title: The value of tubular enzymes for early detection of acute kidney injury after liver transplantation: an observational study.
abstract: Tubular enzymes (TE) are early markers of acute kidney injury (AKI), but their value for liver transplant (LT) recipients is unknown. We sought to evaluate the usefulness of TE to predict AKI after LT. We enrolled Thirty-nine adult patients without AKI who had been admitted to the Intensive Care Unit (ICU). AKI was diagnosed according to the Acute Kidney Injury Network criteria. Of these patients, 23 had received orthotopic LT and 16 controls had been admitted for other conditions. Urinary lactate dehydrogenase (LDH), alkaline phosphatase (AF) and γ-glutamyl transpeptidase (γ-GT) measured on days 1 and 3 of the ICU stay were normalized to urinary creatinine concentrations. AKI was diagnosed in 14 patients: 8 in the LT group and 6 in the control group. In the LT group, on the first day of the patients' stay in the ICU, urinary LDH (P = .032), AF (P = .022), and γ-GT (P = .002) were significantly higher among those who developed AKI; these elevations preceded those of serum creatinine. In forward receiver-operating characteristic (ROC) plot analysis, the areas under the ROC curves were 0.8, 0.86, and 0.92 for LDH, AF, and γ-GT, respectively. We concluded that TE determined early after LT are a helpful predictors of AKI.
authors.affiliation: Nephrology Department, Amato Lusitano Hospital, Castelo Branco, Portugal. santos9_cat@yahoo.com
authors.forename: C
authors.initials: C
authors.lastname: Santos
authors.forename: P
authors.initials: P
authors.lastname: Marcelino
authors.forename: T
authors.initials: T
authors.lastname: Carvalho
authors.forename: J
authors.initials: J
authors.lastname: Coelho
authors.forename: M
authors.initials: M
authors.lastname: Bispo
authors.forename: L
authors.initials: L
authors.lastname: Mourão
authors.forename: R
authors.initials: R
authors.lastname: Perdigoto
authors.forename: E
authors.initials: E
authors.lastname: Barroso
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000209:etiology / Q000652:urine; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000652:urine*; D015415:Biomarkers / Q000097:blood / Q000652:urine; D016022:Case-Control Studies; D004796:Clinical Enzyme Tests; D003404:Creatinine / Q000097:blood; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007684:Kidney Tubules / Q000201:enzymology*; D007770:L-Lactate Dehydrogenase / Q000652:urine*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011174:Portugal; D011237:Predictive Value of Tests; D012372:ROC Curve; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation; D005723:gamma-Glutamyltransferase / Q000652:urine*
chemical_list: D015415:Biomarkers; D003404:Creatinine; D007770:L-Lactate Dehydrogenase; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase