Urinary alpha-GST and pi-GST for prediction of dialysis requirement or in-hospital death in established acute kidney injury

Urinary alpha-GST and pi-GST for prediction of dialysis requirement or in-hospital death in established acute kidney injury

Author Seabra, Victor F. Autor UNIFESP Google Scholar
Perianayagam, Mary C. Google Scholar
Tighiouart, Hocine Google Scholar
Liangos, Orfeas Google Scholar
Santos, Oscar F. P. dos Autor UNIFESP Google Scholar
Jaber, Bertrand L. Google Scholar
Institution St Elizabeths Med Ctr
Tufts Univ
Universidade Federal de São Paulo (UNIFESP)
Tufts Med Ctr
Klinikum Coburg
Abstract Context: Urinary alpha-glutathione S-transferase (alpha-GST) and pi-glutathione S-transferase (pi-GST) are promising proximal and distal tubular leakage markers for early detection of acute kidney injury (AKI).Objective: To examine the performance of these markers for predicting the composite of dialysis requirement or in-hospital death in patients with an established diagnosis of AKI.Materials and methods: Prospective cohort study of 245 adults with AKI. A single urinary alpha-GST and pi-GST measurement was obtained at time of nephrology consultation.Results: Overall, urinary pi-GST performed better than alpha-GST for prediction of dialysis requirement (AUC 0.59 vs. 0.56), and the composite outcome (AUC 0.58 vs. 0.56). in subgroup analyses, pi-GST displayed better discrimination for prediction of dialysis requirement in patients with baseline eGFR < 60 mL/min/1.73 m(2) (AUC 0.61) and oliguria (AUC 0.72). Similarly, alpha-GST performed better in patients with stage-1 (AUC 0.66) and stage-2 AKI (AUC 0.80).Conclusions: in patients with an established diagnosis of AKI, a single urinary pi-GST measurement performed better than alpha-GST at predicting dialysis requirement or death, but neither marker had good prognostic discrimination.
Keywords acute kidney injury
acute renal failure
biomarker
glutathione S-transferase
epidemiology
prognosis
Language English
Sponsor Argutus Medical, Ltd, Dublin, Ireland
National Institute of Diabetes and Digestive and Kidney Diseases
International Society of Nephrology Commission for the Global Advancement of Nephrology (COMGAN)
Grant number National Institute of Diabetes and Digestive and Kidney Diseases: RO3-DK077751
Date 2011-12-01
Published in Biomarkers. London: Informa Healthcare, v. 16, n. 8, p. 709-717, 2011.
ISSN 1354-750X (Sherpa/Romeo, impact factor)
Publisher Informa Healthcare
Extent 709-717
Origin http://dx.doi.org/10.3109/1354750X.2011.631219
Access rights Closed access
Type Article
Web of Science ID WOS:000297225000012
URI http://repositorio.unifesp.br/handle/11600/34324

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