Clinical significance of beta-2-microglobulin, enzymes, cytokines in serum and urine in patients with chronic renal allograft dysfunction

Abstract

The most investigations of the biomarkers of renal allograft dysfunction (RAD) are limited by early post-operational period and are aimed at diagnosis of acute rejection of renal transplant. This work has aimed to establish additional characteristics of chronic RAD by using non-invasive biomarkers of the blood serum and urine.Materials and methods. 79 patients aged 16 to 59 years (47 men and 32 women) took part in our retrospective study. The alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamil transferase (GGT), alkaline phosphatase (ALP), N-acetyl-β-D-glucosaminidase (NAG); interleukins (IL-2, IL-8, IL-10) and beta-2-microglobulin were evaluated.Results. Increased IL-10 and β2-MG serum concentration, and increased urinary concentration and activity of β2-MG, IL-2, IL-8, NAG, AP, AST, GGT were typical for chronic RAD. Only NAG was independently significantly associated with chronic RAD in multivariate regression. From the area under ROC-curves were derived, that β2-MG level in serum and urine, and the activity of NAG in urine had the excellent and good power to classify patients with satisfactory function and chronic RAD.Conclusions. The increase of β2-MG in serum and urine may indicate glomerular and tubular dysfunction, respectively. An increase of urinary NAG indicates the ongoing damage of the tubules. The increase of IL-2 and IL-8 in the urine and IL-10 in serum may indicate the etiology of chronic RAD.