- and inter-run CVs (21% and 3.2%, respectively), average recovery following standard addition (99–109%), and linearity under serial dilution ( R2 = 0.997) were satisfactory. Urine NAG index was significantly correlated with urinary fractional excretion of sodium (FENa; ρ = 0.76, p < 0.001) and plasma creatinine (ρ = 0.74, p = 0.001). Median urine NAG indices were higher in azotemic horses ( p = 0.006), in horses with increased urinary FENa ( p = 0.006), and in horses with increased urine gamma-glutamyl transferase index ( p = 0.032). Urine NAG can be measured in horses and shows positive correlation with 2 current renal biomarkers. Additional work is needed to establish normal equine reference intervals and characterize the increase of urine NAG index in horses in relation to tubular injury.

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Congenital Solitary Functioning Kidney: A Review

Wakabayashi

Pantaleão

Avendanha

et al. 2023

CMC

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Background: Solitary functioning kidney (SFK) is a subgroup of the Congenital Anomalies of the Kidneys and Urinary Tract (CAKUT). Although in the past the prognosis of these patients was considered good, numerous studies have shown different levels of kidney damage associated with this condition. Serum creatinine measurement is still the most used marker to assess renal function, even though the limitations are widely known. Objective: The present review aimed to summarize and update the scientific literature on congenital SFK, discussing its pathophysiology, diagnosis, complications, prognosis, role of novel urinary biomarkers, treatment and follow-up. Results: The natural history of congenital SFK is still an unresolved issue due to several factors. Although it has not yet been proven in humans, Brenner’s hyperfiltration hypothesis is the most concrete theory to explain the poor renal outcomes of patients born with one functioning kidney. The search for novel urinary biomarkers capable of assessing renal function and predicting renal outcomes has already started, but there are still few studies with this specific population. Among the most studied markers, Cystatin C, EGF and NGAL have shown potential usefulness for the follow-up of these patients. The treatment still relies on the search for kidney injury and general renoprotective measures. Conclusion: Further research with longer follow-up duration is needed to better understand the natural course of congenital SFK and the role of novel urinary biomarkers in this specific population. Thus, it will be possible to improve the prognosis of these patients.

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Urinary biomarkers in assessing the nephrotoxic potential of gentamicin in solitary kidney patients after 7 days of therapy

Abstract: We found the nephrotoxic effects of gentamicin at tubular level, but not at glomerular level. The nephrotoxic potential of gentamicin in patients with a SK can be monitored by assessing urinary biomarkers during treatment of UTI.

Cited by 4 publications

References 33 publications

Histopathological Evaluation of Contrast-Induced Acute Kidney Injury Rodent Models

Histopathological Evaluation of Contrast-Induced Acute Kidney Injury Rodent Models

Equine urinary N-acetyl-β-D-glucosaminidase assay validation and correlation with other markers of kidney injury

Congenital Solitary Functioning Kidney: A Review

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