New tubular injury markers in children with a solitary functioning kidney

Pediatr Nephrol. 2014 Sep;29(9):1599-605. doi: 10.1007/s00467-014-2802-y. Epub 2014 Mar 22.

Abstract

Background: The present study aimed to assess whether the urinary profiles of the lysosomal exoglycosidases N‑acetyl‑β‑hexosaminidase (HEX) and its isoenzymes A (HEX A) and B (HEX B), α-fucosidase (FUC), β-galactosidase (GAL), α-mannosidase (MAN), and β- glucuronidase (GLU) are useful biomarkers of tubular dysfunction in children with a solitary functioning kidney (SFK).

Methods: We measured the urinary activity of HEX, its isoenzymes HEX A, HEX B, and FUC, GAL, MAN, and GLU in 52 patients with SFK. Patients were subdivided into two groups: congenital SFK (cSFK)-unilateral renal agenesis and acquired SFK (aSFK)-unilateral nephrectomy. The reference group (RG) contained 60 healthy sex- and age-matched children.

Results: Urinary activity of all exoglycosidases in SFK was significantly higher than in RG (p < 0.05). There were no differences in exoglycosidase activity between cSFK and aSFK (p > 0.05). HEX and its isoenzymes HEX A and HEX B correlated negatively with estimated glomerular filtration rate (eGFR), and all estimated parameters correlated positively with albumin/creatinine ratio (p < 0.001).

Conclusion: Urinary activity of HEX, its isoenzymes HEX A and HEX B, and FUC, GAL, MAN, and GLU is elevated in children with SFK. Long-term follow-up studies in larger groups of children with SFK may help us to better understand their clinical significance.

MeSH terms

  • Adolescent
  • Biomarkers / urine
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Humans
  • Kidney / abnormalities*
  • Kidney Tubules, Proximal / injuries*
  • Male
  • Nephrectomy
  • Urogenital Abnormalities / urine*
  • alpha-L-Fucosidase / urine*
  • alpha-Mannosidase / urine*
  • beta-Galactosidase / urine*
  • beta-N-Acetylhexosaminidases / urine*

Substances

  • Biomarkers
  • beta-Galactosidase
  • alpha-Mannosidase
  • alpha-L-Fucosidase
  • beta-N-Acetylhexosaminidases

Supplementary concepts

  • Renal Adysplasia