Urinary trehalase activitiy in contrast-associated acute kidney injury

Objective: Contrast-associated acute kidney injury (CA-AKI) is the third most common cause of hospital-acquired AKI. Sensitive biomarkers can detect kidney injury early on because kidney damage begins immediately after the administration of a contrast medium. Due to its proximal tubule specificity, urinary trehalase can be a useful and early marker for detecting tubular damage. This study aimed to reveal the power of urinary trehalase activity in diagnosing CA-AKI.

Patients and methods: This is a prospective, observational, and diagnostic validity study. The study was performed in an academic research hospital's emergency department. Patients aged 18 years and over who underwent contrast-enhanced computed tomography in the emergency department were included in the study. Urinary trehalase activities were measured before and 12, 24, and 48 hours after the administration of a contrast medium. The primary outcome was the occurrence of CA-AKI, while the secondary outcomes were risk factors for CA-AKI, duration of hospital stay after contrast use, and the mortality rate in the hospital.

Results: A statistically significant difference between the CA-AKI group and the non-AKI group was found in the activities measured 12 hours after the administration of the contrast medium. Notably, the mean age of the patient group with CA-AKI was considerably higher than that of the non-AKI group. The risk of mortality was found to be remarkably more elevated in patients with CA-AKI. Further, there was a positive correlation between trehalase activity and HbA1c. In addition, a crucial correlation was found between trehalase activity and poor glycemic control.

Conclusions: Urinary trehalase activity can be useful as a marker of acute kidney injuries due to proximal tubule damage. In the diagnosis of CA-AKI, especially the activity of trehalase in the 12th hour might be useful.