Abstract
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Dignostic Value of Brush Border Enzymes of the Proximal Renal Tubules in Rheumathoid Arthritis
by Dejan Spasovski, Jelka Masin-Spasovska, Marina Nada, Jordan Calovski, Emilija Sandevska, Baskim Osmani, Tatjana Sotirova, Svetlana Balkanov, Dusko Dukovski, Arif Ljatifi, Goce Spasovski
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Background: Proximal tubules of the kidney have a dominant function in the excretion of different enzymes in the urine. These enzymes can be used as markers for secondary renal damage under the action of different diseases, medicines, and toxins. The aim of this study was to evaluate the values of alanine aminopeptidase (AAP), γ-glutamyl transferase (γ-GT), and β2 microglobulin (β2m) in urine of patients with untreated rheumatoid arthritis (RA) and to define the possible association between untreated rheumatoid arthritis and tubular function at the brush border region.
Methods: We used a kinetic assay for AAP, standard methods by the International Federation for Clinical Chemistry (IFCC) for γ-GT and Microparticle Enzyme Immunoassay (MEIA), (Abbott AxSYM System) for the determination of β2m in urine of 70 participants (35 untreated RA patients and 35 healthy volunteers (HC)).
Results: From the total of 35 RA patients, AAP enzymuria was found in 24 patients with test sensitivity (68.57 %), γ-GT in 16 patients with test sensitivity (45.71 %), while the presence of urinary β2m was found in a very low percentage of cases. Out of 18 rheumatoid factor (RF) negative patients, 14 patients were AAP and 10 patients were γ-GT positive, while the presence of β2m in urine was not detected. Among 17 RF positive RA patients, the presence of AAP and γ-GT was noticed in 10 and 6 patients, respectively, while the presence of β2m in urine was not detected.
Conclusions: In conclusion, AAP had a higher sensitivity than γ-GT and β2m in detection of asymptomatic renal lesions in untreated RA.
DOI: Clin. Lab. 2011;57:305-314
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