EVALUATION OF ERYTHROCYTE GLUTATHIONE TRANSFERASE AS A POTENTIAL NEW BIOMARKER IN CHRONIC KIDNEY DISEASE AND MAINTENANCE HEMODIALYSIS PATIENTS

Abstract

C hronic kidney disease (CKD) is an important source of long-term morbidity and mortality. It has been estimated that CKD affects more than 20 million people in the United States. Given that most patients are asymptomatic until the disease has significantly progressed, they remain unaware of the condition. Thus, it is essential to have clinical practice guidelines aimed at early detection, evaluation, diagnosis, and treatment of this condition. Hemodialysis is the most common method used to treat advanced and permanent kidney failure, it has made survival possible for more than a million people throughout the world who have end-stage renal disease (ESRD) with limited or no kidney function. Kt/Vurea is a mathematical model that takes into account the urea clearance in a single hemodialysis session. It is commonly used to assess the delivered dose of dialysis in maintenance hemodialysis (MHD) patients. This parameter only reflects the efficacy of dialytic treatments in removing small toxins, but not middle and protein-bound toxins. GSTs may act as ligandins by binding and sequestering a variety of small or large toxic compounds and peptides. Human glutathione transferase P1-1 (hGSTP1-1) is a homodimeric intracellular protein of about 46 kDa expressed in different organs and cell types. The GSTP1-1 is the most abundant form of intra-erythrocyte transferase representing 95% of entire GST pool. Erythrocyte glutathione transferase (e-GST), an enzyme devoted to cell depuration against a lot of large and small toxins, is claimed to be overexpressed in uremic patients.