• Victor F Seabra, Mary C Perianayagam, Hocine Tighiouart, Orfeas Liangos, Oscar F P dos Santos, and Bertrand L Jaber.
• Kidney and Dialysis Research Laboratory, St. Elizabeth's Medical Center, Boston, MA, USA.
• Biomarkers. 2011 Dec 1; 16 (8): 709-17.

ContextUrinary α-glutathione S-transferase (α-GST) and π-glutathione S-transferase (π-GST) are promising proximal and distal tubular leakage markers for early detection of acute kidney injury (AKI).ObjectiveTo 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 MethodsProspective cohort study of 245 adults with AKI. A single urinary α-GST and π-GST measurement was obtained at time of nephrology consultation.ResultsOverall, urinary π-GST performed better than α-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, π-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, α-GST performed better in patients with stage-1 (AUC 0.66) and stage-2 AKI (AUC 0.80).ConclusionsIn patients with an established diagnosis of AKI, a single urinary π-GST measurement performed better than α-GST at predicting dialysis requirement or death, but neither marker had good prognostic discrimination.

10 keywords...

hide…