Neutrophil Gelatinase-Associated Lipocalin as an Early Sign of Diabetic Kidney Injury in Children

Yıldırım, Zeynep Nagehan Yürük; Nayır, Ahmet; Yılmaz, Alev; Gedikbaşı, Asuman; Bundak, Rüveyde

doi:10.4274/jcrpe.2002

Cited by 25 publications

(21 citation statements)

References 26 publications

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“…Thus, the level of urinary NGAL appears to increase in the very early phase of T1DM before microalbuminuria develops. Patients with T1DM should be considered to have diabetic kidney injury from the time of diagnosis and preventive interventions should be initiated at an early stage to preclude the progression to end-stage renal disease [28]. Here, we found that the level of urine NGAL was significantly higher in the normoalbuminuria, microalbuminuria and macroalbuminuria groups compared with the control group, and found that urine NGAL was independently associated with albuminuria in T2DN.…”

Section: Discussionsupporting

confidence: 57%

Urinary RBP and NGAL Levels are Associated with Nephropathy in Patients with Type 2 Diabetes

Shao

et al. 2017

Cell Physiol Biochem

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Background/Aims: The diagnosis of type 2 diabetic nephropathy (T2DN) patients is important to prevent the long-term damaging effects of kidney loss in patients with diabetes and is decisive for patient outcomes. The aim of this study was to explore urine retinol binding protein (RBP) and neutrophil gelatinase-associated lipocalin (NGAL) in T2DN patients with and without albuminuria. Methods: A total of 293 T2DN patients were divided into three groups according to their urine albumin/urine creatinine ratio (UACR): normoalbuminuria group (UACR<30 mg/g, n=100), microalbuminuria group (UACR 30–300 mg/g, n=100) and macroalbuminuria group (UACR>300 mg/g, n=93); 50 non-diabetic subjects were recruited as the control group. The levels of urine RBP, NGAL, TNF-α and IL-18 in T2DN patients and non-diabetic subjects were measured using ELISA assays. Results: We first analyzed the clinical characteristics of the control and T2DN groups and found that urine NGAL, RBP, TNF-α and IL-18 levels were significantly increased and significantly correlated with the degree of albuminuria. In addition, univariate linear regression analysis showed that urine RBP was associated with UACR, BMI, Scr, BUN, TG, disease duration, SBP, NGAL, TNF-α and IL-18 levels, and urine NGAL was positively correlated with UACR, Scr, BUN, RBP, TNF-α and IL-18 levels. Conclusion: The results indicate that urine levels of NGAL and RBP may be independently associated with albuminuria in T2DN and may serve as novel biomarkers for the identification of T2DN.

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Section: Discussionsupporting

confidence: 57%

Urinary RBP and NGAL Levels are Associated with Nephropathy in Patients with Type 2 Diabetes

Shao

et al. 2017

Cell Physiol Biochem

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“…The urinary NGAL level (1.5-fold) already was significantly elevated in normoalbuminuric patients with diabetes compared with nondiabetic controls and was significantly associated with albuminuria [ 14 ]. Mean urinary NGAL and NGAL/creatinine ratio (NGAL/Cr) levels in both microalbuminuric and nonmicroalbuminuric diabetic patients were found to be higher than those in the controls, indicating that tubular involvement may precede glomerular involvement, as urinary NGAL levels are increased in the very early phase of diabetes before microalbuminuria develops [ 24 ].…”

Section: Neutrophil Gelatinase Associated Lipocalinmentioning

confidence: 99%

Urinary Markers of Tubular Injury in Early Diabetic Nephropathy

Fiseha

Tamir

2016

International Journal of Nephrology

100

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Diabetic nephropathy (DN) is a common and serious complication of diabetes associated with adverse outcomes of renal failure, cardiovascular disease, and premature mortality. Early and accurate identification of DN is therefore of critical importance to improve patient outcomes. Albuminuria, a marker of glomerular involvement in early renal damage, cannot always detect early DN. Thus, more sensitive and specific markers in addition to albuminuria are needed to predict the early onset and progression of DN. Tubular injury, as shown by the detection of tubular injury markers in the urine, is a critical component of the early course of DN. These urinary tubular markers may increase in diabetic patients, even before diagnosis of microalbuminuria representing early markers of normoalbuminuric DN. In this review we summarized some new and important urinary markers of tubular injury, such as neutrophil gelatinase associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), liver-type fatty acid binding protein (L-FABP), N-acetyl-beta-glucosaminidase (NAG), alpha-1 microglobulin (A1M), beta 2-microglobulin (B2-M), and retinol binding protein (RBP) associated with early DN.

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“…91 Similarly, elevated urinary NGAL is present in normoalbuminuric diabetic patients, as well as used to assess tubular lesions in the disease, 92 and has been shown to precede microalbuminuria in T1DM. 93,94 In addition, high values of this biomarker were noted in T2DM patients with normoalbuminuria which rose progressively in patients with microalbuminuria and macroalbuminuria. 95 Thus, urinary NGAL in T2DM patients likely has a role in predicting the evolution of disease.…”

Section: Tubular Biomarkersmentioning

confidence: 99%

The role of novel biomarkers in predicting diabetic nephropathy: a review

Uwaezuoke

2017

IJNRD

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Diabetic nephropathy (DN) is one of the microvascular complications of the kidney arising commonly from type 1 diabetes mellitus (T1DM), and occasionally from type 2 diabetes mellitus (T2DM). Microalbuminuria serves as an early indicator of DN risk and a predictor of its progression as well as cardiovascular disease risk in both T1DM and T2DM. Although microalbuminuria remains the gold standard for early detection of DN, it is not a sufficiently accurate predictor of DN risk due to some limitations. Thus, there is a paradigm shift to novel biomarkers which would help to predict DN risk early enough and possibly prevent the occurrence of end-stage kidney disease. These new biomarkers have been broadly classified into glomerular biomarkers, tubular biomarkers, biomarkers of inflammation, biomarkers of oxidative stress, and miscellaneous biomarkers which also include podocyte biomarkers, some of which are also considered as tubular and glomerular biomarkers. Although they are potentially useful for the evaluation of DN, current data still preclude the routine clinical use of majority of them. However, their validation using high-quality and large longitudinal studies is of paramount importance, as well as the subsequent development of a biomarker panel which can reliably predict and evaluate this renal microvascular disease. This paper aims to review the predictive role of these biomarkers in the evaluation of DN.

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Neutrophil Gelatinase-Associated Lipocalin as an Early Sign of Diabetic Kidney Injury in Children

Cited by 25 publications

References 26 publications

Urinary RBP and NGAL Levels are Associated with Nephropathy in Patients with Type 2 Diabetes

Urinary RBP and NGAL Levels are Associated with Nephropathy in Patients with Type 2 Diabetes

Urinary Markers of Tubular Injury in Early Diabetic Nephropathy

The role of novel biomarkers in predicting diabetic nephropathy: a review

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