title: Urinary α-GST and π-GST for prediction of dialysis requirement or in-hospital death in established acute kidney injury.
abstract: BACKGROUND
  Urinary α-glutathione S-transferase (α-GST) and π-glutathione S-transferase (π-GST) are promising proximal and distal tubular leakage markers for early detection of acute kidney injury (AKI).
  
  
  OBJECTIVE
  To examine the performance of these markers for predicting the composite of dialysis requirement or in-hospital death in patients with an established diagnosis of AKI.
  
  
  METHODS
  Prospective cohort study of 245 adults with AKI. A single urinary α-GST and π-GST measurement was obtained at time of nephrology consultation.
  
  
  RESULTS
  Overall, urinary π-GST performed better than α-GST for prediction of dialysis requirement (AUC 0.59 vs. 0.56), and the composite outcome (AUC 0.58 vs. 0.56). In subgroup analyses, π-GST displayed better discrimination for prediction of dialysis requirement in patients with baseline eGFR <60 mL/min/1.73 m(2) (AUC 0.61) and oliguria (AUC 0.72). Similarly, α-GST performed better in patients with stage-1 (AUC 0.66) and stage-2 AKI (AUC 0.80).
  
  
  CONCLUSIONS
  In patients with an established diagnosis of AKI, a single urinary π-GST measurement performed better than α-GST at predicting dialysis requirement or death, but neither marker had good prognostic discrimination.
authors: Kidney and Dialysis Research Laboratory, St. Elizabeth's Medical Center, Boston, MA, USA.
authors: Victor F
authors: VF
authors: Seabra
authors: Mary C
authors: MC
authors: Perianayagam
authors: Hocine
authors: H
authors: Tighiouart
authors: Orfeas
authors: O
authors: Liangos
authors: Oscar F P
authors: OF
authors: dos Santos
authors: Bertrand L
authors: BL
authors: Jaber
mesh_terms: D058186:Acute Kidney Injury / Q000201:enzymology / Q000401:mortality* / Q000628:therapy; D005982:Glutathione Transferase / Q000652:urine*; D017052:Hospital Mortality; D006801:Humans; D011446:Prospective Studies; D006435:Renal Dialysis
chemical_list: D005982:Glutathione Transferase