Urinary low molecular mass proteins and enzymes as early, non invasive markers of nephrotoxicity in the neonate

M. Mussap, V. Fanos, L. Cataldi, M. Plebani

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

As the kidney concentrates and excretes metabolic waste, chemicals, and a lot of drugs, it is often exposed to toxic concentrations of these substances. About 20% of all cases of acute renal failure are due to nephrotoxic agents. Most of the preterm infants in intensive care units may be exposed to nephrotoxic risk factors, and thus the development of a toxic nephropathy require early therapeutic intervention. There are a number of inherent difficulties in diagnostic procedures for nephropathy, including the absence of standard diagnostic criteria. Serum creatinine and blood urea nitrogen (BUN) increased levels are relatively late manifestations of nephrotoxicity and reflect depression of glomerular filtration rate (GFR) consequent to extensive proximal tubular cell necrosis up to the point where over 50-75% of the functioning nephrons have been lost. To overcome this problem, it was recommended to assess urinary low-M(r) proteins levels and urinary enzyme activities as early, non-invasive markers for the assessment of nephrotoxic damage. Increased urinary activity of N-acetyl-β-D-glucosaminidase seems to better reflect severe tubular cell injury, followed by cytolysis, while increased α1-microglobulin (protein HC) urinary level seems to better reflect impaired renal tubular function. Although these investigations may open new perspectives in term of sensitivity and specificity, most of the recently developed markers need further validation.

Original languageEnglish
Pages (from-to)51-64
Number of pages14
JournalEuropean Journal of Laboratory Medicine
Volume6
Issue number1
Publication statusPublished - 1998

Fingerprint

Poisons
Newborn Infant
Kidney
Hexosaminidases
Blood Urea Nitrogen
Nephrons
Enzymes
Glomerular Filtration Rate
Acute Kidney Injury
Premature Infants
Intensive Care Units
Creatinine
Proteins
Necrosis
Sensitivity and Specificity
Wounds and Injuries
Serum
Pharmaceutical Preparations
Therapeutics
alpha-1-microglobulin

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Urinary low molecular mass proteins and enzymes as early, non invasive markers of nephrotoxicity in the neonate. / Mussap, M.; Fanos, V.; Cataldi, L.; Plebani, M.

In: European Journal of Laboratory Medicine, Vol. 6, No. 1, 1998, p. 51-64.

Research output: Contribution to journalArticle

@article{ff0e3af8b27748b09c057bd8912586a4,
title = "Urinary low molecular mass proteins and enzymes as early, non invasive markers of nephrotoxicity in the neonate",
abstract = "As the kidney concentrates and excretes metabolic waste, chemicals, and a lot of drugs, it is often exposed to toxic concentrations of these substances. About 20{\%} of all cases of acute renal failure are due to nephrotoxic agents. Most of the preterm infants in intensive care units may be exposed to nephrotoxic risk factors, and thus the development of a toxic nephropathy require early therapeutic intervention. There are a number of inherent difficulties in diagnostic procedures for nephropathy, including the absence of standard diagnostic criteria. Serum creatinine and blood urea nitrogen (BUN) increased levels are relatively late manifestations of nephrotoxicity and reflect depression of glomerular filtration rate (GFR) consequent to extensive proximal tubular cell necrosis up to the point where over 50-75{\%} of the functioning nephrons have been lost. To overcome this problem, it was recommended to assess urinary low-M(r) proteins levels and urinary enzyme activities as early, non-invasive markers for the assessment of nephrotoxic damage. Increased urinary activity of N-acetyl-β-D-glucosaminidase seems to better reflect severe tubular cell injury, followed by cytolysis, while increased α1-microglobulin (protein HC) urinary level seems to better reflect impaired renal tubular function. Although these investigations may open new perspectives in term of sensitivity and specificity, most of the recently developed markers need further validation.",
author = "M. Mussap and V. Fanos and L. Cataldi and M. Plebani",
year = "1998",
language = "English",
volume = "6",
pages = "51--64",
journal = "European Journal of Laboratory Medicine",
issn = "1122-8652",
publisher = "SIMeL Societa Italiana di Medicina di Laboratorio",
number = "1",

}

TY - JOUR

T1 - Urinary low molecular mass proteins and enzymes as early, non invasive markers of nephrotoxicity in the neonate

AU - Mussap, M.

AU - Fanos, V.

AU - Cataldi, L.

AU - Plebani, M.

PY - 1998

Y1 - 1998

N2 - As the kidney concentrates and excretes metabolic waste, chemicals, and a lot of drugs, it is often exposed to toxic concentrations of these substances. About 20% of all cases of acute renal failure are due to nephrotoxic agents. Most of the preterm infants in intensive care units may be exposed to nephrotoxic risk factors, and thus the development of a toxic nephropathy require early therapeutic intervention. There are a number of inherent difficulties in diagnostic procedures for nephropathy, including the absence of standard diagnostic criteria. Serum creatinine and blood urea nitrogen (BUN) increased levels are relatively late manifestations of nephrotoxicity and reflect depression of glomerular filtration rate (GFR) consequent to extensive proximal tubular cell necrosis up to the point where over 50-75% of the functioning nephrons have been lost. To overcome this problem, it was recommended to assess urinary low-M(r) proteins levels and urinary enzyme activities as early, non-invasive markers for the assessment of nephrotoxic damage. Increased urinary activity of N-acetyl-β-D-glucosaminidase seems to better reflect severe tubular cell injury, followed by cytolysis, while increased α1-microglobulin (protein HC) urinary level seems to better reflect impaired renal tubular function. Although these investigations may open new perspectives in term of sensitivity and specificity, most of the recently developed markers need further validation.

AB - As the kidney concentrates and excretes metabolic waste, chemicals, and a lot of drugs, it is often exposed to toxic concentrations of these substances. About 20% of all cases of acute renal failure are due to nephrotoxic agents. Most of the preterm infants in intensive care units may be exposed to nephrotoxic risk factors, and thus the development of a toxic nephropathy require early therapeutic intervention. There are a number of inherent difficulties in diagnostic procedures for nephropathy, including the absence of standard diagnostic criteria. Serum creatinine and blood urea nitrogen (BUN) increased levels are relatively late manifestations of nephrotoxicity and reflect depression of glomerular filtration rate (GFR) consequent to extensive proximal tubular cell necrosis up to the point where over 50-75% of the functioning nephrons have been lost. To overcome this problem, it was recommended to assess urinary low-M(r) proteins levels and urinary enzyme activities as early, non-invasive markers for the assessment of nephrotoxic damage. Increased urinary activity of N-acetyl-β-D-glucosaminidase seems to better reflect severe tubular cell injury, followed by cytolysis, while increased α1-microglobulin (protein HC) urinary level seems to better reflect impaired renal tubular function. Although these investigations may open new perspectives in term of sensitivity and specificity, most of the recently developed markers need further validation.

UR - http://www.scopus.com/inward/record.url?scp=0031827130&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031827130&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:0031827130

VL - 6

SP - 51

EP - 64

JO - European Journal of Laboratory Medicine

JF - European Journal of Laboratory Medicine

SN - 1122-8652

IS - 1

ER -