SERUM ADENOSINE DEAMINASE LEVELS IN ACUTE KIDNEY INJURY

Abstract

Acute kidney injury describes a sudden
decline in kidney function over hours and
days. Acute kidney injury is frequently
caused by renal ischemia and represents
an important cause of morbidity and mortality
of hospitalised patients. Ischemic tissue
damage involves several different
mechanisms including renal inflammation,
direct tubular damage, and alteration of
vascular response. Inflammation leads to
leucocytes infiltration and free radicals release
which result in damage to cell membrane
and the release of membrane associated
enzymes like ADA. ADA is a marker
of the T cell activation and hence important
in acute and protracted inflammatory
response. AIMS AND OBJECTIVES-The
aim of the study is to evaluate the serum
adenosine deaminase activity in patients
with acute kidney injury and to establish a
relationship between ADA activity and
acute kidney injury.MATERIALS AND
METHODS-Study group included 50 individuals
aged 20 to 60 years who were
clinically diagnosed as acute kidney injury
with serum creatinine level greater than
1.5 mgdl and the control group included 50
healthy individuals
ADA activity was measured by the
method of Guisti and Glantis using semiautoanalyser.
RESULTS-The mean ADA
activity in the study group (47.53 plus or
minus 8.81) was significantly high when
compared to the control group (22.06 plus
or minus 5.94) and the P value is statistically
significant. ADA activity was significantly
correlated with Serum creatinine
( P value less than 0.01) and blood urea
( P value less than 0.01).CONCLUSIONThe
present study showed an increased
level of ADA in acute kidney injury. Further
elevated ADA indicates that there is
increase in release of free radicals and an
oxidative damage. There is also increased
metabolism of adenosine and loss of
beneficial effects of adenosine in acute
kidney injury. Hence ADA would be a
novel therapeutic intervention in acute kidney
injury and can be used as a routine
marker of acute kidney injury.