Variations of urinary N-acetyl-β-D-glucosaminidase levels and its performance in detecting acute kidney injury under different thyroid hormones levels: a prospectively recruited, observational study

Abstract

ObjectiveChanges in thyroid function will be accompanied by changes in urinary N-acetyl-β-D-glucosaminidase (uNAG) levels. Therefore, whether thyroid hormones interfere the ability of uNAG in detecting acute kidney injury (AKI) has raised concern in patients with critical illness.DesignA prospectively recruited, observational study was performed.SettingAdults admitted to the intensive care unit of a grade A tertiary hospital in China.ParticipantsA total of 1919 critically ill patients were enrolled in the study.Main outcome measuresTo investigate the variations of the ability of uNAG to detect AKI in patients with critical illness under different thyroid hormones levels (differences in area under the curve (AUC) for uNAG diagnosis and prediction of AKI with different thyroid hormones levels).ResultsThe bivariate correlation analysis revealed that FT3 and TT3 levels were independently associated with uNAG levels (p<0.001). FT3 and uNAG also showed correlation in multivariable linear regression analysis (p<0.001). After stratification according to the levels of FT3 or TT3, significant variation was observed in the uNAG levels with different quartiles (p<0.05). However, in patients with varying FT3 and TT3 levels, no significant difference was found in the AUCs of uNAG to detect AKI (p>0.05).ConclusionsEven if uNAG levels varied with FT3 and TT3 levels, these hormones did not interfere with uNAG’s ability to detect AKI in patients with critical illness.

Revisiting the Role of NAG across the Continuum of Kidney Disease

“…However, targeted studies showed that this did not affect uNAG’s ability to detect AKI. Namely, the results of Wang et al and Liang et al showed that blood glucose and HbA1c levels, as well as thyroid hormone levels, did not significantly affect the performance of uNAG for AKI detection [ 61 , 62 ].…”

Plasma indole-3-aldehyde as a novel biomarker of acute kidney injury after cardiac surgery: a reanalysis using prospective metabolomic data

“…Under this circumstance, it is important to explore the novel markers for the early detection of AKI before a measurable rise in sCr, which can afford a critical time window for clinicians to stop or even reverse the progressing kidney injury. Although large numbers of biomarkers have been identified to detect AKI so far, including serum cystatin C (sCysC) [ 7 , 8 ], urinary N-acetyl-beta-D-glucosaminidase (uNAG) [ 9 ], urinary matrix metalloproteinase-7 (uMMP-7) [ 10 ], and urinary angiotensinogen (uAGT) [ 11 , 12 ], the search for an optimal and cost-effective combination scheme continues to be a prominent endeavor in the scientific community.…”

Urinary proteome analysis of acute kidney injury in post-cardiac surgery patients using enrichment materials with high-resolution mass spectrometry

“…As a sensitive indicator of renal glomerular and tubular injury, the quantitative proteinuria spectrum has always been important in predicting kidney injury. Some AKI protein biomarkers with potential clinical value have been recently investigated, including the serum/urine levels of cystatin C to reflect the glomerular filtration rate ( Liang et al, 2020 ; Deng et al, 2019 ; Hou et al, 2021 ; Deng et al, 2020 ; Zhang et al, 2019 ) and the relationship between renal tubular epithelial cell damage and inflammatory factors, such as kidney injury molecule-1, liver type fatty acid binding protein and neutrophil gelatinase-associated lipocalin ( Hu et al, 2022 ; Liang et al, 2022 ; Zdziechowska et al, 2020 ). Previous studies on proteomics and early pathobiological events demonstrated that urinary angiotensinogen (AGT) and urinary matrix metalloproteinase-7 (MMP-7) could be used as AKI biomarkers for clinical applications ( Chen C et al, 2016 ; Yang et al, 2017 ).…”