저삼투질 비이온성 조영제에 의한 신손상시 뇨중 N - Acetyl - β - D Glucosaminidase ( NAG ) 활성도의 의의

Objectives: It has been claimed that the incidence of the contrast media induced nephrotoxicity (CMN) was reduced with the introduction of the nonionic low-osmolar contrast media (CM). The commonly used diagnostic tools for nephrotoxicity including serum creatinine levels, creatinine clearance and urine analysis cannot detect damage of renal proximal tubule in early stage. Urine N-Acetyl-β-D Glucosaminidase (NAG) is well documented a useful indicator for proximal tubular damage. Therefore we investigated incidence of nonionic low-osmolar CMN and whether the urine NAG activity could be used as a indicator of CMN. Methods: We studied 32 patients with normal renal functions (mean age: 58.7, M:F=23:9) and assayed their serum concentration of creatinine, urine NAG activities and SDS-PAGE profiles in the urine for 5 days after exposure to CM. Results: Mean creatinine level of 32 patients did not increase in comparison to their preexposure level on post exposure day 1, 3 and 5. But mean urine NAG activities increased significantly in comparison to their preexposure activities from day 1 to day 4 (p