Patients with critical ischemia of the lower limb are at risk of developing kidney dysfunction

• Published in: The American journal of surgery 2003-04, Vol.185 (4), p.360-363
• Main Authors: Morsey, Hesham, Aslam, Mohamed, Standfield, Nigel
• Format: Article
• Language: English
• Subjects: Acetylglucosaminidase - urine; Adult; Aged; Albuminuria - urine; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular disease; Critical ischemia; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Enzymes; Exercise - physiology; Female; Free radicals; Humans; Inflammation Mediators - urine; Intermittent Claudication - complications; Intermittent Claudication - physiopathology; Intermittent Claudication - urine; Ischemia; Ischemia - complications; Ischemia - physiopathology; Ischemia - urine; Lower Extremity - blood supply; Male; Medical sciences; Middle Aged; Mortality; NAG enzyme; Renal Insufficiency - etiology; Renal Insufficiency - urine; Reperfusion injury; Reperfusion Injury - etiology; Reperfusion Injury - physiopathology; Reperfusion Injury - urine; Rest - physiology; Walking
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/S0002-9610(02)01406-X

The aim of this study is to establish a relationship between critical ischemia of the lower limb and kidney dysfunction. At rest, urine samples were collected from three groups: group A, 16 patients with critical ischemia; group B, 22 patients with stable intermittent claudication; and group C, 12 normal individuals. Urinary N-acetyle-β-D-glucosaminidase (NAG) enzyme was measured using spectrophotometer. Microalbuminuria was measured by radioimmunoassay. There was a significant difference in the NAG activity between groups A and B, P = 0.001. Also, between group A and C, P = 0.01. There was no significant difference between groups B and C, P = 0.13. Microalbuminuria was not significantly different among the three groups: A versus B, P = 0.27; A versus C, P = 0.22; B versus C, P = 0.11. Elevated levels of NAG enzyme in patients with critical ischemia of the lower limb suggest that they are at greater risk of developing kidney dysfunction. This could be caused by the release of more free radicals into the systemic circulation.