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γ-Glutamyltranspeptidase-Aktivität im Urin bei Gesunden und Nierenkranken

γ-Glutamyl transpeptidase activity in the urine of patients with renal disease

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Summary

γ-Glutamyl transpeptidase activity (γ-GT) in the kidney is most prominent in the brush border of the proximal tubules and reduced in chronic renal disease and acute renal failure. The normal range for γ-GT in urine is 12.7–37.7 mU/min. No correlation exists between serum and urine γ-GT activity.

37 of 49 renal patients with normal GFR but only 8 of 71 with reduced GFR showed elevated γ-GT activity in urine. Therefore γ-GT excretion was measured together with creatinine clearance (CC). A close correlation (r=0.67) was found in 68 healthy persons and the tolerance limits for both parameters were calculated together. In 114 patients with inactive renal disease the correlation wasr=0.71. The enzyme excretion diminished proportionally to the GFR and thus the remaining functioning nephron population. In patients with chronic renal insufficiency the relation γ-GT/CC makes it possible to detect an increase in enzyme release due to activation of the disease process or additional tubular damage even if the total urinary γ-GT activity is within the normal range.

Zusammenfassung

Die γ-Glutamyltranspeptidase-Aktivität (γ-GT) in der Niere ist bei chronischen Nephropathien und beim akuten Nierenversagen vermindert. Bei Gesunden wurde im Urin eine γ-GT-Aktivität von 12,7–37,7 mU/min ermittelt. Serum- und Urinaktivität verhielten sich unabhängig voneinander. Eine erhöhte γ-GT-Ausscheidung fand sich bei 75% der Nierenkranken mit normaler GFR, aber nur bei 11% mit eingeschränkter GFR.

Zwischen γ-GT-Ausscheidung und Kreatininclearance bestand bei Gesunden (N=68,r=0,67) und Nierenkranken (N=114,r=0,71) eine statistisch hochsignifikante Korrelation. Bei Gesunden wurden deshalb die Toleranzgrenzen für beide Parameter gemeinsam berechnet. Bei Nierenkranken nahm die Enzymausscheidung proportional zur GFR und damit dem funktionsfähig verbleibenden Nierenparenchym ab. Die Relation γ-GT/CKreatinin erlaubt eine pathologisch gesteigerte Enzymabgabe aus den Tubuluszellen bei noch im Normalbereich liegender Gesamtausscheidung zu erkennen.

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  1. Medizinische Universitäts-Poliklinik Köln, Germany

    K. G. Thiele

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Thiele, K.G. γ-Glutamyltranspeptidase-Aktivität im Urin bei Gesunden und Nierenkranken. Klin Wochenschr 51, 339–345 (1973). https://doi.org/10.1007/BF01468100

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