N-acetyl-beta-glucosaminidase urine activity as a marker of early proximal tubule damage and a predictor of the long-term function of the transplanted kidneys.

  • Ewa Kwiatkowska Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University in Szczecin, Poland.;
  • Leszek Domański Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University in Szczecin, Poland.;
  • Joanna Bober Department of Medical Chemistry, Pomeranian Medical University, Szczecin, Poland.;
  • Karolina Kłoda Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University in Szczecin, Poland.;
  • Krzysztof Safranow Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland.;
  • Jolanta Szymańska-Pasternak Department of Medical Chemistry, Pomeranian Medical University, Szczecin, Poland.;
  • Maciej Romanowski Clinical Department of Surgery and Transplantology, Pomeranian Medical University in Szczecin, Poland.;
  • Aneta Sulecka Department of Medical Chemistry, Pomeranian Medical University, Szczecin, Poland.;
  • Andrzej Pawlik Department of Pharmacology, Pomeranian Medical University, Szczecin, Poland.;
  • Kazimierz Ciechanowski Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University in Szczecin, Poland.;
DOI: https://doi.org/10.18388/abp.2014_1896

Abstract

Ischaemia-reperfusion injury (IRI) is a factor leading to the damages of the transplanted kidney, what affects mainly the proximal tubules. Early monitoring of tubule damage can be an efficient tool to predict the allograft dysfunction. Present in proximal tubules, N-acetyl-beta-glucosaminidase (NAG) is a lysosomal enzyme whose excretion rises as a result of IRI or acute rejection. The aim of this study was to monitor the NAG urine activity to evaluate the early proximal tubule damage, and to try to predict the long-term function of the transplanted kidney. The study enrolled 87 Caucasian renal transplant recipients (61.7% males, 38.3% females, mean age 45.56±14.34 years). Urine samples were collected for NAG and creatinine analysis on the 1st day after transplantation, and then in the 3rd and 12th month. Protocol biopsies were performed in the 3rd and 12th month. A significant positive correlation between NAG urine activity in the 3rd month after transplantation and creatinine concentration on the 14th (p=0.004) and 30th day (p=0.05), in the 3rd month (p=0.009) and after the 1st (p=0.005) and 2nd year (p=0.003) was observed. A statistically significantly higher urinary NAG activity in samples collected in the first 3 days and in the 3rd month after transplantation among patients with DGF (p=0.006 and p=0.03 respectively) was found. There was a significant positive correlation between NAG urine activity in the 3rd month and the grade of tubular atrophy in specimens collected in the 3rd (p=0.03) and 12th (p=0.04) month. Monitoring of NAG urine activity is useful in the evaluation of early proximal tubule damage and predicting the long-term function of the transplanted kidneys.
Published
2014-06-11
Issue
Vol. 61 No. 2 (2014)
Section
Articles

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