Serum alkaline phosphatase and γ-glutamyl transferase in acute pyelonephritis
- Author:
Chaehoon HAN
1
;
Young Ki LEE
;
Hayne Cho PARK
;
Ajin CHO
;
Sun Ryoung CHOI
;
Jong Woo YOON
;
Ja Ryong KOO
;
Hyung Jik KIM
;
Jung Woo NOH
;
Min Jeong PARK
Author Information
- Publication Type:Original Article
- Keywords: Alkaline phosphatase; gamma-Glutamyltransferase; Pyelonephritis
- MeSH: Alkaline Phosphatase; gamma-Glutamyltransferase; Humans; Isoenzymes; Length of Stay; Liver; Multivariate Analysis; Pyelonephritis; Transferases
- From:Kidney Research and Clinical Practice 2019;38(2):205-211
- CountryRepublic of Korea
- Language:English
- Abstract: 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 (FE(γ-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). FE(γ-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 FE(γ-GT) levels in patients with elevated serum enzymes may be the result of decreased urinary excretion of these enzymes.
