Short CommunicationUrinary Lipocalin-Type Prostaglandin D Synthase: A Potential Marker for Early Gentamicin-Induced Renal Damage?Nakayama, Hirokazu MSc*; Echizen, Hirotoshi MD, PhD† ; Gomi, Tomoko MD‡ ; Shibuya, Yuko MD‡ ; Nakamura, Yoshitsugu MD§ ; Nakano, Kiyoharu MD§ ; Arashi, Hiroyuki MD¶ ; Itai, Tsutomu MD¶ ; Ohnishi, Satoshi MD¶ ; Tanaka, Masayo PhD* ; Orii, Takao PhD* Author Information From the *Department of Pharmacy, Kanto Medical Center NTT East Corporation; †Department of Pharmacotherapy, Meiji Pharmaceutical University; and Departments of ‡Nephrology; §Cardiovascular Surgery; and ¶Cardiology, Kanto Medical Center NTT East Corporation, Tokyo, Japan. Received for publication June 17, 2008; accepted November 17, 2008. Correspondence: Hirokazu Nakayama, MSc, Department of Pharmacy, Kanto Medical Center NTT East Corporation, 5-9-22 Higashi Gotanda, Shinagawa-ku, Tokyo 141-8625, Japan (e-mail: [email protected]). Therapeutic Drug Monitoring: February 2009 - Volume 31 - Issue 1 - p 126-130 doi: 10.1097/FTD.0b013e31819566f1 Buy Metrics Abstract Urinary excretion of lipocalin-type prostaglandin D synthase (L-PGDS) has been suggested to be a useful biomarker of early diabetic nephropathy. We studied whether L-PGDS is also a marker of gentamicin (GM)-induced renal damage in the “creatinine-blind” range. A prospective study was conducted in 6 patients who were given long-term intravenous administration of GM (18-42 days in combination with a β-lactam/carbapenem antibiotic or vancomycin) for the treatment of infective endocarditis. Urinary excretions of L-PGDS, β2-microglobulin, and N-acetyl-β-d-glucosaminidase were measured in the early (within 10 days from commencement) and late (thereafter) phases of GM therapy. Systemic clearance of GM (CLGM) and creatinine clearance (CLcr) was also measured concomitantly. CLGM was reduced significantly (P < 0.05) by 10% from the early to late treatment phase, whereas urinary L-PGDS excretion showed a significant (P < 0.05) increase (from 7.3 ± 4.6 to 8.7 ± 5.0 mg/g creatinine, mean ± SD) concomitantly. In contrast, no significant changes were observed for urinary β2-microglobulin and N-acetyl-β-d-glucosaminidase concentrations. In conclusion, urinary L-PGDS may be a promising biomarker for the early phase of GM-induced renal impairment. © 2009 Lippincott Williams & Wilkins, Inc.