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 An Update of Management of Idiopathic Nephrotic Syndrome: A Review Article

2013 ◽  
Vol 37 (2) ◽  
pp. 102-121
Author(s):  
MH Rahman ◽  
T Jesmin ◽  
G Muinuddin
Keyword(s):  
Nephrotic Syndrome ◽  
Kidney Disease ◽  
Child Health ◽  
Idiopathic Nephrotic Syndrome ◽  
Indian Subcontinent ◽  
Minimal Change Nephrotic Syndrome ◽  
Review Article ◽  
Minimal Change ◽  
Historical Background

Nephrotic syndrome (NS) is a common childhood kidney disease characterized by protein leakage from the blood to the urine through the glomeruli, resulting of proteinuria, hypoalbuminemia, generalized edema and hypercholesterolemia. The prevalence of minimal change nephrotic syndrome is higher in Indian subcontinent. Such incidence in Bangladesh is yet unknown. This review article discusses historical background, epidemiology, pathogenesis, pathophysiology and classification of nephrotic syndrome. In this review article focuses have been made on management of children aged between 1 to 18 years with idiopathic nephrotic syndrome. This article also provides information of different guideline recommendations and a brief review of relevant treatment trials related to each recommendation. DOI: http://dx.doi.org/10.3329/bjch.v37i2.17268 BANGLADESH J CHILD HEALTH 2013; VOL 37 (2) : 102-121

scholarly journals Rifampicin-Associated Secondary Minimal Change Disease Presenting with Nephrotic Syndrome in a Pulmonary Tuberculosis Patient

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Satyanand Sathi ◽  
Anil Kumar Garg ◽  
Manoj Kumar Singh ◽  
Virendra Singh Saini ◽  
Devinder Vohra
Keyword(s):  
Nephrotic Syndrome ◽  
Pulmonary Tuberculosis ◽  
Minimal Change Disease ◽  
Minimal Change Nephrotic Syndrome ◽  
Tuberculosis Patient ◽  
Minimal Change ◽  
Drug Induced ◽  
Urine Sediment ◽  
Rifampicin Treatment ◽  
Antituberculosis Treatment

Various extraglomerular disease processes have been associated with drug-induced secondary minimal change disease (MCD). In a majority of cases, preferably, a hypersensitivity reaction appears to be involved, and in some cases, there is direct toxic effect over glomerular capillaries. There are several reports to demonstrate that rifampicin has been associated with various nephrotoxic adverse effects, but rifampicin-induced secondary minimal change disease (MCD) is very rare. Here, we report the case of a young adult male who presented with nephrotic proteinuria with bland urine sediment after one month of initiation of rifampicin treatment for pulmonary tuberculosis. The patient had no proteinuria before the start of antituberculosis treatment. Renal biopsy showed nonproliferative glomerulopathy and immunofluorescence did not show significant glomerular immune deposits. Electron microscopy showed diffuse effacement of visceral epithelial cell foot processes and did not show any presence of glomerular immune complexes and thickening of glomerular basement membrane, promoting the diagnosis of minimal change nephrotic syndrome. The patient got complete remission after discontinuation of rifampicin.

Idiopathic nephrotic syndrome

2018 ◽  
Author(s):  
Patrick Niaudet ◽  
Alain Meyrier
Keyword(s):  
Nephrotic Syndrome ◽  
Light Microscopy ◽  
Minimal Change Disease ◽  
Idiopathic Nephrotic Syndrome ◽  
Minimal Change ◽  
Glomerular Sclerosis ◽  
Focal Segmental Glomerular Sclerosis ◽  
Diffuse Mesangial Proliferation ◽  
Segmental Glomerular Sclerosis ◽  
Visceral Epithelial Cell

Idiopathic nephrotic syndrome is defined by the combination of massive proteinuria, hypoalbuminaemia, hyperlipidaemia, and oedema, and of non-specific histological abnormalities of the glomeruli. Light microscopy may disclose minimal change disease, diffuse mesangial proliferation, or focal segmental glomerular sclerosis (FSGS). The two main causes of idiopathic nephrotic syndrome are characterized histologically. On electron microscopy the glomerular capillaries show a fusion of visceral epithelial cell (podocyte) foot processes and with the exception of some variants no significant deposits of immunoglobulins or complement by immunofluorescence. In a majority of children only minimal changes are seen on light microscopy. These children are referred to as having ‘minimal change disease’. In adults with idiopathic nephrotic syndrome, lesions of FSGS are more frequent.

Evaluation of Neutrophil Gelatinase-Associated Lipocalin in Children with Sydenham's Chorea Accompanying Valvular Regurgitation

2018 ◽  
Vol 13 (04) ◽  
pp. 293-299
Author(s):  
Köksal Deveci ◽  
Ahmet Guven ◽  
Demet Alaygut ◽  
Mehmet Oflaz
Keyword(s):  
Immune Response ◽  
Total Protein ◽  
Valvular Regurgitation ◽  
Urinary Ngal ◽  
Creatinine Ratio ◽  
Ngal Level ◽  
Urine Ngal ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Sydenham's Chorea ◽  
Neutrophil Gelatinase

Background Acute rheumatic fever (ARF) is a nonsuppurative complications of Group A β-hemolytic streptococcal (GABHS) infection due to a delayed immune response. Sydenham's chorea (SC) is an important neurological manifestation of ARF, and heart involvement is seen in a large proportion of patients with SC. The immune system has a crucial role in initiating and spreading inflammation, which causes tissue damage in ARF. Aim The purpose of this study was to investigate urine neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for kidney injury in children with rheumatic chorea accompanying valvular involvement. Materials and Methods Twenty-eight consecutive children with SC accompanying evidence of valvular involvement, and 30 nonrheumatic, age- and sex-matched healthy children were included in the study. Cardiac evaluations were performed, and urinary NGAL, micro-total protein and creatinine levels were measured in all participants. Results Age, gender, weight, and height were similar in the patients and controls. Twenty-three patients had isolated mitral regurgitation, and five patients had mitral and aortic regurgitation. While there was no statistically significant difference between the urine creatinine and micro-total protein levels in patients and controls, the patient group demonstrated a significantly higher mean urine NGAL level (18.01 ± 7.9 vs. 3.22 ± 1.4, p = 0.002) and mean urine NGAL/creatinine ratio (2.80 ± 1.9 vs. 0.33 ± 0.1, p = 0.008). However, there were no correlations between severity of chorea and urinary NGAL or urinary NGAL/creatinine ratio, there were significant positive correlations between severity of valvular regurgitation and urinary NGAL (r = 0.751, p < 0.001) and urinary NGAL/creatinine ratio (r = 0.694, p < 0.001). Conclusion The present study revealed that urinary NGAL level and urinary NGAL/creatinine ratio were higher in patients with SC accompanying valvular involvement. The results obtained from this study suggest that ARF may cause subclinical renal injury in patients with intense and prolonged cellular immune response leading to chorea and carditis.

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