Glutathione-S-Transferase and Thiol Stress in patients with acute renal failure

Introduction: Tubular damage is common finding in acute renal failure (ARF). Various etiologies have been put forth to explain the tubular damage in ARF, one important mechanism among them is oxidative damage to renal tubules. Several biomolecules including low-molecular weight peptides and enzymes in urine have been proposed as early markers of renal failure. Current study has been undertaken to study the thiol stress and glutathione-S-transferase (GST) levels in ARF patients. Method: 58 ARF patients and 55 healthy controls were selected based on inclusion and exclusion criteria. Serum thiols, GST, malanoldehyde (MDA) and urine thiols were determined by spectrophotometer based methods. Results: Serum thiols and urine thiols were significantly decreased (p<0.0001), and serum GST and MDA levels were significantly increased (p<0.0001) in ARF patients compared to healthy controls. Serum GST and MDA correlated positively in ARF cases (r² = 0.6938, p<0.0001). Conclusion: There is significant thiol stress and increased lipid peroxidation in ARF patients which leads to tubular cell membrane damage and release of GST into blood stream and into urine. This may be possible mechanism for the increased presence of GST in urine (enzymuria) found in other studies.