• R Loertscher, A Scholer, F Brunner, F Harder, and G Thiel.
• Swiss Med Wkly. 1982 Nov 13; 112 (46): 1658-64.

AbstractFrom January to September 1981 urinary gamma-N-acetyl-glucosaminidase (NAG) excretion was measured in 23 cadaver kidney recipients up to 90 days posttransplant. Conventional immunosuppression with azathioprine and prednisone was used in 12 patients, and cyclosporin A (CyA) in 11 patients. The purpose of this study was to assess the clinical value of NAG determinations in the diagnosis of acute rejection episodes and CyA-induced nephrotoxicity. A total of 26 acute rejection episodes were observed. 14 (54%) of these were associated with a significant increase in NAG excretion. The other 46 episodes of increased NAG excretion (77% of a total of 60 episodes) were unrelated to acute rejection reactions. No obvious reason was apparent in 39 instances (63%). Nine out of 11 patients treated with CyA showed one or more increases in NAG excretion, but the number of such episodes did not differ between patients with CyA serum concentrations below 500 ng/ml and those with levels above 500 ng/ml. Histological signs of CyA toxicity in graft biopsies correlated well with increased NAG excretion. It is concluded that increases in NAG excretion are not sensitive and specific enough to be of definite help in the diagnosis of acute rejection and/or CyA-induced nephrotoxicity.

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