title: Enzyme biomarkers of renal tubular injury in arterial surgery patients.
abstract: OBJECTIVE
  The aim of this study was to verify whether preoperative diabetes, hypertension, and renal function had any relationship with postoperative tubule function in patients submitted to anesthesia for arterial surgery.
  
  
  METHODS
  Prospective observational study. One hundred and forty-four patients submitted to anesthesia for arterial surgery enrolled consecutively and divided into four groups: G1--diabetes and hypertension; G2--diabetes; G3--hypertension; and G4--without hypertension or diabetes. Urine was obtained for laboratory analysis of urinary creatinine (Ucr), alkaline phosphatase (AP), γ-glutamyltransferase (γGT), and blood for cystatin C and creatinine before the surgery (M1) and 24 h after the surgery (M2).
  
  
  RESULTS
  Values of γGT, γGT/Ucr, and AP × γGT/Ucr increased at M2 in G4. Patients without renal function compromise (GFR ≥90 mL/min/1.73 m(2)) presented increased γGT/Ucr and AP × γGT/Ucr values at M2 and those with slightly compromised renal function (60-89 mL/min/1.73 m(2)) presented increased γGT values at M2. There was no correlation between deltaCystatin C and deltaAP, deltaγGT, deltaγGT/Ucr, deltaAP/Ucr, and deltaAP × γGT/Ucr.
  
  
  CONCLUSIONS
  Diabetes, hypertension, and preoperative renal function seem to interfere in tubular enzymuria immediately after surgery in arteriopathic patients. However, when these markers do not increase in postoperative period, renal dysfunction cannot be discarded.
authors.affiliation: Department of Anaesthesiology, Botucatu School of Medicine - UNESP, São Paulo State University, Botucatu, São Paulo, Brazil.
authors.forename: Leopoldo Muniz
authors.initials: LM
authors.lastname: da Silva
authors.forename: Pedro Thadeu Galvão
authors.initials: PT
authors.lastname: Vianna
authors.forename: Norma Sueli Pinheiro
authors.initials: NS
authors.lastname: Módolo
authors.forename: Leandro Gobbo
authors.initials: LG
authors.lastname: Braz
authors.forename: Yara Marcondes Machado
authors.initials: YM
authors.lastname: Castiglia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000378:metabolism / Q000601:surgery; D001158:Arteries / Q000601:surgery*; D015415:Biomarkers / Q000097:blood / Q000652:urine; D003920:Diabetes Mellitus / Q000097:blood / Q000652:urine; D003925:Diabetic Angiopathies / Q000097:blood / Q000150:complications / Q000652:urine; D004798:Enzymes / Q000097:blood / Q000652:urine; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000652:urine; D007668:Kidney / Q000502:physiology; D007684:Kidney Tubules / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011300:Preoperative Care; D011446:Prospective Studies; D014652:Vascular Diseases / Q000150:complications / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000009:adverse effects; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004798:Enzymes