scholarly journals Urinary neutrophil gelatinase-associated lipocalin—an early biomarker for renal injury in patients with beta-thalassemia major

2021 ◽  
Vol 53 (3) ◽  
pp. 37
Author(s):  
Liliya Stoyanova ◽  
Triphon Chervenkov
Keyword(s):  
Renal Injury ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Beta Thalassemia Major ◽  
Early Biomarker ◽  
Neutrophil Gelatinase

scholarly journals SERUM NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN (NGAL) AND URINARY NGAL EXCRETION AS A BIOMARKER OF RENAL INJURY IN CHILDREN WITH BETA THALASSEMIA MAJOR

2021 ◽  
pp. 1-3
Author(s):  
Ruchi Bhatt ◽  
Alok Hemal ◽  
Meetu Singh ◽  
Zeeshan Ahmed
Keyword(s):  
Cystatin C ◽  
Renal Injury ◽  
Linear Regression Analysis ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
P Value ◽  
Urinary Ngal ◽  
Urine Ngal ◽  
Beta Thalassemia Major ◽  
Serum And Urine

Background Frequent blood transfusions among patients with beta thalassemia major leads to iron overload state and leads to damage of various organs including kidney. Very few studies have explored on Serum and urinary NGAL as a biomarkers of renal injury in thalassemia major children. Therefore, this study is planned to investigate the renal injury in beta thalassemic children by measuring serum and urinary NGAL levels and correlating it with cystatin c and creatinine clearance. Methods: The study was a cross-sectional conducted among 25 patients with β thalassemia major, aged 1-18 years, having undergone regular blood transfusion and chelation therapy. Levels of plasma and urinary NGAL were measured and compared to the standard values of the normal range. Linear regression analysis was done. Results: Mean(SD) serum NGAL value in 1- 5 years of age was 1.6(0.26) , in 5-10 years was 2.15(0.23), in 10- 15 years was 2.6 (0.11) and > 15 years it was 18.11(33.76). ( p value <0.005).Mean (SD) urine NGAL value in 1- 5 years of age was 0.66 (0.11) , in 5-10 years was 1.13(0.13), in 10- 15 years was 1.38 (0.18) and > 15 years it was 1.94(0.25). ( p value <0.005).The mean values of plasma N-GAL, and Urinary N-GAL were significantly higher in our patients as compared to that of standard population values(p<0.05). Conclusions: Serum and urine NGAL values are found to be much higher in those with longer duration of transfusion and chelation. Positive correlation was found between urine NGAL levels and cystatin C. Serum and urine NGAL values are fair markers of renal injury in thalassemia major patients on multiple transfusions.

Association between Increases in Urinary Neutrophil Gelatinase–associated Lipocalin and Acute Renal Dysfunction after Adult Cardiac Surgery

2006 ◽  
Vol 105 (3) ◽  
pp. 485-491 ◽  
Author(s):  
Gebhard Wagener ◽  
Michael Jan ◽  
Mihwa Kim ◽  
Kiyoshi Mori ◽  
Jonathan M. Barasch ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Cardiac Surgery ◽  
Renal Injury ◽  
Urinary Ngal ◽  
Acute Renal Injury ◽  
Acute Renal Dysfunction ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Early Biomarker ◽  
Neutrophil Gelatinase

Background Acute renal dysfunction (ARD) and subsequent acute renal failure after cardiac surgery are associated with high mortality and morbidity. Early therapeutic or preventive intervention is hampered by the lack of an early biomarker for acute renal injury. Recent studies showed that urinary neutrophil gelatinase-associated lipocalin (NGAL or lipocalin 2) is up-regulated early (within 1-3 h) after murine renal injury and in pediatric ARD after cardiac surgery. The authors hypothesized that postoperative urinary NGAL concentrations are increased in adult patients developing ARD after cardiac surgery compared with patients without ARD. Methods After institutional review board approval, 81 cardiac surgical patients were prospectively studied. Urine samples were collected immediately before incision and at various time intervals after surgery for NGAL analysis by quantitative immunoblotting. ARD was defined as peak postoperative serum creatinine increase by 50% or greater compared with preoperative serum creatinine. Results Sixteen of 81 patients (20%) developed postoperative ARD, and the mean urinary NGAL concentrations in patients who developed ARD were significantly higher early after surgery (after 1 h: 4,195 +/- 6,520 [mean +/- SD] vs. 1,068 +/- 2,129 ng/ml; P &lt; 0.01) compared with patients who did not develop ARD. Mean urinary NGAL concentrations continued to increase and remained significantly higher at 3 and 18 h after cardiac surgery in patients with ARD. In contrast, urinary NGAL in patients without ARD decreased rapidly after cardiac surgery. Conclusions Patients developing postoperative ARD had significantly higher urinary NGAL concentrations early after cardiac surgery. Urinary NGAL may therefore be a useful early biomarker of ARD after cardiac surgery. These findings may facilitate the early detection of acute renal injury and potentially prevent progression to acute renal failure.

scholarly journals Assessment of Subclinical Renal Glomerular and Tubular Dysfunction in Children with Beta Thalassemia Major

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 100
Author(s):  
Asmaa A. Mahmoud ◽  
Doaa M. Elian ◽  
Nahla MS. Abd El Hady ◽  
Heba M. Abdallah ◽  
Shimaa Abdelsattar ◽  
...  
Keyword(s):  
Cystatin C ◽  
Kidney Injury ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
Good Survival ◽  
Control Group ◽  
Healthy Children ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Beta Thalassemia Major

Background: A good survival rate among patients with beta thalassemia major (beta-TM) has led to the appearance of an unrecognized renal disease. Therefore, we aimed to assess the role of serum cystatin-C as a promising marker for the detection of renal glomerular dysfunction and N-acetyl beta-D-glucosaminidase (NAG) and kidney injury molecule 1 (KIM-1) as potential markers for the detection of renal tubular injury in beta-TM children. Methods: This case-control study was implemented on 100 beta-TM children receiving regular blood transfusions and undergoing iron chelation therapy and 100 healthy children as a control group. Detailed histories of complete physical and clinical examinations were recorded. All subjected children underwent blood and urinary investigations. Results: There was a significant increase in serum cystatin-C (p < 0.001) and a significant decrease in eGFR in patients with beta-TM compared with controls (p = 0.01). There was a significant increase in urinary NAG, KIM-1, UNAG/Cr, and UKIM-1/Cr (p < 0.001) among thalassemic children, with a significant positive correlation between serum cystatin-C, NAG and KIM-1 as regards serum ferritin, creatinine, and urea among thalassemic patients. A negative correlation between serum cystatin-C and urinary markers with eGFR was noted. Conclusion: Serum cystatin-C is a good marker for detection of glomerular dysfunction. NAG and KIM-1 may have a predictive role in the detection of kidney injury in beta-TM children.

scholarly journals Left Atrial Strain Identifies Increased Atrial Ectopy in Patients with Beta-Thalassemia Major

Diagnostics ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 1
Author(s):  
Maria Vlachou ◽  
Vasileios Kamperidis ◽  
Efthymia Vlachaki ◽  
Georgios Tziatzios ◽  
Despoina Pantelidou ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Left Atrial ◽  
Systolic Pressure ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
Tape Recording ◽  
Blood Transfusions ◽  
Systolic Strain ◽  
Peak Systolic Strain ◽  
Beta Thalassemia Major

Patients with beta-thalassemia major (β-ΤΜ) may develop cardiac arrhythmias through a multifactorial mechanism. The current study evaluated the association of cardiac structure and function on echocardiography with atrial ectopic burden on 24-hour tape recording in β-ΤΜ patients. This prospective study included consecutive β-ΤΜ patients. Demographic, laboratory, echocardiographic, cardiac magnetic resonance (CMR) T2* and 24-hour tape recording data were prospectively collected. The patients were classified according to the median value of premature atrial contractions (PACs) on 24-hour tape. In total, 50 β-TM patients (37.6 ± 9.1 years old, 50% male) were divided in 2 groups; PACs ≤ 24/day and > 24/day. Patients with PACs > 24/day were treated with blood transfusion for a longer period of time (39.0 ± 8.6 vs. 32.0 ± 8.9 years, p < 0.007), compared to their counterparts. Older age (OR: 1.121, 95% CI: 1.032–1.217, p = 0.007), longer duration of blood transfusion (OR:1.101, 95% CI:1.019–1.188, p = 0.014), larger LV end-diastolic diameter (OR: 4.522, 95% CI:1.009–20.280, p = 0.049), higher values of LA peak systolic strain (OR: 0.869, 95% CI: 0.783–0.964, p = 0.008), higher MV E/E′ average (OR: 1.407, 95% CI: 1.028–1.926, p = 0.033) and higher right ventricular systolic pressure (OR: 1.147, 95% CI: 1.039–1.266, p = 0.006) were univariably associated with PACs > 24/day. LA peak systolic strain remained significantly associated with PACs > 24/day after adjusting for the duration of blood transfusions or for CMR T2*. The multivariable model including blood transfusion duration and LA peak systolic strain was the most closely associated with PACs > 24/day. Receiver operating characteristic curve analysis identified a left atrial peak systolic strain of 31.5%, as the best cut-off value (83% sensitivity, 68% specificity) for prediction of PACs > 24/day. In β-TM patients, LA peak systolic strain was associated with the atrial arrhythmia burden independently to the duration of blood transfusions and CMR T2*.

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