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KMID : 1102220190380020205
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Kidney Research and Clinical Practice
2019 Volume.38 No. 2 p.205 ~ p.211
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Serum alkaline phosphatase and γ-glutamyl transferase in acute pyelonephritis
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Han Chae-Hoon
Lee Young-Ki
Park Hayne-Cho
Cho A-Jin
Choi Sun-Ryoung
Yoon Jong-Woo
Koo Ja-Ryong
Kim Hyung-Jik
Noh Jung-Woo
Park Min-Jeong
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Abstract
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Background: Elevated serum alkaline phosphatase (AP) and γ-glutamyl transferase (γ-GT) are commonly observed in patients with acute pyelonephritis. The goal of this study was to examine the clinical significance of elevated serum AP and γ-GT levels and to explore the mechanisms underlying these changes.
Methods: We examined serum AP and γ-GT levels in 438 patients with acute pyelonephritis. Urine AP/creatinine (Cr), urine γ-GT/Cr, fractional excretion of AP, and fractional excretion of γ-GT (FEγ-GT) were evaluated in patients with elevated and normal serum levels. AP isoenzymes were also examined.
Results: We identified 77 patients (17.6%) with elevated serum AP and 134 patients (30.6%) with elevated serum γ-GT. Among them, both enzymes were elevated in 64 patients (14.6%). Older age, longer hospital stay, elevated baseline serum Cr, and complicated pyelonephritis were associated with increases in serum AP and γ-GT. Multivariate analysis showed that high serum AP levels were significantly correlated with renal impairment (odds ratio, 2.13; 95% confidence interval, 1.08?4.19; P = 0.029). FEγ-GT was significantly lower in patients with elevated serum enzyme levels. The liver fraction for AP isoenzyme profile did not increase in patients with elevated serum AP.
Conclusion: Our results demonstrated that elevated serum AP and γ-GT levels are associated with complicated pyelonephritis and renal impairment. Lower FEγ-GT levels in patients with elevated serum enzymes may be the result of decreased urinary excretion of these enzymes.
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KEYWORD
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Alkaline phosphatase, gamma-Glutamyltransferase, Pyelonephritis
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