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KARACİĞER SİROZLU HASTALARDA BÖBREK ZEDELENMESİNİN GÖSTERGESİ OLARAK N-ASETİL p-D GLUKOZAMİNİDAZ (NAG) ENZİMÜRİSİNİN DEĞERİ

URINARY N-ACETYL |3-D GLUCOSAMINIDASE AS AN INDICATOR OF RENAL INJURY IN PATIENTS WITH LIVER CIRRHOSIS

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 1999

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
In this study, the importance of urinary N-acetyl p-u glucosaminidase (NAG) as an index of renal injury was assessed inpatients with liver cirrhosis. The study was carried out on 14 cirrhotic patients without primary renal disease or who did not receive my nephrotoxic agents. Twelve age and sex matched people were used as control group. The etiology of liver disease was HBV in 10, HCV in 4. Ten of the patients were classified as Child A, 3 as Child B and 2 as Child C according to Child-Pugh classification. Serum creatinine (SCr), urinary sodium level (UNa), urinary NAG level in 24-hour urine specimen and creatinine clearance (CCr) were determined. There were no statistically significant changes in SCr, CCr and UNa level in the cirrhotic patients as compared to the control group (2.4±0.84;0.2±0.09: p<0.000). However, NAG enzymuria in the cirrhotic patients was statistically higher than normal controls. Urinary NAG activity was markedly correlated to the degree of liver damage (r:0.72, p<0.01). These preliminary results suggested that urinary NAG activity was a useful index for early diagnosis of renal tubular injury in the cirrhotic patients.
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Abstract (Original Language): 
Bu çalışmada, karaciğer sirozlu hastalarda idrar NAG aktivitesinin durumu ve karaciğer yetmezliğinin derecesi ile olan ilişkisi araştırılmıştır. Çalışma 8 i erkek 6 sı kadın toplam 14 sirozlu hasta ile yaş ve cins uyumlu 12 sağlıklı kontrol üzerinde yürütülmüştür. Siroz, 10 olguda HBV, 4 olguda HCVna bağlı idi. Child sınıflandırmasına göre hastaların 9 'u Child A, 3 ü Child B, 2 'si Child C idi. Hasta ve kontrol gruplarında serum kreatinin (SCr) ve 24 saatlik idrarlarında NAG (U/L), kreatinin, sodyum konsantrasyonları ölçüldü ve kreatinin klirensi hesaplandı. Sirozlu hastalarda SCr ni daha yüksek, kreatinin klirensinin daha düşük olmasına rağmen farkın istatistiksel açıdan anlamlı olmadığı saptandı. Ancak, sirotik hastalarda normallere göre sodyum atılımının azaldığı, idrar NAG aktivitesinin anlamlı ölçüde yükseldiği dikkati çekti (2.4±0.84; 0.2±0.09: P<0.000). Sirozun ileri evresinde böbrek fonksiyonlarında azalma olurken sodyum atılımının giderek azaldığı, idrar NAG aktivitesindeki artışın belirginleştiği saptandı. Sirozun evresi ile NAG enzimürisinin derecesi arasında anlamlı korelasyon (r:0.72, p<0.01) dikkati çekti. Bulgularımız, sirozlu hastalarda idrar NAG aktivitesinin anlamlı derecede arttığını ve bu artışın karaciğer yetmezliğinin derecesi ile ilişkili olduğunu göstermektedir.
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  • 2
79-82
  • Turkish

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