DOI QR코드

DOI QR Code

Correlation between glomerular filtration rate and urinary N acetyl-beta-D glucosaminidase in children with persistent proteinuria in chronic glomerular disease

  • Hong, Jeong-Deok (Department of Pediatrics, Chung-Ang University College of Medicine) ;
  • Lim, In-Seok (Department of Pediatrics, Chung-Ang University College of Medicine)
  • Received : 2010.11.02
  • Accepted : 2011.11.25
  • Published : 2012.04.15

Abstract

Purpose: Urinary excretion of N acetyl-beta-D glucosaminidase (NAG) and ${\beta}_2$-microglobulin (${\beta}_2$-M) was increased in the presence of proximal tubular damage. Based on these urinary materials, we investigated the ability of expecting renal function in chronic glomerular diseases. In this study, we evaluated the relationship between glomerular filtration rate (GFR) urinary NAG, and urinary ${\beta}_2$-M. Methods: We evaluated 52 children with chronic kidney disease at the Chung-Ang University Hospital between January 2003 and August 2009. We investigated the 24-hour urinalysis and hematologic values in all 52 patients. Serum creatinine, creatinine clearance (Ccr), serum cystatin C, urinary ${\beta}_2$-M and urinary NAG were measured. Results: Out of 52 patients, there were 13 children with minimal change in disease, 3 children with focal segmental glomerulosclerosis, 17 children with immunoglobulin A nephropathy, 15 children with Henoch-Sch$\ddot{o}$nlein purpua nephritis, 3 children with poststreptococcal glomerulonephritis, and 1 child with thin glomerular basement membrane disease. In these patients, there were significant correlation between the Ccr and urinary NAG (r=-0.817; $P$ <0.01), and between the GFR (as determined by Schwartz method) and urinary NAG (r=-0.821; $P$ <0.01). In addition, there was a significant correlation between the GFR (as determined by Bokencamp method) and urinary NAG (r=-0.858; $P$ <0.01). Conclusion: In our study, there was a significant correlation between the GFR and urinary NAG, but there was no correlation between the GFR and urinary ${\beta}_2$-M, suggesting that the GFR can be predicted by urinary NAG in patients with chronic glomerular disease.

Keywords

References

  1. Vogt BA, Avner ED. Renal failure. In: Kliegman RM, Berman RE, Jenson HB, Stanton BM, editors. Nelson textbook of pediatrics. 18th ed. Philadelphia: Saunders, 2007:2206-13.
  2. Choi Y. Proteinuria and nephrotic syndrome. In: Han JS, editor. Nephrology. 3rd ed. Seoul: Seoul National University Press, 2003:183-9.
  3. Kim HJ, Kang SK. Tubulointerstitial disease. In: Kim HJ, editor. Clinical nephrology. 2nd ed. Seoul: Gwangmoon Publishing Co., 2005:435-42.
  4. Braden GL, O'Shea MH, Mulhern JG. Tubulointerstitial diseases. Am J Kidney Dis 2005;46:560-72. https://doi.org/10.1053/j.ajkd.2005.03.024
  5. Rosner MH, Bolton WK. Renal function testing. Am J Kidney Dis 2006;47:174-83. https://doi.org/10.1053/j.ajkd.2005.08.038
  6. Costigan MG, Rustom R, Bone JM, Shenkin A. Origin and significance of urinary N-acetyl-beta, D-glucosaminidase (NAG) in renal patients with proteinuria. Clin Chim Acta 1996;255:133-44. https://doi.org/10.1016/0009-8981(96)06400-5
  7. Shemesh O, Golbetz H, Kriss JP, Myers BD. Limitations of creatinine as a filtration marker in glomerulopathic patients. Kidney Int 1985;28:830-8. https://doi.org/10.1038/ki.1985.205
  8. Schwartz GJ, Brion LP, Spitzer A. The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am 1987;34:571-90.
  9. Schwartz GJ, Haycock GB, Edelmann CM Jr, Spitzer A. A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 1976;58:259-63.
  10. Bökenkamp A, Domanetzki M, Zinck R, Schumann G, Byrd D, Brodehl J. Cystatin C serum concentrations underestimate glomerular filtration rate in renal transplant recipients. Clin Chem 1999;45:1866-8.
  11. Newman DJ. Cystatin C. Ann Clin Biochem 2002;39(Pt 2):89-104. https://doi.org/10.1258/0004563021901847
  12. Coll E, Botey A, Alvarez L, Poch E, Quinto L, Saurina A, et al. Serum cystatin C as a new marker for noninvasive estimation of glomerular filtration rate and as a marker for early renal impairment. Am J Kidney Dis 2000;36:29-34. https://doi.org/10.1053/ajkd.2000.8237
  13. Piscator M. Early detection of tubular dysfunction. Kidney Int Suppl 1991;34:S15-7.
  14. Bazzi C, Petrini C, Rizza V, Arrigo G, Napodano P, Paparella M, et al. Urinary N-acetyl-beta-glucosaminidase excretion is a marker of tubular cell dysfunction and a predictor of outcome in primary glomerulonephritis. Nephrol Dial Transplant 2002;17:1890-6. https://doi.org/10.1093/ndt/17.11.1890
  15. Price RG. The role of NAG (N-acetyl-beta-D-glucosaminidase) in the diagnosis of kidney disease including the monitoring of nephrotoxicity. Clin Nephrol 1992;38 Suppl 1:S14-9.
  16. Agardh CD, Agardh E, Isaksson A, Hultberg B. Association between urinary N-acetyl-beta-glucosaminidase and its isoenzyme patterns and microangiopathy in type 1 diabetes mellitus. Clin Chem 1991;37(10 Pt 1):1696-9.
  17. Sherman RL, Drayer DE, Leyland-Jones BR, Reidenberg MM. Nacetyl- beta-glucosaminidase and beta 2-microglobulin. Their urinary excretion in patients with renal parenchymal disease. Arch Intern Med 1983;143:1183-5. https://doi.org/10.1001/archinte.1983.00350060107017
  18. Berggard I, Bearn AG. Isolation and properties of a low molecular weight beta-2-globulin occurring in human biological fluids. J Biol Chem 1968; 243:4095-103.
  19. Cunningham BA, Wang JL, Berggard I, Peterson PA. The complete amino acid sequence of beta 2-microglobulin. Biochemistry 1973;12: 4811-22. https://doi.org/10.1021/bi00748a001
  20. Bernier GM, Conrad ME. Catabolsm of human beta-2-microglobulin by the rat kidney. Am J Physiol 1969;217:1359-62.
  21. Peterson PA, Evrin PE, Berggard I. Differentiation of glomerular, tubular, and normal proteinuria: determinations of urinary excretion of beta-2- macroglobulin, albumin, and total protein. J Clin Invest 1969;48:1189-98. https://doi.org/10.1172/JCI106083
  22. Garcon G, Leleu B, Zerimech F, Marez T, Haguenoer JM, Furon D, et al. Biologic markers of oxidative stress and nephrotoxicity as studied in biomonitoring of adverse effects of occupational exposure to lead and cadmium. J Occup Environ Med 2004;46:1180-6. https://doi.org/10.1097/01.jom.0000141665.22881.69
  23. Chiaramonte C, Cigna RM, Cataliotti F. Microproteinuria as a marker of renal damage in children. Minerva Urol Nefrol 2002;54:237-42.
  24. Terai C. Renal function tests in patients with rheumatoid arthritis. Nihon Rinsho 2005;63 Suppl 1:375-8.

Cited by

  1. Effects of low-flow sevoflurane anesthesia on renal function in low birth weight infants vol.15, pp.1, 2012, https://doi.org/10.1186/1471-2253-15-6
  2. Association Between Pulse Wave Velocity and a Marker of Renal Tubular Damage (N-Acetyl-β-D-Glucosaminidase) in Patients Without Diabetes vol.17, pp.4, 2012, https://doi.org/10.1111/jch.12492