title: Urinary lipocalin-type prostaglandin D synthase: a potential marker for early gentamicin-induced renal damage?
abstract: 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.
authors.affiliation: Department of Pharmacy, Kanto Medical Center NTT East Corporation, Tokyo, Japan. hnakayam@east.ntt.co.jp
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Nakayama
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Echizen
authors.forename: Tomoko
authors.initials: T
authors.lastname: Gomi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Shibuya
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Kiyoharu
authors.initials: K
authors.lastname: Nakano
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Arashi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Itai
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ohnishi
authors.forename: Masayo
authors.initials: M
authors.lastname: Tanaka
authors.forename: Takao
authors.initials: T
authors.lastname: Orii
mesh_terms: 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
chemical_list: 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