Urinary glutathione-S-transferases (GSTs) in the urine is a new sensitive method for detection of kidney damage. In general, GSTs offer the following possibilities: aGST is a very specific and sensitive marker of proximal tubular injury. It is rapidly released in the event of tubular injury, sooner than serum markers of renal injury. a-GST has been shown to be an excellent marker of tubular injury resulting from a variety of nephrotoxic drugs, such as Cyclosporin and aminoglycosides, or anoxic stress resulting from transplantation or intra-opera- tive ischaemia. p-GST is a marker of distal tubular injury. Previously, it has been difficult to monitor this important tissue non-invasively. Little has been published on toxic, or other, damage to the distal tubules. This may be due to previous difficulties in monitoring this tissue, but it makes it a stimulating esciting area for research. For example, infection and transplant rejection often affect predominantly the distal tubules. Urinary a- and p-GST levels may indicate renal effects in advance to serum markers such as creatinine. By measuring both a and p-GST it is possible to identify injuried areas of the renal tubule.

        Key words: urine, glutathione-S-transferase, renal tubular damage, clinical diagnosis.