scholarly journals Evaluation of Serum and Urinary Neutrophil Gelatinase - Associated Lipocalin in Pediatric Patients with Chronic Nephrotic Syndrome

GEGET ◽  
2011 ◽  
Vol 11 (1) ◽  
pp. 83-96
Author(s):  
Khadija Abou ◽  
ina Ezzat ◽  
Ilanan Farhan ◽  
ЅаІу Abdel Mohsen
2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Ewa Gacka ◽  
Marcin Życzkowski ◽  
Rafał Bogacki ◽  
Andrzej Paradysz ◽  
Lidia Hyla-Klekot

Introduction.The use of cyclosporine (CsA) in the treatment of nephrotic syndrome (NS) contributed to a significant reduction in the amount of corticosteroids used in therapy and its cumulative side effects. One of the major drawbacks of CsA therapy is its nephrotoxicity. Prolonged CsA treatment protocols require sensitive, easily available, and simple to measure biomarkers of nephrotoxicity. NGAL is an antibacterial peptide, excreted by cells of renal tubules in response to their toxic or inflammatory damage.Aim of the Study.The aim of this study was to assess the suitability of the NGAL concentration in the urine as a potential biomarker of the CsA nephrotoxicity.Material and Methods.The study was performed on a group of 31 children with NS treated with CsA. The control group consisted of 23 children diagnosed with monosyptomatic enuresis. The relationship between NGAL excreted in urine and the time of CsA treatment, concentration of CsA in blood serum, and other biochemical parameters was assessed.Results.The study showed a statistically significant positive correlation between urine NGAL concentration and serum triglycerides concentration and no correlation between C0 CsA concentration and other observed parameters of NS. The duration of treatment had a statistically significant influence on the NGAL to creatinine ratio.Conclusions.NGAL cannot be used alone as a simple CsA nephrotoxicity marker during NS therapy. Statistically significant correlation between NGAL urine concentration and the time of CsA therapy indicates potential benefits of using this biomarker in the monitoring of nephrotoxicity in case of prolonged CsA therapy.


2017 ◽  
Vol 13 (1) ◽  
pp. 51-55
Author(s):  
Farhana Jalil ◽  
Mohammed Hanif ◽  
Golam Muin Uddin ◽  
Shireen Afroz

Introduction: Idiopathic nephrotic syndrome (INS) is the most common glomerular disorder of childhood. Clinical outcome of children with nephrotic syndrome depends on underlying histopathlogy and responsiveness to steroid treatment. Minimal change disease (MCD) has a favorable long-term prognosis whereas, other than minimal change nephrotic syndrome is often resistant to steroid and is more likely to progress to end-stage renal disease (ESRD). Neutrophil gelatinase-associated lipocalin (NGAL) which is a small protein belonging to the lipocalin superfamily has been demonstrated to be a powerful risk marker of chronic kidney disease progression. This study was undertaken to determine whether urinary NGAL could be used as a biomarker in differentiating minimal change disease from other glomerular histologic lesions in idiopathic nephrotic syndrome in children. Objectives: To evaluate the association between urinary NGAL and histological pattern in idiopathic nephrotic syndrome. Materials and Methods: This cross-sectional, multicenter study was conducted in the Department of Paediatric Nephrology, Dhaka Shishu Hospital and Department of Paediatric Nephrology, Bangabandhu Sheikh Mujib Medical University from June 2014 to May 2015. Fifty-one children with idiopathic nephrotic syndrome comprising 12 children with minimal change disease (MCD) and 39 with other than minimal change nephrotic syndrome were included. Urinary NGAL was measured using a commercially available HUMAN NGAL/ LIPOCALIN 2 ELISA kit which employed the quantitative sandwich enzyme immunoassay technique. Median urinary NGAL level were compared between MCD and other than MCD. Median urinary NGAL and urinary creatinine ratio also compared between two groups. The prognostic accuracy of urinary NGAL was assessed by receiver operating characteristic (ROC) curve analysis. Results: Median urinary NGAL (uNGAL) level of MCD group was 44.5 [IQR: 32-109.5] (ng/ml) and that of the other than MCD group was 130 [IQR:85-172] (ng/ml). This difference was statistically significant (p=0.004). Median urine NGAL and urine creatinine ratio was significant between two groups (MCD=105.5 ng/mg and other than MCD=288 ng/mg, p-value was<0.001). The area under the curve (AUC) for the uNGAL as a biomarker to differentiate MCD from other than MCD was 0.78 [95% CI: 0.64-0.92] (p=0.004) and showed an optimized sensitivity of 0.82 and specificity of 0.75 with an optimal trade-off value of 72 ng/ml. Conclusion: Urinary NGAL was found to be a reliable biomarker to differentiate the histological pattern in idiopathic nephrotic syndrome. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 51-55


2021 ◽  
Vol 42 (1) ◽  
pp. 63-68
Author(s):  
Varathon Lumyai ◽  
◽  
Nattachai Srisawat ◽  
Promwong Ngamwuttiwong ◽  
Chanatee Bunyaratavej ◽  
...  

Objective: To evaluate the benefit of urine neutrophil gelatinase-associated lipocalin (NGAL) measurement to predict the ureteral patency in pediatric patients undergoing pyeloplasty. Materials and Methods: Ureteropelvic junction obstruction patients who underwent unilateral dismembered pyeloplasty had urine NGAL measurements taken intraoperatively during pyeloplasty and postoperatively at six months following surgery. All patients were evaluated preoperatively and postoperatively with renal scans. Pairwise comparisons and correlation analyses were performed to determine the dynamics and benefits of urine NGAL measurement. Results: Thirteen patients were included in this pilot study with a mean age of 3.2 years at surgery. Mean intraoperative bladder urine level was 4.43 ng/mL, and median intraoperative renal pelvic urine NGAL level was 3.70 ng/mL. There was no significant difference between these two levels (p-value = 0.76). Six months after pyeloplasty, 9/13 patients demonstrated significant reduction in the bladder urine NGAL level (at least 50% reduction), and 5/13 patients showed ureteral patency based on postoperative renal scan (more than 5% improvement in differential renal function or the conversion of diuretic half time. However, the finding of significant reduction of urine NGAL level did not correlate with ureteral patency (r = -0.50, p-value = 0.08). Conclusion: Although bladder urine NGAL level reduces in most pediatric patients following pyeloplasty, this decline is not reflective of the finding of ureteral patency from renal scanning. The benefits of urine NGAL measurement in this context remain unclear and require further large-scale investigation.


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