URINARY ENZYMES AS BIOMARKERS OF RENAL INJURY IN EXPERIMENTAL NEPHROTOXICITY OF IMMUNOSUPPRESSIVE DRUGS

被引:17
作者
BURDMANN, EA [1 ]
ANDOH, TF [1 ]
LINDSLEY, J [1 ]
RUSSELL, J [1 ]
BENNETT, WM [1 ]
PORTER, G [1 ]
机构
[1] OREGON HLTH SCI UNIV,DEPT MED,DIV NEPHROL HYPERTENS & CLIN PHARMACOL,PORTLAND,OR 97201
基金
巴西圣保罗研究基金会;
关键词
D O I
10.3109/08860229409044857
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Urinary excretion of N-acetyl-beta-D-glucosaminidase (NAG) and of alanine-aminopeptidase (AAP) was studied after administration of cyclosporine A (CSA A), FK 506, or the corresponding vehicles to salt-depleted rats. On days 7, 14, and 28 after treatment for CSA and day 14 after treatment for FK 506, measurements of the urinary enzymes, serum creatinine (S-Cr), creatinine clearance (Cl-Cr), and blinded renal histology were done. After 1 week on CSA there was a dramatic increase of 489% in the urinary excretion of AAP (162.6 IU/g Cr, CSA vs. 27.6 IU/g Cr control, p <.03), a significant decrease of 32% in Cl-Cr, a significant increase of 41% in S-Cr, and mild proximal tubular atrophy and vacuolization. After 2 or 4 weeks of CSA treatment there were no more differences in the urinary AAP between CSA and control rats, but the urinary excretion of NAG was increased: 29.6 IU/g Cr, CSA vs. 20.9 IU/g Cr, control, p <.03 on day 14 and 26.9 IU/g Cr, CSA vs. 21.5 IU/g Cr, control, p <.008 on day 28. At the same time there was a progressive decline of the Cl-Cr, a progressive increase in the S-Cr, and an increase in the severity of the histological lesion. After 14 days of treatment with FK 506 we observed a striking elevation in urinary AAP (62.6 IU/g Cr, FK 506 vs. 36.0 IU/g Cr, control, p <.01) consistent with a significant decrease in Cl-Cr, a significant increase in S-Cr, and a moderate proximal tubular vacuolization and atrophy. Thus, there was an early and significant increase in enzymuria after treatment with both drugs, even in the presence of mild histological lesion, pointing to the values of AAP and NAG as markers of renal injury in CSA and FK experimental nephrotoxicity.
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页码:161 / 168
页数:8
相关论文
共 21 条
[1]  
McNally P.G., Feehally J., Pathophysiology of cyclosporin A nephrotoxicity: experimental and clinical observations, Nephrol Dial Transplant, 7, pp. 791-804, (1992)
[2]  
Randhawa P.S., Shapiro R., Jordan M.L., Starzl T.E., Demetris A.J., The histopathological changes associated with allograft rejection and drug toxicity in renal transplant recipients maintained on FK 506, Am J Surg Pathol, 17, pp. 60-68, (1993)
[3]  
Burdmann E.A., Rosen S., Lindsley J., Elzinga L., Andoh T., Bennett W.M., Cyclosporine G produces less chronic nephrotoxicity than cyclosporine A in a low salt rat model, Transplantation, (1993)
[4]  
Andoh T.F., Burdmann E.A., Lindsley J., Houghton D.C., Bennett W.M., FK 506-induced nephrotoxicity in sodium-depleted rats, JASN, 3, (1992)
[5]  
Bennett W.M., Porter G.A., Overview of clinical nephrotoxicity, Toxicology of the Kidney2nd ed, pp. 61-97, (1993)
[6]  
Price R.G., Urinary enzymes, nephrotoxicity and renal disease, Toxicology, 23, pp. 99-134, (1982)
[7]  
Bennett W.M., Elzinga L.W., Porter G.A., Tubulointerstitial disease and toxic nephropathy, The Kidney4th ed, pp. 1430-1496, (1991)
[8]  
Lockwood T.D., Bosmann H.C., The use of urinary N-acetyl-β-glucosaminidase in human renal toxicology. I. partial biochemical characterization and excretion in humans and release from the isolated perfused rat kidney, Toxicol Appl Pharmacol, 49, pp. 323-336, (1979)
[9]  
Lauwerys R.R., Bernard A., Early detection of the nephrotoxic effects of industrial chemicals: state of the art and future prospects, Am J Ind Med, 11, pp. 275-285, (1987)
[10]  
Mueller P.W., MacNeil M.L., Steinberg K.K., Stabilization ol alanine aminopeptidase, gamma glutamyltranspeptidase, and N-acetyl-β-glucosaminidase activity in normal urines, Arch Environ Contam Toxicol, 15, pp. 343-347, (1986)