Abstract
The measurement of enzyme activity in urine provides a sensitive assessment for renal tubular cell damage. The present study was undertaken to evaluate the clinical value of the determination of tubular brush-border-associated enzymes, alkaline phosphatase (AP), gamma-glutamyl transferase (GGT), leucine aminopeptidase (LAP), and dipeptidyl peptidase IV (DPP), of patients with normal graft function (NOR, n = 20), with acute tubular necrosis (ATN, n = 11), with an acute rejection episode (ARE, n = 17) after transplantation, and of healthy persons (n =20). The second urine of the morning was collected daily during the patients’ stay in hospital. The enzyme activities were measured at 25 °C and were expressed as U/mmol creatinine. The enzymuria in NOR is higher than in healthy controls, but is still in the normal range. By 5 days after transplantation the initial increased excretion declines as the graft function improves. Elevated enzymuria (DPP 0.69 ± 0.56, AP 3.06 ± 3.24, GGT 4.16 ± 4.13, and LAP 1.39 ± 1.27) was observed during the rejection episodes. Two days before clinical diagnosis of rejection, the release of DPP-IV and GGT increases to double, and the AP and LAP increases to 3 times the value on the fourth day before rejection. Successful treatment of rejection coincided with a quick return by the third day of the rejection period to the previous enzyme distribution. In ATN no decrease of enzymuria occurs and the excretion is much higher than in ARE. Our method with the every day monitoring of kidney graft function offers the possibility for the early diagnosis of acute rejection.
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References
Corbett R, Gardner GJ, Kind PRN, Thompson AE, Price R (1983) Comparison of urinary N-acetyl-beta-D-gucosaminidase and urinary fibrin degradation products for diagnosis of rejection after renal transplantation. Clin Chim Acta 128: 141–150
Dance N, Prince PG, Cattel WR, Land-sell J, Richards B (1970) The excretion of N-acetyl-beta-D-gucosaminidase and galactosidase by patients with renal disease. Clin Chim Acta 27: 87–92
Dyck RF, Cardella CJ, Sacks MA (1979) Urinary lysosomal enzyme excretion after renal allotransplantation. Clin Chim Acta 91: 111–116
Horpacsy G, Zinsmeyer J, Schroder K, Mebel M (1977) Value of determining urinary enzymes after human kidney transplantation. Early warning of rejection or not? Clin Chem 23: 770–771
Jung K, Pergande M, Schreiber G, Schroder K (1983) Stability of enzymes in urine at 37 °C. Clin Chim Acta 131: 185–191
Whiting PH, Nicholls AJ, Catto GRD, Edward N, Engeset J (1980) Patterns of N-acetyl-beta-D-glucosaminidase excretion after renal transplantation. Clin Chim Acta 108: 1–7
Whiting PH, Peterson J, Power DA, Stewart RDM, Catto GRD, Edward N (1983) Diagnostic value of urinary Nacetyl-beta-D-glucosaminidase its isoenzymes and the fractional excretion of sodium following renal transplantation. Clin Chim Acta 130: 369–376
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© 1996 Springer-Verlag Berlin Heidelberg
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Sárváry, E. et al. (1996). Diagnostic value of urinary enzyme determination in renal transplantation. In: Mühlbacher, F., et al. Transplant International . Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-00818-8_18
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DOI: https://doi.org/10.1007/978-3-662-00818-8_18
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-61024-3
Online ISBN: 978-3-662-00818-8
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