Lack of Relationship between Urinary Glycosaminoglycans and Indices of Tubular or Glomerular Renal Damage

Bernard, Alfred; Ouled, A.; Roels, Harry; Lauwerys, Robert; Vandeleene, Bernard; Lambert, A

doi:10.1159/000184878

Cited by 12 publications

(5 citation statements)

References 5 publications

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“…I Application to workers exposed to mercury vapour Table 6 Immnunological miiarkers inl control and workers exposed to Hg detection of glomerular or tubular injury is unclear as no relation has been found with other indices of renal damage in humans. 56 An increased excretion of GAG has also been suggested to be an indicator of damage to the renal papilla,57 which is rich in GAG.58 Like other kidney derived components (for example, Tamm-Horsfall glycoprotein), the urinary excretion of GAG is also dependent on renal synthesis, a reduction of which might explain the slight decrease in urinary GAG found in the cohort exposed to Hg (table 3). Urinary kallikrein is a serine protease (EC 4.4.21.35), synthesised by distal tubule cells, which might serve as an index of distal nephrotoxicity.…”

Section: Discussionmentioning

confidence: 99%

Markers of early renal changes induced by industrial pollutants. I. Application to workers exposed to mercury vapour.

Cárdenas

Roels

Bernard

et al. 1993

Occupational and Environmental Medicine

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Several markers of renal changes have been measured in a cohort of 50 workers exposed to elemental mercury (Hg) and in 50 control workers. After application of selection criteria 44 exposed and 49 control workers were retained for the final statistical analysis. Exposed workers excreted on average 22 micrograms Hg/g creatinine and their mean duration of exposure was 11 years. Three types of renal markers were studied--namely, functional markers (creatinine and beta 2-microglobulin in serum, urinary proteins of low or high molecular weight); cytotoxicity markers (tubular antigens and enzymes in urine), and biochemical markers (eicosanoids, thromboxane, fibronectin, kallikrein, sialic acid, glycosaminoglycans in urine, red blood cell membrane negative charges). Several bloodborne indicators of polyclonal activation were also measured to test the hypothesis that an immune mechanism might be involved in the renal toxicity of elemental Hg. The main renal changes associated with exposure to Hg were indicative of tubular cytotoxicity (increased leakage of tubular antigens and enzymes in urine) and biochemical alterations (decreased urinary excretion of some eicosanoids and glycosaminoglycans and lowering of urinary pH). The concentrations of anti-DNA antibodies and total immunoglobulin E in serum were also positively associated with the concentration of Hg in urine and in blood respectively. The renal effects were mainly found in workers excreting more than 50 micrograms Hg/g creatinine, which corroborates our previous estimate of the biological threshold of Hg in urine. As these effects, however, were unrelated to the duration of exposure and not accompanied by functional changes (for example, microproteinuria), they may not necessarily represent clinically significant alterations of renal function.

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Section: Discussionmentioning

confidence: 99%

Markers of early renal changes induced by industrial pollutants. I. Application to workers exposed to mercury vapour.

Cárdenas

Roels

Bernard

et al. 1993

Occupational and Environmental Medicine

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“…Their determination in urine has been suggested for the detection of minimal glomerular damage in diabetics, urolithiases or urinary tract infections [1][2][3]. This was recently challenged be cause a correlation between the urinary GAG concentra tion and other parameters of kidney damage could not be confirmed [4].This discrepancy could perhaps be ascribed to the way the urine was collected or to the method of diuresis accounting. Indeed, if there is a circadian rhythm and/or if the GAG excretion does not parallel the creatinine excretion a spot urine corrected for creatinine content could be inappropriate for detecting a difference be tween patients and controls.…”

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confidence: 99%

“…Indeed, if there is a circadian rhythm and/or if the GAG excretion does not parallel the creatinine excretion a spot urine corrected for creatinine content could be inappropriate for detecting a difference be tween patients and controls. Therefore, we tried to evalu ate the relations between GAG excretion, circadian rhythm, urinary creatinine, specific gravity and diuresis.GAG were assayed by the method of Whiteman [5,6] as in the studies by Baggio et al [1,2] and Bernard et al [4], An external quality control with these last authors showed a very good linear correlation between both laboratories (r = 0.99; n = 12). …”

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confidence: 99%

Glycosaminoglycans and Urine Flow Rate

Hotz

Pilliod²,

Boillat³

1989

Nephron

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The value of glycosaminoglycans determination in urine has been challenged because the relation between the glycosaminoglycans concentration and other signs of kidney damage is a matter of controversy. It is quite possible that the observed discrepancies could be due to the influence of the urine flow rate, the urine concentration and the time of day on the glycosaminoglycans concentration. Therefore, standardization of the urine sampling time and selection of the most appropriate unit to quantify glycosaminoglycans excretion seem to be essential.

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“…More interesting is that the blood pressure increases the GAG excretion as well. As both blood pressure and diuresis are not always considered, this can explain some discrepancies between authors [29]. It could explain as well why the measurement of the red blood ceil negative charges which are thought to reflect changes in the negative charges of glomerular polyanions do not closely parallel the urinary GAG concentration in cadmium-exposed workers [3], Never hydrocarbon-exposed workers must have com pletely different jobs from the exposed ones.…”

Section: Discussionmentioning

confidence: 99%