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 GGT is not excreted by glomerular filtration; thus, its presence in urine indicates acute damage to tubular epithelial cells.

 GGT appears early in the urine when there is acute tubular damage, and this occurs prior to the development of azotemia.

 However, urinary GGT activity decreases quickly after an acute episode of tubular injury, even in the presence of ongoing tubular impairment.

 To allow for the effect of urine flow, GGT concentrations in the urine are generally expressed as a ratio to urinary creatinine concentrations.