Urinary lipocalin-type prostaglandin D synthase: a potential marker for early gentamicin-induced renal damage?
Urinary excretion of lipocalin-type prostaglandin D synthase (L-PGDS) has been suggested to be a useful biomarker of early diabetic nephropathy. We studied whether L-PGDS is also a marker of gentamicin (GM)-induced renal damage in the "creatinine-blind" range. A prospective study was conducted in 6 patients who were given long-term intravenous administration of GM (18-42 days in combination with a beta-lactam/carbapenem antibiotic or vancomycin) for the treatment of infective endocarditis. Urinary excretions of L-PGDS, beta2-microglobulin, and N-acetyl-beta-D-glucosaminidase were measured in the early (within 10 days from commencement) and late (thereafter) phases of GM therapy. Systemic clearance of GM (CLGM) and creatinine clearance (CLcr) was also measured concomitantly. CLGM was reduced significantly (P < 0.05) by 10% from the early to late treatment phase, whereas urinary L-PGDS excretion showed a significant (P < 0.05) increase (from 7.3 +/- 4.6 to 8.7 +/- 5.0 mg/g creatinine, mean +/- SD) concomitantly. In contrast, no significant changes were observed for urinary beta2-microglobulin and N-acetyl-beta-D-glucosaminidase concentrations. In conclusion, urinary L-PGDS may be a promising biomarker for the early phase of GM-induced renal impairment.
Nakayama
Hirokazu
H
Department of Pharmacy, Kanto Medical Center NTT East Corporation, Tokyo, Japan. hnakayam@east.ntt.co.jp
Echizen
Hirotoshi
H
Gomi
Tomoko
T
Shibuya
Yuko
Y
Nakamura
Yoshitsugu
Y
Nakano
Kiyoharu
K
Arashi
Hiroyuki
H
Itai
Tsutomu
T
Ohnishi
Satoshi
S
Tanaka
Masayo
M
Orii
Takao
T
D000118:Acetylglucosaminidase / Q000652:urine; D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D015415:Biomarkers; D003404:Creatinine / Q000652:urine; D004697:Endocarditis, Bacterial / Q000188:drug therapy / Q000652:urine; D005260:Female; D005839:Gentamicins / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D006207:Half-Life; D006801:Humans; D007262:Infusions, Intravenous; D019746:Intramolecular Oxidoreductases / Q000652:urine*; D007674:Kidney Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000652:urine*; D007677:Kidney Function Tests; D054834:Lipocalins / Q000652:urine*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D001613:beta 2-Microglobulin / Q000652:urine
D000900:Anti-Bacterial Agents; D015415:Biomarkers; D005839:Gentamicins; D054834:Lipocalins; D001613:beta 2-Microglobulin; D003404:Creatinine; D000118:Acetylglucosaminidase; D019746:Intramolecular Oxidoreductases; C022466:prostaglandin R2 D-isomerase