SERUM ADENOSINE DEAMINASE LEVELS IN ACUTE KIDNEY INJURY

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.