Urinary N-acetyl-β-D-glucosaminidase Research Articles

Dahuang Fuzi Decoction ameliorates tubular epithelial apoptosis and renal damage via inhibiting TGF-β1-JNK signaling pathway activation in vivo

Ethnopharmacological relevanceDahuang Fuzi Decoction (DFD) is a traditional well-prescribed formula for the treatment of chronic kidney disease (CKD) in China. This study was carried out to examine the effects of DFD in adenine-induced tubular epithelial apoptosis and renal damage, in comparison with allopurinol (AP), then to clarify the therapeutic mechanisms in vivo. Materials and methodsA rat model of renal damage was created by adenine. Rats in Normal and Vehicle groups received distilled water, while rats in DFD and AP groups received DFD and AP, respectively. Proteinuria; urinary N-acetyl-β-d-glucosaminidase (NAG) levels; the blood biochemical parameters; renal histopathology damage; transferase-mediated dUTP nick-end labeling (TUNEL)-staining; the key molecular protein expressions in mitochondrial and transforming growth factor (TGF)-β1-c-JunNH2-terminal kinase (JNK) pathways were examined, respectively. ResultsAdenine administration induced severe renal damages, as indicated by the mass proteinuria, the heavy urinary NAG, and the marked histopathological injury in tubules and interstitium. This was associated with the activation of TGF-β1-JNK signaling pathway and tubular epithelial apoptosis. DFD treatment, however, significantly prevented proteinuria and urinary NAG elevation, and attenuated tubular epithelial apoptosis. It suppressed the protein expressions of Bax and cleaved caspase-3, whereas it enhanced the protein expression of Bcl-2. Furthermore, it also suppressed the protein levels of TGF-β1 as well as phosphorylated-JNK (p-JNK). ConclusionDFD alleviated adenine-induced tubular epithelial apoptosis and renal damage in vivo, presumably through the suppression of TGF-β1-JNK pathway activation.

Early prediction of acute kidney injury biomarkers after endovascular stent graft repair of aortic aneurysm: a prospective observational study

BackgroundAcute kidney injury (AKI) is a common and serious condition usually detected some time after onset by changes in serum creatinine (sCr). Although stent grafting to repair aortic aneurysms is associated with AKI caused by surgical procedures or the use of contrast agents, early biomarkers for AKI have not been adequately examined in stent graft recipients. We studied biomarkers including urinary neutrophil gelatinase-associated lipocalin (NGAL), blood NGAL, N-acetyl-β-d-glucosaminidase (NAG), microalbumin (Alb), and liver fatty acid-binding protein (L-FABP) as prospective early biomarkers for AKI in patients who had received stent graft repairs of aortic aneurysms.MethodsIn addition to pre-surgical sampling, at 2 to 6 h and at 1, 3 to 4, and 5 days or later (until stable) after surgery, urine and serum biomarkers were sampled from 47 patients who underwent stent graft repair of aortic aneurysms.ResultsUsing Acute Kidney Injury Network criteria, 6 (14%) of 42 retained patients developed AKI. NGAL corrected with urine Cr (NGAL/Cr) values demonstrated the best predictive value for AKI (97% specificity, 83% sensitivity at a 65.1 μg/gCr cutoff). The area under the receiver-operator characteristic curve of NGAL/Cr value 2 h after surgery was 0.9. Although NGAL/Cr, L-FABP corrected with urine Cr (L-FABP/Cr), L-FABP, NAG, and Alb corrected by urine Cr (Alb/Cr) all reached peak values before AKI detection by sCr in AKI patients, all biomarkers reached the cutoff value before AKI detection after adaption of cutoff value.ConclusionsAfter stent graft repair of aortic aneurysm, NGAL/Cr is a potentially useful early biomarker for AKI.

Analysis of glycosuria in okapi (Okapia johnstoni): examination of urinary N-acetyl-β-D-glucosaminidase.

We analyzed the urinary excretion of glucose and N-acetyl-β-D-glucosaminidase (NAG) in six okapis (Okapia johnstoni) in captivity to investigate the cause of their urinary sugar excretion. The urinary glucose-positive okapi had significantly higher urinary NAG indices than the urinary glucose-negative okapi. There was also a positive correlation between urinary glucose levels and urinary NAG indices. These results suggest that the proximal tubular function of the glycosuric okapi may have been obstructed, which impaired glucose reabsorption.

Evaluation of urinary enzymes in newborns treated with gentamicin.

In recent years, there has been an increasing amount of study on early diagnosis of kidney injury through sensitive and specific biomarkers. We examined the practical applicability of the urinary levels of NAG (N-acetyl-β-D-glucosaminidase), AP (alkaline phosphatase), and LDH (lactate dehydrogenase) as renal dysfunction screening biomarkers in full and pre-term newborns treated with gentamicin. Fourteen pre-term and fifteen full-term newborns who received gentamicin for suspected infections were enrolled. Serum and urine specimens were obtained before the zero days and after gentamicin infusion on the 1st, 3rd, and 5th days of treatment. In full-term newborns a significant increase in urinary NAG, LDH, AP after 5 days of gentamicin administration compared with control group was noted (P<0.05, P<0.001 and P<0.01; respectively). Our findings indicate that urinary enzymes may be useful in full-term newborns as a non-invasive method for evaluation of tubular function.

MP20-13 OXYGEN NANO-BUBBLE WATER EXERTS INHIBITORY EFFECTS ON KIDNEY STONE FORMATION BY INHIBITING RENAL TUBULAR CELL INJURY

You have accessJournal of UrologyStone Disease: Basic Research I1 Apr 2014MP20-13 OXYGEN NANO-BUBBLE WATER EXERTS INHIBITORY EFFECTS ON KIDNEY STONE FORMATION BY INHIBITING RENAL TUBULAR CELL INJURY Yasuhiko Hirose, Kazumi Taguchi, Yasuhiro Fujii, Kazuhiro Niimi, Shuzo Hamamoto, Ryosuke Ando, Masahito Hirose, Atsushi Okada, Yasue Kubota, Yasunori Ito, Takahiro Yasui, Keiichi Tozawa, and Kenjiro Kohri Yasuhiko HiroseYasuhiko Hirose More articles by this author , Kazumi TaguchiKazumi Taguchi More articles by this author , Yasuhiro FujiiYasuhiro Fujii More articles by this author , Kazuhiro NiimiKazuhiro Niimi More articles by this author , Shuzo HamamotoShuzo Hamamoto More articles by this author , Ryosuke AndoRyosuke Ando More articles by this author , Masahito HiroseMasahito Hirose More articles by this author , Atsushi OkadaAtsushi Okada More articles by this author , Yasue KubotaYasue Kubota More articles by this author , Yasunori ItoYasunori Ito More articles by this author , Takahiro YasuiTakahiro Yasui More articles by this author , Keiichi TozawaKeiichi Tozawa More articles by this author , and Kenjiro KohriKenjiro Kohri More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.735AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Renal tubular cell injury induced by oxalate plays an important role in kidney stone formation. Water containing oxygen nano-bubbles (ONB: nanometer-sized bubbles generated from oxygen micro-bubbles) has anti-inflammatory effects. Therefore, we investigated the inhibitory effects of ONB water on kidney stone formation in ethylene glycol (EG)-treated rats. METHODS ONB water can be produced by rapidly collapsing oxygen micro-bubbles in hard water with a salt concentration of 1.0% by mass. Further, ONB water with a salt concentration of 0% by mass can be prepared by passing the resulting ONB water twice through a reverse osmosis membrane, obtaining ONB water was defined as 100% ONB water. A mixture comprising half 100% ONB water and half distilled water was defined as 50% ONB water. We divided 60 rats, aged 4 weeks, into 5 groups: (1) control, a water-fed group; (2) 100% ONB, a 100% ONB water-fed group; (3) EG, the EG-treated water-fed group; and (4), and (5) EG+50% ONB and EG+100% ONB, the 2 EG-treated, ONB water-fed groups. The rats consumed these fluids by free access for 5 weeks, and the EG-treated groups were also administered 1.2 mL of 10% EG and 0.5 μg of vitamin D3 via a stomach tube for the last 2 weeks. Six rats in each group were sacrificed after 7 days and 6 after 14 days. The pooled 24-hour urine and blood samples of these rats were collected, and their kidneys were excised. Renal CaOx deposits, urinary excretion of N-acetyl-β-D-glucosaminidase (NAG), and renal expression of MCP-1 and OPN as inflammation-related proteins, and the crystal binding molecule hyaluronic acid were compared among the 5 groups. RESULTS In the EG group, CaOx deposits tended to increase at 14 days compared to 7 days after EG administration. However, CaOx deposits were significantly lower in the EG+50% ONB and EG+100% ONB groups than in the EG group 14 days after administration (Figure). In the EG+50% ONB and EG+100% ONB groups, ONB water significantly decreased urinary NAG excretion, and renal MCP-1, OPN, and hyaluronic acid expression compared to the EG group. CONCLUSIONS ONB water exerted substantial effects on kidney stone formation in the rat kidney by inhibiting renal tubular cell injury. ONB water may be a prophylactic for kidney stones. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e201 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Yasuhiko Hirose More articles by this author Kazumi Taguchi More articles by this author Yasuhiro Fujii More articles by this author Kazuhiro Niimi More articles by this author Shuzo Hamamoto More articles by this author Ryosuke Ando More articles by this author Masahito Hirose More articles by this author Atsushi Okada More articles by this author Yasue Kubota More articles by this author Yasunori Ito More articles by this author Takahiro Yasui More articles by this author Keiichi Tozawa More articles by this author Kenjiro Kohri More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...

Evaluation of Renal Functions in Preterm Infants With Respiratory Distress Syndrome

The aim of this prospective study was to evaluate urinary glutathione S transferases π (GST-π), beta-2-microglobulin (B2-MG), and N-acetyl-β-d-glucosaminidase (NAG) levels as markers revealing the effect of respiratory distress syndrome (RDS) on renal function in preterm infants. The study was performed with 76 preterm infants whose gestational ages were between 28 and 32 weeks. Twenty-six preterm infants with RDS (cases) and 50 preterm infants without RDS (controls) enrolled in the study. Blood and urine samples were obtained on postnatal (PN) day 3 and 30. Urinary GST-π levels were measured by enzyme-linked immunosorbent assay (ELISA), and urinary B2-MG levels were determined by nephelometric method. There was no significant difference in urinary B2-MG and GST-π levels between RDS and non-RDS groups on PN day 3 (P > 0.05 for each). However, preterm infants with RDS had significantly higher urinary B2-MG and GST-π levels than the control group on PN day 30 (P = 0.0001 and P = 0.031, respectively). Urinary NAG levels were higher in RDS group than those of the controls on both PN day 3 and 30, but these findings were not statistically significant (P > 0.05, for each). Preterm infants with RDS had increased levels of both GST-π and B2-MG levels on PN day 30, suggesting subclinical tubular dysfunction, probably secondary to hypoxic stress.

Cadmium exposure and its health effects: A 19-year follow-up study of a polluted area in China

BackgroundDayu County, which is located in southwestern Jiangxi Province in China, has been a cadmium (Cd)-contaminated area since the 1960s. A series of studies about Cd pollution were carried out in the 1980s. However, no further studies of the area were conducted during the following 19years. AimTo observe cadmium (Cd) exposure levels and its health risks among residents living in contaminated areas that have been exposed to environmental cadmium pollution for 45years. MethodsSubjects involved in the survey in 1987 were interviewed again in 2006. Rice and urine samples from surviving subjects were collected to assess the level of cadmium exposure. Urinary Cd (U-Cd), urinary β2-microglobulin (U-β2-M) and urinary N-acetyl-β-d-glucosaminidase (U-NAG) were used as biomarkers to evaluate renal function. A medical examination was also performed on all subjects to diagnose clinical symptoms of Cd-exposure. ResultOf the 96 subjects of the 1987 study who were alive in 2006, a total of 76 subjects were successfully recruited to this study. The average cadmium concentration in rice from the exposed areas was 0.59±0.41mg/kg in 2006, the average concentration of U-Cd, U-β2-M and U-NAG from cadmium-exposed areas was 25.82±0.20μg/g Cr, 6525.71±0.93μg/g Cr and 13.65±0.24μmol/g Cr, respectively, in 2006. Compared with the 1987 results, the 2006 results showed that the U-β2-M level in the exposed areas increased significantly after 19years (p<0.05). The levels of U-Cd and U-NAG did not significantly change over time. ConclusionThe concentration of Cd in polluted areas in 2006 is higher than it was in 1987. Renal dysfunction has worsened after 45years of continuous exposure. Thus, environmental protection and special procedures to remove cadmium in these areas require urgent consideration.

Use of the kidney injury molecule-1 as a biomarker for early detection of renal tubular dysfunction in a population chronically exposed to cadmium in the environment

Cadmium (Cd) has been found as an environmental pollutant in Mae Sot district, Tak province, Thailand. Prolong exposure to high levels of Cd of the resident increases high risk of Cd toxicity especially to kidney which is the primary target of Cd. In order to investigate the early effect of Cd induced renal dysfunction, a kidney injury molecule-1 (KIM-1), a novel biomarker of renal tubular dysfunction, was measured using an enzyme linked immunosorbent assay (ELISA). The method was validated and used to quantify the KIM-1 concentrations in the urine of 700 subjects (260 men, 440 women) who lived in the Cd contaminated area. The KIM-1 concentrations were compared to the concentrations of two conventional renal tubular dysfunction biomarkers, N-acetyl-β-D-glucosaminidase (NAG) and β2-microglobulin (β2-MG). Urinary KIM-1 was correlated with urinary and blood Cd as well as NAG. After adjustment of age and smoking, urinary KIM-1 was correlated with blood Cd more than urinary NAG did. Clear dose response relationships of urinary KIM-1 with urinary Cd were shown in both men and women. These results indicate that the urinary KIM-1 might be more sensitive biomarker than urinary NAG and β2-MG for an early detection of renal tubular dysfunction. It is useful as a tool to detect renal effect of toxicity due to chronic Cd exposure at high level.

Impaired endocytosis in proximal tubule from subchronic exposure to cadmium involves angiotensin II type 1 and cubilin receptors

BackgroundChronic exposure to low cadmium (Cd) levels produces urinary excretion of low molecular weight proteins, which is considered the critical effect of Cd exposure. However, the mechanisms involved in Cd-induced proteinuria are not entirely clear. Therefore, the present study was designed to evaluate the possible role of megalin and cubilin (important endocytic receptors in proximal tubule cells) and angiotensin II type 1 (AT1) receptor on Cd-induced microalbuminuria.MethodsFour groups of female Wistar rats were studied. Control (CT) group, vehicle-treated rats; LOS group, rats treated with losartan (an AT1 antagonist) from weeks 5 to 8 (10 mg/kg/day by gavage); Cd group, rats subchronically exposed to Cd (3 mg/kg/day by gavage) during 8 weeks, and Cd + LOS group, rats treated with Cd for 8 weeks and LOS from weeks 5–8. Kidney Cd content, glomerular function (evaluated by creatinine clearance and plasma creatinine), kidney injury and tubular function (evaluated by Kim-1 expression, urinary excretion of N-acetyl-β-D-glucosaminidase (NAG) and glucose, and microalbuminuria), oxidative stress (measured by lipid peroxidation and NAD(P)H oxidase activity), mRNA levels of megalin, expressions of megalin and cubilin (by confocal microscopy) and AT1 receptor (by Western blot), were measured in the different experimental groups. Data were analyzed by one-way ANOVA or Kruskal-Wallis test using GraphPad Prism 5 software (Version 5.00). P < 0.05 was considered statistically significant.ResultsAdministration of Cd (Cd and Cd + LOS groups) increased renal Cd content. LOS-treatment decreased Cd-induced microalbuminuria without changes in: plasma creatinine, creatinine clearance, urinary NAG and glucose, oxidative stress, mRNA levels of megalin and cubilin, neither protein expression of megalin nor AT1 receptor, in the different experimental groups studied. However, Cd exposure did induce the expression of the tubular injury marker Kim-1 and decreased cubilin protein levels in proximal tubule cells whereas LOS-treatment restored cubilin levels and suppressed Kim-1 expression.ConclusionLOS treatment decreased microalbuminuria induced by Cd apparently through a cubilin receptor-dependent mechanism but independent of megalin.

Evaluation of Urinary Biomarkers for the Prognosis of Drug-associated Chronic Tubulointerstitial Nephritis

BackgroundThe efficacy of urinary biomarkers for predicting adverse clinical outcomes in drug-induced chronic tubulointerstitial nephritis (D-CTIN) has not been well described. MethodsA total of 54 patients with D-CTIN were prospectively followed-up in this study. The urinary excretion of α1-microglobulin and transforming growth factor-β1 and the activity of urinary N-acetyl-β-d-glucosaminidase (NAG) and matrix metalloproteinases (MMPs) 2 and 9 at baseline were measured. Changes in the estimated glomerular filtration rate (GFR) over a period of 11 to 54months (median, 38months) of follow-up were recorded. The efficacy of urinary biomarkers for differentiating patients with various outcomes was tested. Ten patients with IgA nephropathy and 20 healthy volunteers were enrolled as controls. ResultsThe areas under the receiver operating characteristic curve for urinary NAG, MMP-9, MMP-2 and α1-microglobulin for predicting deterioration of the estimated GFR were 0.879, 0.867, 0.735 and 0.709, respectively (P<0.05 for all). Partial regression coefficient results demonstrated that urinary NAG (P=0.02), MMP-2 (P=0.046) and MMP-9 (P=0.041) were inversely correlated with the rate of GFR decline. ConclusionsUrinary NAG, MMP-2 and MMP-9 may be considered as possible candidates for forecasting the progression rate of D-CTIN.

Urinary biomarkers in the early diagnosis of renal damage in diabetes mellitus patients

PURPOSE: The aim of this study was to determine the prevalence of tubular enzymes such as N-acetyl-β-D-glucosaminidase (NAG), alanine aminopeptidase (AAP) and gamma glutamyl transferase (γ-GT), α1-microglobulin, β2-microglobulin (β2-M) as well as microalbuminuria among patients with diabetes mellitus. MATERIAL AND METHODS: Biomarkers were evaluated in 285 type 1 diabetes mellitus patients and 30 healthy volunteers as a control group. Urinary levels of tubular enzymes such as NAG, AAP and γ-GT as well as microalbuminuria, α1-microglobulin and β2-M were determined by routine methods. Diabetes mellitus patients were divided into two groups - with normoalbuminuria (3-30 mg/L) and microalbuminuria (31-300 mg/L). RESULTS: Compared with healthy individuals, diabetes mellitus patients with normoalbuminuria excreted significantly higher levels of urinary NAG (p&lt;0.05). In patients with microalbuminuria, the most significant changes of urinary NAG, AAP and g-GT, serum cystatin C and β2-M (p&lt;0.001) were established. There was no significant difference between the patients and controls in respect to serum/urine creatinine. Urinary α1-microglobulin level was higher in the patients with poor glucose control (HbA1c &gt;8.5%) and directly related to albuminuria. A significantly decrease of creatinine clearance in these patients was found out, too. CONCLUSION: Measuring the urinary NAG excretion, α1-microglobulin and cystatin C could be useful for the assessment of renal failure in diabetes mellitus patients. The activity of AAP and γ-GT is a less sensitive indicator of tubular lesions. The levels of β2-M and cystatin C which diagnostic accuracies are superior to those of serum creatinine represent early indicators of incipient diabetic nephropathy. Therefore, urinary biomarkers are useful in early detection of tubular and glomerular lesions in type 1 diabetes mellitus patients. Scripta Scientifica Medica 2013; 45(3): 58-64.

Urinary Expression of Novel Tissue Markers of Kidney Injury After Ureteroscopy, Shockwave Lithotripsy, and in Normal Healthy Controls

Shockwave lithotripsy (SWL) and ureteroscopy (URS) are minimally invasive treatment alternatives for kidney stones. Although less invasive, SWL subjects the renal parenchyma to a high level of energy and the potential to cause renal injury. The ability to detect renal injury post-SWL in a reliable and noninvasive way would be clinically beneficial. Kidney injury molecule 1 (KIM-1) and N-acetyl-β-D-glucosaminidase (NAG) are two proteins secreted by the kidney into the urine and have been found to be sensitive markers of acute kidney injury in transplant patients. The aim of this work was to measure urinary levels of KIM-1 and NAG in patients with kidney stone who were treated by SWL or URS and in nonstone volunteers. Patients with kidney stones who were treated by SWL (n = 50) or URS (n = 10) were recruited. Voided urine samples were collected before and 2 to 3 hours after URS and SWL. In addition, further urinary specimens were collected 2 days and 2 weeks post-SWL treatment. Voided urine samples from healthy volunteers were also collected. Mean KIM-1 values were increased in patients with kidney stones when compared with volunteers. KIM-1 and NAG levels significantly increased post-SWL and returned to baseline within 2 weeks post-SWL. Poor kidney function was significantly associated with increased biomarker activity both in baseline and post-SWL measurements. There was no significant change in urinary KIM-1 and NAG concentrations before and after URS. Kim-1 and NAG levels significantly increased post-SWL treatment suggesting a potential role for these urinary markers in identifying patients at higher risk of tissue injury.

Oxygen nano-bubble water reduces calcium oxalate deposits and tubular cell injury in ethylene glycol-treated rat kidney

Renal tubular cell injury induced by oxalate plays an important role in kidney stone formation. Water containing oxygen nano-bubbles (nanometer-sized bubbles generated from oxygen micro-bubbles; ONB) has anti-inflammatory effects. Therefore, we investigated the inhibitory effects of ONB water on kidney stone formation in ethylene glycol (EG)-treated rats. We divided 60 rats, aged 4weeks, into 5 groups: control, the water-fed group; 100% ONB, the 100% ONB water-fed group; EG, the EG treated water-fed group; EG+50% ONB and EG+100% ONB, water containing EG and 50% or 100% ONB, respectively. Renal calcium oxalate (CaOx) deposition, urinary excretion of N-acetyl-β-D-glucosaminidase (NAG), and renal expression of inflammation-related proteins, oxidative stress biomarkers, and the crystal-binding molecule hyaluronic acid were compared among the 5 groups. In the control and 100% ONB groups, no renal CaOx deposits were detected. In the EG+50% ONB and EG+100% ONB groups, ONB water significantly decreased renal CaOx deposits, urinary NAG excretion, and renal monocyte chemoattractant protein-1, osteopontin, and hyaluronic acid expression and increased renal superoxide dismutase-1 expression compared with the EG group. ONB water substantially affected kidney stone formation in the rat kidney by reducing renal tubular cell injury. ONB water is a potential prophylactic agent for kidney stones.

Moderate-Intensity Single Exercise Session Does Not Induce Renal Damage

The aim of this study was to determine whether a single moderate-intensity exercise session induces renal injury based on various parameters that reflect kidney dysfunction, including urinary L-type fatty acid-binding protein (L-FABP). Adult outpatients (n = 31) with chronic kidney disease (CKD) not receiving renal replacement therapy participated in this study. Urine was collected before and after a single 20-min moderate-intensity exercise session. Urinary levels of L-FABP, albumin, N-acetyl-β-d-glucosaminidase (NAG), and α1-microglobrin (α1MG) were measured. In addition, 12 patients with estimated glomerular filtration fraction less than 30 ml/min/1.73 ml(2) were selected from all patients and evaluated using the same analysis. Urinary values of L-FABP, albumin, NAG, and α1MG did not increase significantly after exercise compared with before exercise (urinary L-FABP, from 8.3 to 9.4 μg/g of creatinine; urinary albumin, from 293.1 to 333.7 mg/g of creatinine; urinary NAG, from 9.2 to 8.2 U/g of creatinine; urinary α1MG, from 11.4 to 9.8 mg/g of creatinine, not significant). Similar findings were seen in all patients, regardless of degree of renal dysfunction. A single session of moderate-intensity exercise was not associated with an increase in renal parameters used to assess renal damage.

2087 OXYGEN NANO-BUBBLE WATER EXERTS INHIBITORY EFFECTS ON KIDNEY STONE FORMATION BY PROTECTING RENAL TUBULAR CELL INJURY

You have accessJournal of UrologyStone Disease: Basic Research (I)1 Apr 20132087 OXYGEN NANO-BUBBLE WATER EXERTS INHIBITORY EFFECTS ON KIDNEY STONE FORMATION BY PROTECTING RENAL TUBULAR CELL INJURY Yasuhiko Hirose, Takahiro Yasui, Kazumi Taguchi, Kazuhiro Niimi, Shuzo Hamamoto, Atsushi Okada, Yasunori Ito, Shoichi Sasaki, and Kenjiro Kohri Yasuhiko HiroseYasuhiko Hirose Nagoya, Japan More articles by this author , Takahiro YasuiTakahiro Yasui Nagoya, Japan More articles by this author , Kazumi TaguchiKazumi Taguchi Nagoya, Japan More articles by this author , Kazuhiro NiimiKazuhiro Niimi Nagoya, Japan More articles by this author , Shuzo HamamotoShuzo Hamamoto Nagoya, Japan More articles by this author , Atsushi OkadaAtsushi Okada Nagoya, Japan More articles by this author , Yasunori ItoYasunori Ito Nagoya, Japan More articles by this author , Shoichi SasakiShoichi Sasaki Nagoya, Japan More articles by this author , and Kenjiro KohriKenjiro Kohri Nagoya, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2506AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Renal tubular cell injury induced by CaOx crystals plays an important role in kidney stone formation. Water containing oxygen nano-bubbles (ONB: nanometer-sized bubbles generated from oxygen micro-bubbles) has anti-inflammatory effects. Therefore, we investigated the inhibitory effects of ONB water on kidney stone formation in ethylene glycol (EG)-treated rats. METHODS ONB water can be produced by rapidly collapsing oxygen micro-bubbles in hard water with a salt concentration of 1.0% by mass. Further, ONB water with a salt concentration of 0% by mass can be prepared by passing the resulting ONB water twice through a reverse osmosis membrane, obtaining ONB water was defined as 100% ONB water. A mixture comprising half 100% ONB water and half distilled water was defined as 50% ONB water. We divided 60 rats, aged 4 weeks, into 5 groups: (1) control, a water-fed group; (2) 100% ONB, a 100% ONB water-fed group; (3) EG, the EG-treated water-fed group; and (4), and (5) EG+50% ONB and EG+100% ONB, the 2 EG-treated, ONB water-fed groups. The rats consumed these fluids by free access for 5 weeks, and the EG-treated groups were also administered 1.2 mL of 10% EG and 0.5 μg of vitamin D3 via a stomach tube for the last 2 weeks. Six rats in each group were sacrificed after 7 days and 6 after 14 days. The pooled 24-hour urine and blood samples of these rats were collected, and their kidneys were excised. Renal CaOx deposits, urinary excretion of N-acetyl-β-D-glucosaminidase (NAG), and renal expression of MCP-1 and OPN as inflammation-related proteins, SOD-1 as an oxidative stress biomarker, and the crystal binding molecule hyaluronic acid were compared among the 5 groups. RESULTS In the EG group, CaOx deposits tended to increase at 14 days compared to 7 days after EG administration. However, CaOx deposits were significantly lower in the EG+50% ONB and EG+100% ONB groups than in the EG group 14 days after administration (Figure). In the EG+50% ONB and EG+100% ONB groups, ONB water significantly decreased urinary NAG excretion, and renal MCP-1, OPN, and hyaluronic acid expression, and increased renal SOD-1 expression compared to the EG group. CONCLUSIONS ONB water exerted substantial effects on kidney stone formation in the rat kidney by protecting renal tubular cell injury. ONB water may be a prophylactic for kidney stones. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e856 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yasuhiko Hirose Nagoya, Japan More articles by this author Takahiro Yasui Nagoya, Japan More articles by this author Kazumi Taguchi Nagoya, Japan More articles by this author Kazuhiro Niimi Nagoya, Japan More articles by this author Shuzo Hamamoto Nagoya, Japan More articles by this author Atsushi Okada Nagoya, Japan More articles by this author Yasunori Ito Nagoya, Japan More articles by this author Shoichi Sasaki Nagoya, Japan More articles by this author Kenjiro Kohri Nagoya, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Significance of joint detection of serum cystatin C, procalcitonin, and urine N-acetyl-β-D-glucosaminidase combined detection on localization diagnosis of the urinary tract infection in children

Objective To explore the differences of biological markers level between upper urinary tract infection(UUTI) and lower urinary tract infection(LUTI) in children for providing help for localization diagnosis of urinary tract infection(UTI). Methods One hundred and nine children with UTI hospitalized in Children's Hospital of Tianjin from May 2010 to Jan.2012 were divided into UUTI group (18 cases) and LUTI group (91 cases). The clinical information (sex, age, onset symptoms), laboratory test including blood urea nitrogen and creatinine, biological markers including serum cystatin C(CysC), procalcitonin(PCT), β2-microglobulin (β2-MG), urine microalbumin(mAlb), transferrin(TF), α1-microglobulin(α1-MG), β2-MG and N-acetyl-β-D-glucosaminidase(NAG)were recorded. Then SPSS 17.0 software was used to analyze the data. Results UUTI children showed higher level of serum CysC, PCT, urine mAlb, TF, α1-MG, β2-MG and NAG than LUTI children did.The area under ROC curve of the 7 biological markers were all between 0.71 and 0.87.Logistic regression test was used to do multiple regression analysis and establish the multiple regression model.The standard of eliminating or screening variables was 0.05.CysC, PCT, NAG were identified as influence factors.Combining test result of CysC, PCT, NAG could improve diagnostic value so that the sensitivity could reach 90%and the specificity could reach 88.9%. Conclusions Both of serum CysC, PCT and urine mAlb, TF, α1-MG, β2-MG, NAG can be used for the positioning diagnosis of UTI, and the diagnostic value of joint test of serum change of CysC, PCT, urine NAG is higher than any single biological marker. Key words: Urinary tract infection; Cystatin C; Procalcitonin; N-acetyl-β-D-glucosaminidase; Early renal damage; Localization diagnosis

Effect and safety of Mizoribine on frequency recurrence nephrotic syndrome in children

Objective To observe urinary protein, serum albumin, cholesterol and recurrence of children with frequency recurrence nephrotic syndrome(NS) after using Mizorbine(MZR). Methods Eighteen cases of recurrent frequency NS were given enough hormone and MZR.Urinary protein, serum albumin, cholesterol, urinary N-acetyl-β-D-glucosaminidase(NAG) and recurrence were observed.The difference of recurrence between the children treated with steroid and the children treated with steroid and MZR more than 6 months were compared. Results In the combined treatment with both sufficient hormone and MZR, out of the 18 cases, there were one lost case and one invalid case. For the remaining 16 cases, edema subsided when they were reexamined in the first month, and the urine protein changed to negative within about 3 to 10 days (the average time was 6.33 days). There were 10 cases who were ree-xamined after 6 months, in which for 8 cases the serum albumin returned to normal in the first month (≥35 g/L), 1 case returned to normal in 3 month and 1 case in 6 month. The level of blood cholesterol returned to normal for 7 cases in the first month (<5.7 mmol/L), 3 cases returned to normal in 3 months. In the reexamining of urine protein in 24 hours in the first month, 7 cases returned to normal (<0.4 g), 2 cases reduced and there was no change in 1 case. Relapse occurred in 2 cases, in one of which the level of urine protein returned to normal if changing the MZR to alternate-day implosive therapy. After treatment, partial tubular functions restored and in the first month, the level of NAG returned to normal in 7 cases, decreased in 9 cases and increased in 1 case. In the experiment group, no child was observed vomiting, to have diarrhea and other gastrointestinal symptoms. The blood pressure, breathing and heart rate were within the normal range before and after the treatment. The increase of urea nitrogen and creatinine was observed only in 1 case. Conclusions MZR with enough hormone treating frequency recurrence NS can promote urine protein negative, and make serum albumin, cholesterol, urinary NAG decrease, and reduce the recurrence.When MZR made regular doses of the application can not effectively reduce the recurrence frequency, and the pulse treatment may be a kind of effective methods. Key words: Mizoribine; Nephrotic syndrome; Child

Urinary N-acetyl-β-D-glucosaminidase levels are positively correlated with 2-hr plasma glucose levels during oral glucose tolerance testing in prediabetes.

BackgroundUrinary N‐acetyl‐β‐D‐glucosaminidase (NAG) excretion is increased in patients with impaired glucose tolerance (IGT). This study investigated when during the oral glucose tolerance test (OGTT) the plasma glucose, urine glucose, and insulin levels correlate most strongly with urinary N‐acetyl‐β‐d‐glucosaminidase (NAG) levels in prediabetic subjects.MethodsThe OGTT was administered to 80 subjects who had not yet received a diagnosis of diabetes mellitus (DM) and in whom HbA1c levels were ≤6.8% and fasting plasma glucose levels were <7.0 mmol/l. Forty‐two subjects had normal glucose tolerance (NGT), 31 had impaired glucose tolerance (IGT), and 7 had DM according to World Health Organization criteria. Serum levels of cystatin C, the estimated glomerular filtration rate, the urinary albumin‐to‐creatinine (Cr) ratio, urinary and serum β2‐microglobulin, and urinary NAG were measured as markers of renal function.Results NAG levels were significantly higher in subjects with DM and in subjects with IGT than in subjects with NGT. No significant associations were observed between glycemic status and other markers of renal function. Multiple linear regression analysis showed that the NAG level was positively correlated with plasma glucose levels at 120 min of the OGTT and was associated with the glycemic status of prediabetic patients.ConclusionThese results suggest that postprandial hyperglycemia is an independent factor that causes renal tubular damage in prediabetes patients.

Diagnostic value of N-acetyl-β-D-glucosaminidase for the early prediction of acute kidney injury after percutaneous nephrolithotripsy

The present observational study was undertaken in order to evaluate the diagnostic value of urinary N-acetyl-β-D-glucosaminidase (NAG) for the prediction of acute kidney injury (AKI) in patients after percutaneous nephrolithotripsy (PNL). Pre- and post-operative patient data were collected for 90 patients who underwent PNL between September 2008 and December 2010. The patients included 64 males and 26 females with an average age of 52.8±9.7 years. Pre- and post-operative urinary NAG was measured by colorimetric assay and serum creatinine levels were determined for comparative analysis. Urinary NAG levels significantly increased after PNL compared to pre-operative levels (P<0.05). AKI occurred in 11 cases after surgery. A comparison of the AKI and non-AKI groups revealed no significant differences in age, gender ratio or baseline creatinine levels (P>0.05); however, there were significant differences between the groups as regards surgical duration, post-operative infection rate, C-reactive protein levels and number of hospital days (P<0.05). NAG levels were significantly higher in the AKI compared to the non-AKI group after surgery (P<0.05). The diagnostic utility of the increase in urinary NAG 24 h after surgery was assessed by receiver operating characteristic (ROC) analysis. For an increase in NAG of 235.44%, the area under the ROC curve was 0.878 (P<0.01) and the sensitivity and specificity for AKI diagnosis were 81.8 and 91.1%, respectively. Urinary NAG significantly increased in patients suffering from AKI after surgery. This parameter is more sensitive than serum creatinine and can reflect the impairment of kidney function at an earlier stage. The surgical duration and post-operative infection rate are possible risk factors for AKI. Urinary NAG may have some clinical value in the early diagnosis of AKI after surgery.

Urinary N-acetyl-β-D glucosaminidase as a surrogate marker for renal function in autosomal dominant polycystic kidney disease: 1 year prospective cohort study

BackgroundRenal failure is one of the most serious complications associated with autosomal dominant polycystic kidney disease (ADPKD). To date, early markers have failed to predict renal function deterioration at the early stages. This 1-year prospective study evaluated N-acetyl-β-D-glucosaminidase (NAG) as a new surrogate marker for renal function in ADPKD.MethodsA total of 270 patients were enrolled in the study, and we measured urinary NAG, β2-microglobulin, neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) prospectively for 1 year to compare their predictive values for renal function.ResultsBaseline urinary NAG/Cr was negatively correlated with estimated glomerular filtration rate (GFR) (r2 = 0.153, P < 0.001) and positively correlated with total kidney volume (TKV) (r2 = 0.113, P < 0.001). Among other biomarkers, urinary NAG/Cr better discriminated patients with decreased renal function from those with conserved renal function, showing the largest area under the curve (AUC 0.794). Immunohistochemical study revealed strong staining along the cyst-lining epithelial cells as well as the nearby compressed tubular epithelial cells. However, both single and repeated measurements of urinary NAG/Cr failed to predict renal function decline in 1 year.ConclusionsUrinary NAG/Cr may be a useful surrogate marker for renal function in ADPKD patients.