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Open Access Research article

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

Hayne Cho Park12, Jin Ho Hwang1, Ah-Young Kang3, Han Ro4, Myung-Gyu Kim3, Jung Nam An1, Ji In Park1, Seung Hyup Kim5, Jaeseok Yang3, Yun Kyu Oh1, Kook-Hwan Oh1, Jung Woo Noh6, Hae Il Cheong278, Young-Hwan Hwang19* and Curie Ahn1238*

Author Affiliations

1 Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-Ro Jongno-Gu, Seoul, 110-744, South Korea

2 Research Center for Rare Diseases, Seoul National University Hospital, Seoul, South Korea

3 Transplantation Center, Seoul National University Hospital, Seoul, South Korea

4 Department of Internal Medicine, Gacheon University Gil Hospital, Incheon, South Korea

5 Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea

6 Department of Internal Medicine, Hallym University College of Medicine, Seoul, South Korea

7 Department of Pediatrics and Adolescent Medicine, Seoul National University College of Medicine, Seoul, South Korea

8 Kidney Research Institute, Seoul National University Hospital, Seoul, South Korea

9 Department of Internal Medicine, Eulji General Hospital, Eulji University 280-1 Hagye 1-dong, Nowon-gu, Seoul, 139-711, Korea

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BMC Nephrology 2012, 13:93  doi:10.1186/1471-2369-13-93

Published: 30 August 2012

Abstract

Background

Renal 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.

Methods

A 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.

Results

Baseline 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.

Conclusions

Urinary NAG/Cr may be a useful surrogate marker for renal function in ADPKD patients.

Keywords:
Autosomal dominant polycystic kidney disease; Biomarkers; Renal function