Evaluation of renal injury in children with uncorrected CHDs with significant shunt using urinary neutrophil gelatinase-associated lipocalin

AbstractBackground:CHDs can be complicated by renal injury which worsens morbidity and mortality. Urinary neutrophil gelatinase-associated lipocalin, a sensitive and specific biomarker of renal tubular injury, has not been studied in children with uncorrected CHDs. This study evaluated renal injury in children with uncorrected CHDs using this biomarker.Methods:The patients were children with uncorrected CHDs with significant shunt confirmed on echocardiogram with normal renal ultrasound scan, in the paediatric cardiology clinic of a tertiary hospital. The controls were age-matched healthy children recruited from general practice clinics. Information on bio-data and socio-demographics were collected and urine was obtained for measurement of urinary neutrophil gelatinase-associated lipocalin levels.Results:A total of 65 children with uncorrected CHDs aged 2 to 204 months were recruited. Thirty-one (47.7%) were males while 36 (55.4%) had acyanotic CHDs. The median urinary neutrophil gelatinase-associated lipocalin level of patients of 26.10 ng/ml was significantly higher than controls of 16.90 ng/ml (U = 1624.50, p = 0.023). The median urinary neutrophil gelatinase-associated lipocalin level of patients with cyanotic and acyanotic CHDs were 30.2 ng/ml and 22.60 ng/ml respectively; (Mann–Whitney U = 368.50, p = 0.116). The prevalence of renal injury using 95th percentile cut-off value of urinary neutrophil gelatinase-associated lipocalin was 16.9%. Median age of patients with renalinjury was 16 (4–44) months.Conclusions:Children with uncorrected CHDs have renal injury detected as early as infancy. The use of urinary neutrophil gelatinase-associated lipocalin in early detection of renal injury in these children may enhance early intervention and resultant prevention of morbidity and reduction in mortality.

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Are Tubular Injury Markers NGAL and KIM-1 Useful in Pediatric Neurogenic Bladder?

Journal of Clinical Medicine ◽

10.3390/jcm10112353 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2353

Author(s):

Joanna Bagińska ◽

Agata Korzeniecka-Kozerska

Keyword(s):

Neurogenic Bladder ◽

Kidney Injury ◽

Healthy Children ◽

Tubular Injury ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Activity Assessment ◽

Kidney Injury Molecule 1 ◽

Tract Infections ◽

Neutrophil Gelatinase

The lack of early biomarkers of renal damage in children with neurogenic bladder (NB) prompts us to investigate the role of promising proteins: neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1). This prospective analysis was conducted on 58 children with NB and 25 healthy children. We assessed urinary levels of NGAL and KIM-1 in both groups. Age, sex, anthropometric measurements, activity assessment, renal function, and urodynamics parameters were analyzed. The differences between the median uNGAL and uKIM-1 in the NB group compared to control were recorded. However, only uNGAL levels were statistically significantly higher. Statistically significant correlation was found between gender, recurrent urinary tract infections, bladder trabeculation, its compliance, activity assessment, and uNGAL. To conclude, elevated levels of uNGAL may be considered a biomarker of tubular injury in children with NB due to MMC in contrast to uKIM-1.

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Neutrophil gelatinase-associated lipocalin accurately predicts renal tubular injury in patients with chronic hepatitis B treated with nucleos(t)ide analogs

Hepatology Research ◽

10.1111/hepr.12908 ◽

2017 ◽

Vol 48 (2) ◽

pp. 144-152

Author(s):

Yao Zhang ◽

Jing Li ◽

Fahong Li ◽

Xun Qi ◽

Jiming Zhang

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Tubular Injury ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Renal Tubular ◽

Neutrophil Gelatinase

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Neutrophil gelatinase-associated lipocalin (NGAL) is localised to the primary cilium in renal tubular epithelial cells - A novel source of urinary biomarkers of renal injury

Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease ◽

10.1016/j.bbadis.2019.165532 ◽

2019 ◽

Vol 1865 (12) ◽

pp. 165532 ◽

Cited By ~ 1

Author(s):

Hilary Cassidy ◽

Jennifer Slyne ◽

Michael Higgins ◽

Robert Radford ◽

Peter J. Conlon ◽

...

Keyword(s):

Epithelial Cells ◽

Primary Cilium ◽

Renal Injury ◽

Urinary Biomarkers ◽

Tubular Epithelial Cells ◽

Renal Tubular Epithelial Cells ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Renal Tubular ◽

Neutrophil Gelatinase

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Neutrophil Gelatinase-Associated Lipocalin for the Assessment of Reversible versus Persistent Renal Tubular Damage in ST-Segment Myocardial Infarction Patients

Blood Purification ◽

10.1159/000513943 ◽

2021 ◽

Vol 50 (6) ◽

pp. 925-930

Author(s):

Ariel Banai ◽

Keren-Lee Rozenfeld ◽

Itamar Loewenstein ◽

David Zahler ◽

Moshe Shtark ◽

...

Keyword(s):

Myocardial Infarction ◽

Kidney Injury ◽

Coronary Intervention ◽

Tubular Damage ◽

Symptom Duration ◽

Tubular Injury ◽

Renal Tubular Damage ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Renal Tubular ◽

Neutrophil Gelatinase

Background: Most studies investigated the value of neutrophil gelatinase-associated lipocalin (NGAL) as a marker of renal tubular injury only at a single time point. We investigated the possible utilization of NGAL level dynamics for the identification of different renal injury patterns in ST-elevation myocardial infarction (STEMI) patients. Methods: Blood samples for plasma NGAL in 132 STEMI patients were drawn immediately before and 24 h following primary coronary intervention. Abnormal elevation of NGAL levels was defined using the cardiac surgery-associated NGAL score with NGAL levels ≥100 ng/mL suggesting renal tubular damage. According to NGAL levels at 0 and 24 h, patients were stratified into 3 groups: no tubular damage (NGAL <100 ng/mL in both exams), reversible tubular damage (NGAL >100 ng/mL at 0 h but <100 ng/mL at 24 h), and persistent tubular damage (NGAL >100 ng/mL at both 0 and 24 h). Results: Mean age was 62 ± 13 years, and 78% were men. Of these patients, 29/132 (22%) demonstrated reversible tubular damage, and 36/132 (27%) persistent tubular damage. Only 13/132 patients (10%) progressed to clinical acute kidney injury during hospitalization, all of whom had persistent tubular injury. In multivariate regression model, symptom duration was independently associated with persistent tubular damage, both as continues variable (odds ratio [OR] 1.02, 95% confidence interval [CI] 1.01–1.04; p = 0.04) and for symptom duration >360 min (OR 2.66, 95% CI 1.07–6.63; p = 0.03). Conclusions: Renal tubular damage is common among STEMI patients. Dynamic NGAL measurement may differentiate between reversible and persistent tubular damage. Further trials are needed in order to assess the complex cardiorenal interactions.

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Neurophil gelatinase-associated lipocalin as a new biomarker in laboratory medicine

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2012-0227 ◽

2012 ◽

Vol 50 (9) ◽

Cited By ~ 44

Author(s):

Konstantinos Makris ◽

Demetrios Rizos ◽

Nikolaos Kafkas ◽

Alexander Haliassos

Keyword(s):

Renal Injury ◽

Current Knowledge ◽

Molecular Form ◽

Cardiorenal Syndrome ◽

Molecular Forms ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Renal Tubular Cells ◽

Disease States ◽

Renal Tubular ◽

Neutrophil Gelatinase

AbstractNeutrophil gelatinase-associated lipocalin (NGAL) is a 25 kDa protein of the lipocalin superfamily. This protein is expressed and secreted by immune cells, hepatocytes, and renal tubular cells in various pathologic states. NGAL has recently generated great interest as an early biomarker of renal injury. However, like many other endogenous biomarkers it is not produced by just one cell type and it exists in more than one molecular form. As recent research has shown different pathological conditions may involved in the production of this molecule. This review summarizes the current knowledge about the biology of NGAL and examines the role of this molecule of acute renal injury as well as in other pathologic conditions like neoplasia, anemia, pregnancy, cardiovascular disease chronic kidney disease and in cardiorenal syndrome. Commercial and research immunoassays are used to measure NGAL in both plasma and urine but these assays are not standardized. The existence of different molecular forms of NGAL and their expression at various disease states further complicates the interpretation of the results. Pre analytical issues and biological variation are also not fully elucidated.

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Up-regulation of matrix metalloproteinases-9 in the kidneys of diabetic rats and the association with neutrophil gelatinase-associated lipocalin

BMC Nephrology ◽

10.1186/s12882-021-02396-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Huayu Yang ◽

Haiping Chen ◽

Fenghua Liu ◽

Qing Ma

Keyword(s):

Diabetic Rats ◽

Diabetic Rat ◽

Tubular Epithelial Cells ◽

Tubular Injury ◽

Renal Tubular Epithelial Cells ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Matrix Metalloproteinases 9 ◽

Renal Tubular ◽

Neutrophil Gelatinase ◽

Diabetic Rat Model

Abstract Background Matrix metalloproteinases-9 (MMP-9) can regulate extracellular matrix deposition in diabetic glomerular injury. However, it remains unknown whether MMP-9 is involved in the renal tubular injury. Meanwhile, neutrophil gelatinase-associated lipocalin (NGAL), defined as a biomarker of proximal tubular injury, may influence MMP-9 by forming the MMP-9/NGAL complex. The aim of this study was to investigate MMP-9 expression in proximal renal tubules and the relationship of MMP-9 and NGAL in diabetic rat model treated with Valsartan. Methods Sprague Dawley rats were randomly divided into three groups: Diabetic group, Control group, and Treated group. The diabetic rat model was established by injection of streptozotocin. Related indexes were measured at the end of the 2nd, 4th, 8th and 12th week post-modeling. Results In diabetic groups, the concentrations of MMP-9 markedly increased in the serum and urine of rats in the early stage, even before the appearance of pathological albuminuria. Markedly elevated MMP-9/NGAL complex concentrations were also tested in diabetic groups. Western blot and qPCR tests confirmed that MMP-9 expression levels in the proximal renal tubular epithelial cells of diabetic rats were significantly higher than in control groups (P < 0.05). Correlation analysis showed that MMP-9 was positively correlated with NGAL at both protein and gene expression levels. In addition, Valsartan observably reduced tubular injury as well as MMP-9 expression in diabetic rats. Conclusions In diabetic kidney injury, the expression of MMP-9 in the proximal renal tubular epithelial cells was significantly increased. Besides, a positive correlation was found between MMP-9 and NGAL expression, along with high levels of MMP-9/NGAL complex, which indicated that NGAL might participate in the regulation of MMP-9 expression. The administration of Valsartan may reduce this effect.

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