scholarly journals Association of Urinary Vitamin D Binding Protein and Neutrophil Gelatinase-Associated Lipocalin with Steroid Responsiveness in Idiopathic Nephrotic Syndrome of Childhood

2020 ◽  
Vol 31 (5) ◽  
pp. 946
Author(s):  
Medha Rajappa ◽  
Amit Choudhary ◽  
PS Mohanraj ◽  
Sriram Krishnamurthy
Keyword(s):  
Vitamin D ◽  
Nephrotic Syndrome ◽  
Idiopathic Nephrotic Syndrome ◽  
Binding Protein ◽  
Vitamin D Binding Protein ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Steroid Responsiveness ◽  
Neutrophil Gelatinase

scholarly journals Urinary Neutrophil Gelatinase-Associated Lipocalin and Its Association with the Histological Pattern in Idiopathic Nephrotic Syndrome

2017 ◽  
Vol 13 (1) ◽  
pp. 51-55
Author(s):  
Farhana Jalil ◽  
Mohammed Hanif ◽  
Golam Muin Uddin ◽  
Shireen Afroz
Keyword(s):  
Nephrotic Syndrome ◽  
Minimal Change Disease ◽  
Idiopathic Nephrotic Syndrome ◽  
Minimal Change Nephrotic Syndrome ◽  
Minimal Change ◽  
Urinary Ngal ◽  
Creatinine Ratio ◽  
Histological Pattern ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

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

scholarly journals Urinary Vitamin D-Binding Protein as a Biomarker of Steroid-Resistant Nephrotic Syndrome

2016 ◽  
Vol 11 ◽  
pp. BMI.S31633 ◽  
Author(s):  
Michael R. Bennett ◽  
Angad Pordal ◽  
Christopher Haffner ◽  
LaTawnya Pleasant ◽  
Qing Ma ◽  
...  
Keyword(s):  
Vitamin D ◽  
Nephrotic Syndrome ◽  
Binding Protein ◽  
Area Under The Curve ◽  
Vitamin D Binding Protein ◽  
Cross Sectional ◽  
Steroid Resistant ◽  
Steroid Resistant Nephrotic Syndrome ◽  
Urine Creatinine ◽  
Normal Controls

Background Idiopathic nephrotic syndrome (NS) is one of the most common glomerular disorders of childhood and is associated with increased urinary vitamin D-binding protein (uVDBP) excretion. We tested the hypothesis that uVDBP represents a biomarker to differentiate steroid-resistant nephrotic syndrome (SRNS) from the more benign forms of steroid-sensitive nephrotic syndrome (SSNS). Methods This cross-sectional study included children with SRNS ( n = 24), SSNS ( n = 28), and normal controls ( n = 5). Urine and clinical data were collected from patients. Measurements of uVDBP were performed with a commercially available ELISA kit and normalized to urine creatinine. Results Concentrations of uVDBP were significantly higher ( P < 0.001) in patients with SRNS (13,659 ng/mL, interquartile range [IQR] 477–22,979) than in patients with SSNS (94 ng/mL, IQR 53–202) and normal controls (23 ng/mL, IQR 22–99, P = 0.002). Significance did not change when the results were corrected for urine creatinine. uVDBP was significantly negatively correlated with estimated glomerular filtration rate (eGFR; R = −0.76, P = 0.03). However, uVDBP was still markedly elevated in patients with SRNS with eGFR >100 mL/minute/1.73 m2. There was a positive correlation between microalbuminuria (MALB/Cr) and uVDBP ( R = 0.67, P < 0.001). However, uVDBP displayed a much higher discriminatory ability for distinguishing SRNS than MALB/Cr (area under the curve = 0.92 vs 0.67, respectively). An uVDBP cutoff of 362 ng/mL yielded the optimal sensitivity (80%) and specificity (83%) to distinguish SRNS from SSNS. Conclusions In this preliminary study, uVDBP represents a noninvasive biomarker that could distinguish SRNS from the more benign SSNS with high discriminatory power.

Studies on vitamin D binding protein in the nephrotic syndrome.

1985 ◽  
Vol 31 (5) ◽  
pp. 718-721 ◽  
Author(s):  
K Colston ◽  
N J Williams ◽  
H J Cleeve
Keyword(s):  
Vitamin D ◽  
Nephrotic Syndrome ◽  
Gradient Analysis ◽  
Dissociation Constants ◽  
Binding Capacity ◽  
Specific Binding ◽  
Binding Protein ◽  
Normal Subjects ◽  
Sucrose Density Gradient ◽  
Vitamin D Binding Protein

Abstract We studied the properties of vitamin D binding protein in plasma and urine from nine patients with nephrotic syndrome. Samples were incubated with 25-[3H]hydroxyvitamin D3, after which we determined binding capacity and apparent dissociation constants. Binding capacity was markedly less in plasma from patients with nephrotic syndrome than that from normal subjects, but binding affinity was unchanged. Specific binding of 25-hydroxy[3H]vitamin D3 could be demonstrated in urine from all the nephrotic patients, and sucrose density-gradient analysis of these urines revealed a single binding peak with sedimentation characteristics similar to those of vitamin D binding protein in plasma.

Sign in / Sign up

Export Citation Format

Share Document