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      Urinary and aminopeptidase N in the diagnosis of graft rejection after live donor renal transplantation

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      Clinica Chimica Acta
      Elsevier BV

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          Abstract

          An evaluation of the usefulness of urinary N-acetyl-beta-D-glucosaminidase (NAG) and aminopeptidase N (AAP) measurements in the diagnosis and prediction of acute and chronic renal allograft rejection was made. Enzyme activities were measured in 2,745 morning spot urine samples from 53 consecutive live donor renal allograft recipients up to 180 days after transplantation. Reference ranges of urinary enzyme activities in 14 recipients with normal graft function were higher than those established in a carefully selected group of healthy controls. 89 and 91% of 76 clinically diagnosed acute rejection episodes (ARE) in the remaining 39 graft recipients were accompanied by sharp increase over baseline of NAG and AAP respectively. All rejection episodes occurring in the early period after transplantation were characterised by high enzymuria. AAP was more sensitive than NAG as the magnitude of its increase over baseline was more, while NAG was more specific with less number of false positive elevations. Both enzymes were found to be equally good prognostic indices of graft loss and chronic graft deterioration. Regular monitoring of urinary NAG and AAP activities throughout the post transplant period would thus be valuable in (a) diagnosis and prediction of ARE in the early as well as late post operative period and (b) prediction of eventual graft outcome.

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          Author and article information

          Journal
          Clinica Chimica Acta
          Clinica Chimica Acta
          Elsevier BV
          00098981
          August 1985
          August 1985
          : 150
          : 2
          : 69-85
          Article
          10.1016/0009-8981(85)90257-8
          2864149
          db9fcdaf-37d9-43f2-adca-c92294efc27c
          © 1985

          https://www.elsevier.com/tdm/userlicense/1.0/

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