Urinary excretion of proteins and tubular enzymes in renal transplant patients

Donadio, Carlo; Puccini, R; Lucchesi, Annalisa; Giordani, Roberto; Rizzo, G

doi:10.3109/08860229809045167

Cited by 19 publications

(22 citation statements)

References 10 publications

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“…Higher excretion of p-GST, an isoenzyme localized and released from various nephron segments, in particular the distal tubule, can be a sign of widespread renal damage, which is distinctive for an AGR. Tissue localization of this isoenzyme may explain higher excretion in AGR than in ATN patients, where ischemic injury focuses mostly on proximal tubule [17]. Significantly raised p-GST excretion in AGR group compared to SGF and ATN recipients suggests the usefulness of its measurement for differentiation of AGR from other post-transplant renal disorders [7,16].…”

Section: Discussionmentioning

confidence: 99%

Enzymuria and low molecular weight protein excretion as the differentiating marker of complications in the early post kidney transplantation period

et al. 2006

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Renal function in the early post-transplantation period depends largely on factors affecting the kidney prior to implantation. Function of the graft may be also disturbed by the most common complications of the early post-operative period such as acute graft rejection (AGR), acute tubular necrosis (ATN) and may be modified by nephrotoxic action of cyclosporine A (CsA). Evaluation of excretion of enzymes and low molecular weight proteins (LMWP) may help in the differentiation of these complications. Aim Comparison of the urinary excretion of markers of tubular injury in patients with AGR, ATN, or patients with stable graft function (SGF) was made and differences between groups and correlations between markers and cold ischemia time (CIT), warm ischemia time (WIT) and blood trough level of cyclosporine A (CsA0) were determined. Material and methods In 60 cadaveric renal allograft recipients in the early post-transplantation period urinary excretion of N-acetyl-beta-D-glucosaminidase (NAG) and B isoenzyme (NAG-B), alanylaminopeptidase (AAP), gamma-glutamyltransferase (GGT), alpha and pi isoenzymes of glutathione S-transferase (alpha-GST, pi-GST), retinol binding protein (RBP) and beta2- microglobulin (beta2M), were analyzed. Results NAG and NAB-B activities were higher in ATN (P<0.05, P<0.01) and in AGR (P<0.005, P<0.02) than in SGF. Excretion of pi-GST was higher in AGR than in SGF (P<0.0002) or ATN (P<0.007). CIT and WIT in patients with ATN were higher (P<0.05) than in SGF group. In ATN patients, correlations of CIT with RBP (P<0.05) and pi-GST (P<0.05), and WIT with RBP (P<0.05), and pi-GST (P<0.001) were found. Conclusions High urinary NAG and NAG B excretion characterizes ATN and AGR patients. Evaluating urinary excretion of pi-GST may be helpful in differentiating AGR from ATN. However, taking into account ischemia time is necessary in interpreting the pi-GST value in early post transplant period.

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Section: Discussionmentioning

confidence: 99%

Enzymuria and low molecular weight protein excretion as the differentiating marker of complications in the early post kidney transplantation period

et al. 2006

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“…Measurement is performed by immunonephelometric or ELISA methods Superior to tubular enzymuria in predicting the need for renal replacement therapy in ATN. Widespread variation in usefulness, sensitivity, and specificity (17,19,20,23,43) NHE-3 Sodium transporter localized in apical membrane and subapical endosomes of proximal tubular cells and apical membrane of thick ascending limb cells. Detection in urine by means of antibodies (immunoblotting)…”

Section: Urinary Enzymesmentioning

confidence: 99%

Biomarkers of Acute Renal Injury and Renal Failure

Trof

Maggio

Leemreis

et al. 2006

Shock

179

101

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Acute renal failure (ARF) is a frequent problem in the intensive care unit and is associated with a high mortality. Early recognition could help clinical management, but current indices lack sufficient predictive value for ARF. Therefore, there might be a need for biomarkers in detecting renal tubular injury and/or dysfunction at an early stage before a decline in glomerular filtration rate is noted by an increased serum creatinine. A MEDLINE/PubMed search was performed, including all articles about biomarkers for ARF. All publication types, human and animal studies, or subsets were searched in English language. An extraction of relevant articles was made for the purpose of this narrative review. These biomarkers include tubular enzymes (alpha- and pi-glutathione S-transferase, N-acetyl-glucosaminidase, alkaline phosphatase, gamma-glutamyl transpeptidase, Ala-(Leu-Gly)-aminopeptidase, and fructose-1,6-biphosphatase), low-molecular weight urinary proteins (alpha1- and beta2-microglobulin, retinol-binding protein, adenosine deaminase-binding protein, and cystatin C), Na+/H+ exchanger, neutrophil gelatinase-associated lipocalin, cysteine-rich protein 61, kidney injury molecule 1, urinary interleukins/adhesion molecules, and markers of glomerular filtration such as proatrial natriuretic peptide (1-98) and cystatin C. These biomarkers, detected in urine or serum shortly after tubular injury, have been suggested to contribute to prediction of ARF and need for renal replacement therapy. However, excretion of these biomarkers may also increase after reversible and mild dysfunction and may not necessarily be associated with persistent or irreversible damage. Large prospective studies in human are needed to demonstrate an improved outcome of biomarker-driven management of the patient at risk for ARF.

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“…Increased excretion rates are seen in patients treated with specific tubolotoxic agents such as aminoglycosides. NAG is in fact one of the most sensitive parameters for indicating renal damage (17,18,19). The fact that this parameter seemed to be more sensitive towards ECC induced renal damage than the other parameters may indicate that the ECC had preferentially affected the tubules (Fig.…”

Section: Discussionmentioning

confidence: 95%

Impairment of Renal Function After Cardiopulmonary Bypass Is Not Influenced by Dopexamine

et al. 2001

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Introduction: The objective of this study was to evaluate the effects of dopexamine on renal function in 4 groups of patients either with or without renal dysfunction. Transient renal dysfunction is often not clinically relevant in patients with normal renal function, but it is an important clinical factor in patients with pre-existing renal failure. Dopexamine (DX) is a commonly used catecholamine which probably exerts a selective effect at the splanchnic bed. Material and Methods: 24 patients with normal renal function and 24 patients with impaired renal function (creatinine in serum ! 1.5 mg/dL) were each randomly allocated to 2 groups. Group 1 (control) without renal dysfunction and group 3 (control/ dysfunction) with renal dysfunction were considered as control groups, while the patients in DX and DX/dysfunction groups received 1 mg/kg/ min dopexamine until the end of surgery. Kidney function was investigated using standard parameters and by investigating specific proteins and enzymes. Results: All patients showed pathologic excretions of the investigated parameters during cardiopulmonary bypass (CPB) with no differences between the study groups. The distal tubule, the lysosomal regions, Henle's loop and the glomerular tuft were all damaged. Heart

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Urinary excretion of proteins and tubular enzymes in renal transplant patients

Cited by 19 publications

References 10 publications

Enzymuria and low molecular weight protein excretion as the differentiating marker of complications in the early post kidney transplantation period

Enzymuria and low molecular weight protein excretion as the differentiating marker of complications in the early post kidney transplantation period

Biomarkers of Acute Renal Injury and Renal Failure

Impairment of Renal Function After Cardiopulmonary Bypass Is Not Influenced by Dopexamine

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