title: Utility of urinary alkaline phosphatase and γ-glutamyl transpeptidase in diagnosing acute kidney injury in dogs.
abstract: The diagnostic utility of urinary alkaline phosphatase (uALP) and γ-glutamyl transpeptidase (uGGT) activities in naturally occurring acute kidney injury (AKI) was investigated in a heterogeneous group of dogs. The study included client-owned dogs with AKI (n = 32), chronic kidney disease (CKD, n = 13), lower urinary tract infection (LUTI, n = 15) and healthy controls (n = 24). uGGT and uALP activities were normalised to urinary creatinine (uCr) concentrations (uGGT/uCr and uALP/uCr, respectively). uALP/uCr and uGGT/uCr were positively and significantly correlated (r = 0.619, P <0.001), and differed significantly (P ≤ 0.001) among groups, as well as between AKI and LUTI or CKD groups (P < 0.05), but not between the AKI and control groups. Areas under the receiver operator characteristics (ROC) curve for uALP/uCr and uGGT/uCr as predictors of AKI were 0.75 and 0.65, respectively, with optimal cut-off points showing poor to moderate sensitivity (59% for uALP/uCr and 79% for uGGT/uCr) and specificity (59% for uALP/uCr and 75% for uGGT/uCr). Higher cut-off points, with 90% specificity, showed low sensitivity (41% for both uALP/uCr and uGGT/uCr). In conclusion, uALP/uCr is superior to uGGT/uCr as a marker of AKI, but both uGGT/uCr and uALP/uCr have unsatisfactory discriminatory power for diagnosing naturally occurring AKI in dogs and therefore cannot be recommended as sole screening tests for canine AKI. However, both may serve as ancillary, confirmatory, biomarkers for detecting AKI in dogs if appropriate cut-off points with high specificities are used.
authors.affiliation: Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 761001, Israel. Electronic address: ran.nivy@mail.huji.ac.il.
authors.forename: Ran
authors.initials: R
authors.lastname: Nivy
authors.affiliation: Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 761001, Israel.
authors.forename: Yochai
authors.initials: Y
authors.lastname: Avital
authors.affiliation: Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 761001, Israel.
authors.forename: Itamar
authors.initials: I
authors.lastname: Aroch
authors.affiliation: Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 761001, Israel.
authors.forename: Gilad
authors.initials: G
authors.lastname: Segev
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000662:veterinary*; D000469:Alkaline Phosphatase / Q000652:urine*; D000818:Animals; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000652:urine; D004283:Dog Diseases / Q000175:diagnosis*; D004285:Dogs; D007677:Kidney Function Tests / Q000662:veterinary; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000662:veterinary; D005723:gamma-Glutamyltransferase / Q000652:urine*
chemical_list: D015415:Biomarkers; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase
keywords: Acute kidney injury; Canine; Renal failure; Urinary alkaline phosphatase; γ-Glutamyl transpeptidase