title: The investigation of specific biochemical markers in monitoring kidney function of drug addicts.
abstract: BACKGROUND
  An increasingly important issue in the Polish population is drug abuse. It leads to extensive damage of parenchymal organs, including kidney. Establishing early markers of organ damage and their monitoring during rehabilitation therapy is therefore of pivotal importance. This study evaluated the utility of highly specific and selective markers (NGAL, IL-18, a and π-GST isoenzyme, and ß2-M). The influence of opioid drugs and other factors on kidney function (HIV and HCV infections, duration and the kind of drugs abused) was determined.
  
  
  METHODS
  Urine collected from 83 subjects who abused drugs and 33 healthy volunteers was tested with ELISA using specific antibodies (IBL, Biotron, Bioporto-Diagnostics). HIV infection was confirmed with western-blotting and HCV with PCR. CD4 lymphocytes were quantified with flow cytometry. RFLP and PCR were used to determine the viral load of HIV and HCV (genotype).
  
  
  RESULTS
  A significant increase of IL-18, NGAL and β2M activity in heroin addicts compared to the control group was noted as well as the influence of HIV infection on NGAL and β2M excretion. A statistically significant (p=0.04) correlation between the viral load and IL-18 concentration was noted while no significant influence of the duration and the kind of drugs abused, the route of intake or the age of addicts was seen. Only the NGAL concentration was sex dependent and significantly higher in women.
  
  
  CONCLUSIONS
  This study showed the specific, clinical utility of IL-18, NGAL, and β2M in the evaluation of renal function in drug addicts. Early detection of nephropathy with biochemical indicators might help prevent severe conditions that require hospitalization and intensive care.
authors.affiliation: Monitoring Laboratory for Infections Among Drug Users, Department of Infectious Diseases, Wroclaw Medical University, Poland; Substitution Daycare Center, Wroclaw Health Center, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Gąsiorowski
authors.affiliation: Laboratory of Environmental Nephrotoxicity Markers, Department of Toxicology, Wroclaw Medical University, Poland.
authors.forename: Zofia
authors.initials: Z
authors.lastname: Marchewka
authors.affiliation: Department of Clinical Pharmacology, Wroclaw Medical University, Poland; Substitution Daycare Center, Wroclaw Health Center, Poland.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Łapiński
authors.affiliation: Laboratory of Environmental Nephrotoxicity Markers, Department of Toxicology, Wroclaw Medical University, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Szymańska
authors.affiliation: Department of Clinical Pharmacology, Wroclaw Medical University, Poland.
authors.forename: Krystyna
authors.initials: K
authors.lastname: Głowacka
authors.affiliation: Monitoring Laboratory for Infections Among Drug Users, Department of Infectious Diseases, Wroclaw Medical University, Poland.
authors.forename: Brygida
authors.initials: B
authors.lastname: Knysz
authors.affiliation: Laboratory of Environmental Nephrotoxicity Markers, Department of Toxicology, Wroclaw Medical University, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Długosz
authors.affiliation: Department of Clinical Pharmacology, Wroclaw Medical University, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Wiela-Hojeńska
mesh_terms: D000209:Acute-Phase Proteins / Q000652:urine*; D000328:Adult; D015415:Biomarkers / Q000652:urine; D015496:CD4-Positive T-Lymphocytes; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000652:urine; D064368:Healthy Volunteers; D006526:Hepatitis C / Q000453:epidemiology / Q000652:urine; D006801:Humans; D020382:Interleukin-18 / Q000652:urine*; D007527:Isoenzymes / Q000652:urine; D007677:Kidney Function Tests / Q000379:methods*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D008875:Middle Aged; D011518:Proto-Oncogene Proteins / Q000652:urine*; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000652:urine*; D019562:Viral Load; D055815:Young Adult; D001613:beta 2-Microglobulin / Q000652:urine*
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D020382:Interleukin-18; D007527:Isoenzymes; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D001613:beta 2-Microglobulin