Acute effects of acetaminophen on renal function and urinary excretion of some proteins and enzymes in patients with kidney disease

The acute effects of acetaminophen, a commonly used as analgesic drug, upon the urinary excretion of some proteins and enzymes as markers of kidney da mage, was investigated. Patients with chronic glomerulonephritis (GN) and B alkan endemic nephropathy (BEN), having kidney vulnerable to toxic drugs, w ere enrolled in the study. Timed urine specimens were collected: before dru g administration, and in 3-hour periods for 24 hours after an oral close of 2 g of acetaminophen. Urinary excretion of albumin before acetaminophen treatment was significant ly higher in patients with GN and BEN than in healthy adults, however, beta (2-mi)icroglobulin excretion was increased in BEN patients only. Urinary ex cretion of creatinine markedly increased immediately after acetaminophen in gestion. Urinary excretion of total protein and albumin was not changed aft er acetaminophen administration. However, acetaminophen treatment produced a significant increase in beta(2-mi)icroglobulin excretion in patient with BEN and GN, and in clinically healthy members of nephropathic families. Excretion of aminopeptidase N (APN) activity before acetaminophen treatment was significantly higher in patients with GN, however, NAGA excretion was higher in both GN and BEN patients than in healthy controls. After acetamin ophen administration urinary excretion of APN, di-peptidylpeptidase IV (DPP IV), gamma-glutamyltranspeptidase (GGT) and N-acetyl-beta-D-glucosaminidas e (NAGA) did not increase significantly in any group studied. This study has shown that urinary excretion of APN, DPP IV NAGA and GGT, as markers of kidney brush border and lysosomal damage, did not change after 2 g of acetaminophen taken orally. beta(2-mi)icroglobulin was a marker of a cute acetaminophen nephrotoxicity in kidney disease patients and in clinica lly healthy adults from nephropathic families.