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Related Experiment Videos

Early warning of rejection?

J M Wellwood, B G Ellis, J H Hall

    British Medical Journal
    |May 5, 1973
    PubMed
    Summary
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    Urinary N-acetyl-beta-D-glucosaminidase (NAG) is a sensitive biomarker for early detection of acute kidney transplant rejection. Elevated NAG levels can predict rejection up to three weeks before other tests indicate a problem.

    Area of Science:

    • Nephrology
    • Biochemistry
    • Transplant Medicine

    Background:

    • Renal allograft recipients require sensitive markers for early detection of rejection.
    • Current diagnostic methods for rejection may not be sufficiently sensitive for early intervention.

    Purpose of the Study:

    • To investigate the diagnostic value of urinary enzyme excretion in renal allograft rejection.
    • To identify specific urinary enzymes that can serve as early indicators of acute rejection.

    Main Methods:

    • Studied urinary excretion of N-acetyl-beta-D-glucosaminidase (NAG), beta-galactosidase (GAL), beta-glucosidase (GLU), and alkaline phosphatase (AP) in 83 renal allograft patients.
    • Assessed urinary lactic dehydrogenase (LDH) in normal subjects and transplant patients.
    • Correlated urinary enzyme levels with renal function tests and episodes of acute rejection.

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    Main Results:

    • Urinary NAG excretion was elevated in 94% of acute rejection episodes.
    • Increased urinary NAG levels were observed up to three weeks prior to other detectable changes in renal function.
    • Other urinary enzymes and serum enzyme levels were less sensitive indicators of rejection.

    Conclusions:

    • Urinary NAG is a highly sensitive and early marker for acute renal allograft rejection.
    • Monitoring urinary NAG may facilitate timely intervention and improve graft outcomes.
    • Serum enzyme levels are not useful for diagnosing renal allograft rejection.