Urinary Gamma-glutamyl Transferase Research Articles

Correlation of Urinary Gamma Glutamyl Transferase to Creatinine Ratio with Albumin Creatinine Ratio in Patients with Type 2 Diabetes Mellitus

Correlation of Urinary Gamma Glutamyl Transferase to Creatinine Ratio with Albumin Creatinine Ratio in Patients with Type 2 Diabetes Mellitus

Evaluation of kidney injury through early markers in canine pyometra

Fourteen female dogs diagnosed with pyometra were studied at three separate times: at diagnosis (T0) and 24 h (T1) and 10-15 days (T2) after ovariohysterectomy (OH). The means of the markers, symmetric dimethylarginine (SDMA) (17.71 to 26.54 μg/dL) and the urinary gamma-glutamyl transferase to creatinine ratio (uGGT/uCr) (1.06 to 2.62 U/mg), varied, showing an increase with time. Further, the elevation of gamma-glutamyl transferase (uGGT) (56.61 to 128.12 U/L) and the urinary protein to creatinine ratio (RPC) (0.26 to 1.24) was evident at T0 and T1. A reduction in the means of RPC, uGGT, and uGGT/uCr was observed 10-15 days after OH. Despite the elevation of these markers, the concentration of creatinine (1.11 to 1.40 mg/dL), urea (40.07 to 67.16 mg/dL), and urinary specific gravity (1.027 to 1.028) only presented slight variation. In canine pyometra, complications secondary to acute renal injury may be present that may be mild and transient in most treated animals. As elevation in SDMA and RPC preceded changes in creatinine levels for the evaluation of glomerular filtration, tubular markers could assist in the early identification of renal damage in canine pyometra.

Concentrations and kinetics of renal biomarkers in dogs with gastric dilatation-volvulus with and without 24-h intravenous lidocaine.

Gastric dilatation volvulus (GDV) can lead to organ failure including acute kidney injury (AKI). Due to its cytoprotective, antioxidant and anti-inflammatory effects, lidocaine has a potential to prevent AKI in dogs with GDV. Prospective, observational cohort study in client-owned dogs with GDV. To determine concentrations of renal biomarkers for AKI in dogs with GDV with and without intravenous (IV) lidocaine therapy. Thirty-two dogs were randomized to receive either IV lidocaine (2 mg/kg, followed by a lidocaine constant rate infusion at a dose of 50 μg/kg/min over 24 h; n = 17) or no lidocaine (n = 15). Blood and urine samples were taken at admission (T 0) (only blood), during or immediately after surgery (T 1), and 24 (T 24) and 48 (T 48) h after surgery. Plasma creatinine (pCr), plasma neutrophil gelatinase-associated lipocalin (pNGAL), urinary NGAL (uNGAL), uNGAL to creatinine ratio (UNCR), and urinary gamma-glutamyl transferase to creatinine ratio (uGGT/uCr) were evaluated. Biomarker concentrations were compared between dogs with and without IV lidocaine and the course of each marker was determined in comparison to its admission value. In the entire population, a significantly higher pCr at T 0 (median, 95 μmol/L, interquartile range, 82-105) compared with T 1 (69 μmol/L, 60-78), T 24 (63 μmol/L, 52-78), and T 48 (78 μmol/L, 65-87) (P < 0.001) was found. Plasma NGAL increased significantly between T 0 (5.66 ng/mL, 3.58-7.43) and T 24 (7.50 ng/mL, 4.01-11.89) (P = 0.006) and T 48 (9.86 ng/mL, 5.52-13.92) (P < 0.001), respectively. Urinary NGAL increased significantly between T 1 (0.61 ng/mL, 0.30-2.59) and T 24 (2.62 ng/mL, 1.86-10.92) (P = 0.001) and T 48 (4.79 ng/mL, 1.96-34.97 (P < 0.001), respectively. UNCR increased significantly between T 1 (0.15 μg/mmol, 0.09-0.54) and T 24 (1.14 μg/mmol, 0.41-3.58) (P = 0.0015) and T 48 (1.34 μg/mmol, 0.30-7.42) (P < 0.001), respectively. Concentrations of uGGT/uCr increased significantly from T 0 highest at T 24 (6.20 U/mmol, 3.90-9.90) and significantly decreased at T 48 (3.76 U/mmol, 2.84-6.22) (P < 0.001). No significant differences in any renal biomarker concentration were found between dogs with and without IV lidocaine therapy. Plasma NGAL, uNGAL and UNCR remained increased up to 48 h post-surgery. No evidence of lidocaine-associated renoprotection was found.

Vincristine sulfate treatment influence on kidney function of female dogs with transmissible venereal tumor

Chemotherapy agents have some undesirable and non-selective cytostatic effects. Considering that kidneys are vulnerable to drug-induced toxicity, this study evaluated renal injury caused by vincristine sulfate (VS) in 12 female dogs diagnosed with transmissible venereal tumor (TVT). The animals were treated with VS (0.025 mg/kg IV) every 7 days for 4 weeks. During treatment, the animals were subjected to clinical examination, blood count, serum measurement of symmetric dimethylarginine (SDMA), blood urea nitrogen (BUN), creatinine, alanine aminotransferase, and alkaline phosphatase. In addition, urinalysis and urinary gamma-glutamyl transferase (GGT) measurements were performed. All parameters were determined three times: before beginning the treatment (T0), after 14 days (T1), and after 28 days (T2). During the study period, there were no changes in serum urea or creatinine levels, urine specific gravity, or persistent proteinuria. Furthermore, urinary GGT measurement did not indicate tubular lesions, and consistent elevation of SDMA was found in only one patient above the reference range. The results showed that weekly therapy with VS as a single agent for 28 days does not induce renal injury in most cases.

Kidney injury molecule-1 and urinary gamma-glutamyl transferase as biomarkers of acute kidney injury in cats.

To evaluate the concentration of kidney injury molecule-1 and activity of urinary gamma-glutamyl transferase in cats with urethral obstruction and healthy cats. Blood and urine samples were collected from a group of 15 healthy cats (control group) and a group of 20 cats with urethral obstruction at presentation, and 24hours and 7 days after unblocking the obstruction. The serum creatinine, urinary creatinine and urinary gamma-glutamyl transferase were measured by spectrophotometry and kidney injury molecule-1 by the sandwich enzyme-linked immunosorbent assay. On presentation, cats with obstruction had serum creatinine concentration and urinary gamma-glutamyl transferase index higher than healthy cats (mean difference 544 μmol/L, 95% confidence intervals 222 to 865 μmol/L, and 0.0022 U/μmol-uCre, 0.00043 to 0.0039 U/μmol-uCre, respectively), urine creatinine concentration lower (mean difference 25,624 µmol/L, 17,329 to 33,919 µmol/L), and no significant difference in the kidney injury molecule-1/urinary creatinine ratio (mean difference 13 pg/μmol-uCre, -33 to 59 pg/μmol-uCre). In the group of cats with urinary obstruction, over time serum creatinine decreased, urine creatinine increased, urinary gamma-glutamyl transferase index did not change significantly, and kidney injury molecule-1/urinary creatinine ratio increased. Cats with post-renal obstruction and potential intrinsic renal damage had higher urinary gamma-glutamyl transferase index than healthy cats at the time of presentation and showed increase in kidney injury molecule-1/urinary creatinine ratio over time.

Índice de resistividade renal como auxiliar no diagnóstico de lesão renal aguda em cadelas com piometra

This study aimed to evaluate the renal function of six bitches of various breeds and ages, with open pyometra, attended in the Small Animal Medical Clinic sector of the Veterinary Hospital from Federal University of Campina Grande, through the measurement of laboratory tests: urea and creatinine serum, dosage of the urinary Protein-Creatinine Ratio (PCR), urinary gamma-glutamyltransferase (GGT) and determination of the renal resistivity index (RI). The levels of urea and creatinine were elevated in 16.6% (1/6) of the female dogs; the urinary protein-creatinine ratio was increased in 66.6% (4/6), while the urinary gamma-glutamyltransferase value was elevated in 50% (3/6). The renal resistivity index was increased in the right and left kidneys by 66.6% (4/6) of bitches, with no statistical difference between them. It was concluded that the renal resistivity index was a practical and effective method to assist in the diagnosis of acute kidney injury, along with other early markers, such as PCR and urinary GGT.

Measurement of Selected Renal Biochemical Parameters in Healthy Adult Donkeys Considering the Influence of Gender, Age and Blood Freezing.

Simple SummaryIn animal medicine, laboratory test profiles containing selected blood or urine parameters are used to diagnose diseases of a given organ. The normal values of the serum and urine biochemical parameters are well-known in horses, but they have not been studied well in donkeys. This means that their results are often compared with horses’ reference values. The interest in donkeys continues to grow, as well as increasing attention being paid to kidney damage in animals. The objective of the study was to determine the values of the selected serum and urine parameters to assess the renal function in healthy donkeys. The effects of age, sex and freezing of the material were then assessed. Sixty-five healthy adult donkeys participated in the study. The results showed different reference values for the kidney parameters such as urea, total protein, albumin, urine protein/creatinine ratio and fractional electrolyte excretion in donkeys compared to those reported for horses. The donkeys’ gender had an effect on the creatinine and urea, while age had an effect on the albumin, total protein and electrolytes. Freezing of the material also influenced most of the parameters. To the authors’ knowledge, this is the first study to analyze the selected renal biomarkers in donkeys.The reference values of the serum and urine biochemical parameters have not been well-studied in donkeys. This study aimed to assess the normal values of the selected renal biomarkers, such as: serum creatinine, blood urea nitrogen (BUN), albumin, total protein (TP), electrolytes and symmetric dimethylarginine (SDMA), urine protein concentration (UPC), urine protein/creatinine ratio (UPCR), the urine gamma-glutamyl transferase (GGTP)-to-creatinine ratio, serum creatinine-to-urine creatinine ratio (sCr/uCr), serum BUN-to-serum creatinine ratio (sBUN/sCr) and UPC-to-TP ratio, as well as the fractional electrolyte excretion of sodium (FENa) and potassium (FEK) in donkeys. The effects of age, gender and deep freezing of the serum material were investigated. Sixty-five healthy adult donkeys were involved in this study. The results showed higher BUN and TP values and lower albumin, UPCR, FENa and FEK levels in donkeys when compared to the reference values in horses. A significant gender relationship for creatinine and BUN was found. Age influenced the values of albumin, TP, potassium and chlorine. Potassium, sodium and SDMA did not show significant concentration changes after freezing. The study results demonstrated that horse reference range values for some parameters cannot be applied to donkey samples. Only a few of the serum parameters were not affected by freezing, and this should be taken into account when storing biological materials.

Potential Acute Renal Injury in Sheep with Bluetongue Serotype 4.

Bluetongue is a vector-borne disease with epidemic potential. Recently, outbreaks of Bluetongue were reported across Greece, caused by the Bluetongue virus (BTV) serotype 4. Regarding its pathogenesis, BTV infection involves various target organs with limited data referring to the kidneys. The objective of this study was to identify the possible impact of BTV infection on kidneys using common renal biomarkers. Urine and blood samples collected from 30 sheep with clinical signs of bluetongue (BTV sheep) and 30 clinically healthy sheep (normal sheep) from the same farms were finally selected and included in the study from an initial population of 47 sheep per group, based on the absence of active urine sediment. Complete urinalysis was performed and urine protein to creatinine ratio (UPC) and urine gamma-glutamyl transferase to creatinine (UGGTC) ratio were determined. Blood urea nitrogen (BUN), creatinine, total proteins, albumin (ALB), and inorganic phosphate (P) were determined in serum samples. UPC and UGGTC were significantly higher (p < 0.05) in BTV sheep compared to normal, whereas urine specific gravity (USG) was significantly lower (p < 0.05). Cylindruria was also detected in BTV sheep, and absence of azotemia in BTV and normal sheep. All these findings are indicative of renal tubular injury and/or dysfunction and suggestive of an association between BTV infection and acute damage of renal tissue.

Distribution of urinary gamma-glutamyltransferase activity in 40- to 74-year-old Japanese women

Urinary gamma-glutamyltransferase (u-γGT) concentration (U/L) and excretion (urinary creatinine-corrected u-γGT; u-γGT/u-Cre, U/g creatinine) are useful markers for kidney disease. However, there is limited information available on u-γGT and u-γGT/u-Cre distribution in the elderly Japanese population. In this study, we investigated the distribution of u-γGT and u-γGT/u-Cre in 113 Japanese women aged 40–74 years. The u-γGT was assessed from spot urine samples (collected from 09:00 to 14:00) spectrophotometrically according to the Japan Society of Clinical Chemistry reference measurement procedure using l-γ-glutamyl-3-carboxy-4-nitroanilide as the substrate. The u-Cre was measured enzymatically using creatininase, creatinase, sarcosine oxidase, and peroxidase. None of the participants was diagnosed with any kidney disease. Median u-γGT and u-γGT/u-Cre values (central 95% interval values) were 29.7 (5.3–144.0) U/L and 57.9 (32.9–122.7) U/g creatinine, respectively. The distribution of u-γGT tended to decline with age. There was a statistically significant difference in the u-γGT value between the 40-59- and 60-74-year-old groups. In contrast, there was no significant difference in the u-γGT/u-Cre between each age group. The u-Cre level also declined with age. It is suggested that the decline of u-γGT with aging would be masked by the u-Cre correction.

The Effect of One Session Acute Exercise on the Urinary Excretion of Urinary Gamma-Glutamyl Transferase, Protein and Creatinine Levels of Elite Football Players

The aim of the present study was to evaluate the effect of one session acute exercise on the urinary excretion of urinary Gamma-glutamyl transferase, protein and creatinine levels in elite football players. A total of 30 Premier League football players with a mean age (26.1±3.80), a mean height (180.01±7.39), a mean weight (78.6±9.26) and a mean body mass index (24.87±1.13) were voluntarily and purposefully selected as statistical samples. The urinary sample of the players was collected in two stages. In the first stage, the players&amp;#39; urinary samples were taken on the rest day when they had not exercised for 24 hours. In the second stage, it was taken immediately after exercise and transferred to the laboratory. To test the hypotheses, especially to compare urinary protein, creatinine, and gamma-glutamyl transferase levels before and after exercise, and to compare excretion levels of protein, creatinine, and gamma-glutamyl transferase between the positions, ANOVA test was used. There was a significant difference between the levels of gamma-glutamyl transferase, proteinuria and creatinine before and after exercise (P

A utilização da metodologia semiautomática não interfere significativamente na mensuração da atividade da gama glutamil transferase urinária em cães

The urinary gamma-glutamyltransferase (GGTu) is a precocious indicator of renal lesion and the gold standard for the measurement of its activity is the automated method, although semi-automation is often utilized and studies relating this methodology to the occurrence and intensity of analytical errors are still scarce. Therefore, this work aimed to calculate the systematic and random errors in the determination of the GGTu activity in dogs with the use of the semi-automated method and evaluate if that methodology statistically differs from the automated method. 49 dog urine samples were collected through cystocentesis and centrifuged for separation of the supernatant, which was employed for the measurement of the GGTu activity by automated (reference) and semi-automated methods.&nbsp; Linear regression and Pearson correlation (r) tests were employed for the establishment of the systematic error. The random error was calculated according to Westgard; Hunt (1973). Lin’s concordance correlation coefficient was employed to evaluate the presence of concordance between automated and semi-automated techniques. In the analysis of results, a constant error of + 9.51 UI/L (a = 9.5118), a proportional error of – 9.37% (b=0.9063) and a random error of 9.91% was observed when the semi-automated methodology was employed. The determination (R2) and Lin coefficients were, respectively, 0.9859 with p&lt;0.0001 and 0.9912, suggesting a great similarity and almost perfect concordance between the two methods. Therefore, the data verified that the semi-automation does not interfere significantly in the measurement of the GGTu activity within the minimum and maximum values observed in the study.

Equine urinary N-acetyl-β-D-glucosaminidase assay validation and correlation with other markers of kidney injury.

Detection of equine acute kidney injury (AKI) is hindered by limited markers of early renal damage in horses. N-acetyl-β-D-glucosaminidase (NAG), a lysosomal enzyme in renal tubular epithelium released into urine during tubular insult, has shown promise for early identification of AKI in humans and other species. We validated an assay for NAG in equine urine and measured urinary NAG in 7 azotemic and 7 non-azotemic client-owned adult horses. The enzymatic NAG assay was validated using within- and between-run coefficients of variation (CVs), recovery following standard addition, and linearity of dilution. Intra- and inter-run CVs (21% and 3.2%, respectively), average recovery following standard addition (99-109%), and linearity under serial dilution (R2 = 0.997) were satisfactory. Urine NAG index was significantly correlated with urinary fractional excretion of sodium (FENa; ρ = 0.76, p < 0.001) and plasma creatinine (ρ = 0.74, p = 0.001). Median urine NAG indices were higher in azotemic horses (p = 0.006), in horses with increased urinary FENa (p = 0.006), and in horses with increased urine gamma-glutamyl transferase index (p = 0.032). Urine NAG can be measured in horses and shows positive correlation with 2 current renal biomarkers. Additional work is needed to establish normal equine reference intervals and characterize the increase of urine NAG index in horses in relation to tubular injury.

Kidney disease in natural infection by Ehrlichia canis in dogs

Canine monocytic ehrlichiosis, caused by the intracellular bacterium Ehrlichia canis, can affect different organs, including the kidneys, in different stages of infection, and kidney involvement is considered one of the main causes of death related to the disease. This study aimed to investigate the occurrence of kidney disease in dogs naturally infected with E. canis and to correlate antibody levels with the severity of renal disease. Serum concentrations of urea, creatinine, and proteins (albumin and globulin), along with urine concentration, urine gamma-glutamyl transferase, and urine protein levels, were evaluated in 60 dogs with E. canis infection diagnosed by polymerase chain reaction. The detection of anti-E. canis antibodies was also performed for each dog. Of the 60 dogs with E. canis infection, 73.33% presented anti-E. canis antibodies. Laboratory abnormalities consistent with renal disease were observed in 33 (55%) infected dogs, and of these, 43.3% were in stage I chronic kidney disease. A positive correlation was observed between antibody levels and total plasma protein (p = 0.0332) and serum globulin (p = 0.0057) levels. In this study, renal disease was observed on routine laboratory testing in 55% of dogs with monocytic ehrlichiosis; however, there was no correlation between the stage of renal disease and the antibody titer against E. canis.

Urinary calcium assessment and its relation with age, sex and Encephalitozoon cuniculi serological status in otherwise healthy pet rabbits

BackgroundUrinary calcium excretion by rabbits is set proportionately higher than that of other species, giving the rabbit urine its characteristic cloudy appearance. During pregnancy, lactation and growth, or when metabolic...

Validation of a spectrophotometric method for GGT measurement in canine urine and determination of the urine GGT-to-creatinine ratio reference interval and biological variation in 41 healthy dogs.

The urine gamma-glutamyl transferase (GGT)-to-creatinine ratio has been used to monitor patients at risk of acute renal injury. We validated the spectrophotometric quantification of GGT in urine in a commercial biochemistry analyzer. The assay was precise, accurate, and linear. Intra-assay precision was 3.59% in 4 samples, with GGT concentrations of 47-195 U/L. Inter-assay precision in 3 samples with activities of 11-51 U/L was 7.74%. Accuracy was 97.3%, with an absolute bias of 2.7 U/L. Urine GGT was unaffected by hematuria, hemoglobinuria, or bacteriuria. Urine GGT was stable at 20°C and 4°C for up to 3 d. Storage by freezing at -20°C resulted in a significant reduction in enzyme activity. A pH outside the range of 6.5-8 resulted in reduced GGT activity. The biological variation of urine GGT-to-creatinine ratio provided an index of individuality of 1.6, indicating that a population-based reference interval (RI) can be used. The reference change value was calculated, and an increase in consecutive measurements >43% is required to be regarded as significant. The urine GGT-to-creatinine ratio RI obtained in a population of 41 healthy dogs was 8.5-28.5 U/g.

Biomarkers and renal arterial resistive index in dogs naturally infected with Leishmania infantum.

Canine visceral leishmaniasis frequently causes glomerulonephritis and tubulointerstitial nephritis, nephropathies for which diagnosis has been limited by the low sensitivity of traditional tests. The aim of this study was to evaluate serum cystatin C and urinary gamma-glutamyltransferase (uGGT) levels and the urinary GGT/urinary creatinine ratio (uGGT/uCR) and to measure the renal arterial resistive index (RARI) in dogs with leishmaniasis with varying degrees of renal injury based on the urine protein: creatinine ratio (UP/C) and serum creatinine (SCr) level. We tested 59 untreated adult dogs of both sexes and undefined breeds naturally infected with Leishmania infantum. The dogs were grouped into four groups based on UP/C and SCr level: group 1 (n = 15), dogs with SCr levels < 1.4mg/dL and UP/C < 0.5; group 2 (n = 13), dogs with SCr levels < 1.4mg/dL and UP/C of 0.5-1.0; group 3 (n = 16), dogs with SCr levels < 1.4 and UP/C > 1.0; and group 4 (n = 15), dogs with SCr levels > 1.4. A fifth group of healthy dogs (n = 10) was the control. uGGT concentrations and uGGT/uCR were higher in dogs with proteinuria and SCr < 1.4mg/dL, whereas the serum cystatin C concentrations and RARI were higher only in dogs with SCr levels > 1.4. In conclusion, uGGT and uGGT/uCR may be useful tools for early detection and assessment of renal lesions associated with leishmaniasis; however, cystatin C is useful for monitoring the progression of kidney disease when measured sequentially.

Evaluation of Urinary Gamma Glutamyl Transferase as an Early Biomarker of Diabetic Nephropathy in Type 2 Diabetic Patients

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Reference limits of the urinary gamma-glutamyltransferase in a healthy population and effects of short-term storage on the enzyme activity

BackgroundGamma-glutamyltransferase (GGT) is present mainly in proximal renal tubule, and urinary GGT is an indicator of tubular damage since it may show renal changes before they are identified by using conventional measurements. Therefore, it is of interest to establish the reference limits of urinary GGT for a healthy population, as well as to investigate the stability of GGT in urine samples stored at 4 °C and −20 °C. MethodsGGT was assessed in urine samples from 127 healthy patients by use of a reference method based on the 5-Amino-2-Nitrobenzoate formation. Stability of GGT was evaluated in 10 urine samples stored at temperatures of 4 °C and −20 °C for a period up to 4 weeks. ResultsUrinary GGT values for healthy volunteers were 14 U/g creatinine for the lower reference limit and 79 U/g creatinine for the upper reference limit. Urinary GGT values were approximately 56% lower in samples stored at −20 °C than fresh samples, while samples stored at 4 °C presented a decrease of 11% in GGT values compared to fresh samples. ConclusionsReference limits for urinary GGT in healthy subjects were 14 to 79 U/g creatinine, and it is recommended to measure urinary GGT in fresh specimens.

Clinical utility of urine kidney injury molecule-1 (KIM-1) and gamma-glutamyl transferase (GGT) in the diagnosis of canine acute kidney injury.

The aim of the present study was to evaluate the sensitivity and specificity of urine KIM-1 and urine GGT for the detection of naturally-occurring AKI, compared to healthy control dogs, dogs with stable chronic kidney disease (CKD), and dogs with lower urinary tract disorders (LUTD). The study included AKI grade 1 (n = 21), AKI grade 2 to 5 (n = 11), stable CKD (n = 11), LUTD (n = 15), and healthy dogs (n = 37). Urine KIM-1 (ng/mg) and GGT (U/l) were normalized to urine creatinine (uCr). Statistically significant difference in KIM/uCr (p = 0.0007) and GGT/uCr (p < 0.0001) was found among the study groups. Area under the curve (AUC) for KIM-1/uCr and GGT/uCr as predictors of AKI was 0.81 and 0.91 respectively. Values of KIM-1/uCr of 0.73ng/mg and of GGT/uCr of 54.33 showed the best combination of sensitivity and specificity (75% and 75.6%; 85.7% and 89.1% respectively). A significant positive correlation (p < 0.0001) between KIM-1/uCr and GGT/uCr was found. Both urine KIM-1/uCr and GGT/uCr seemed to be potentially good markers for the diagnosis of AKI. Dogs with AKI showed significantly higher levels of urine KIM-1/uCr and urine GGT/uCr, compared with healthy dogs. Caution should be used in the evaluation of elevated urine KIM-1/uCr and GGT/uCr in dogs with pre-existing CKD and/or LUTD. Urine KIM-1/uCr and GGT/uCr might have a significant clinical utility, as complementary test, particularly in diagnosis early, non-azotemic stages of AKI.

Nephroprotective Efficacy of Methanolic Extract of Kalmegh (Andrographis paniculata) in Acute Renal Failure in Dogs

Comparative nephroprotective activity of the methanolic extract of Andrographis paniculata (400 mg/kg body weight) and peritoneal dialysis was studied in dogs suffering from acute renal failure. The activities of hemoglobin, serum creatinine, blood urea nitrogen, serum total protein, urine gamma glutamyl transferase were evaluated. The methanolic extract of Andrographis paniculata significantly increased the hemoglobin and serum total protein level, and decreased the levels of serum creatinine, blood urea nitrogen and urine GGT, as observed in peritoneal dialysis treatment.