Validity of urine neutrophile gelatinase-associated lipocalin in children with primary vesicoureteral reflux

Nickavar, Azar; Valavi, Ehsan; Safaeian, Baranak; Moosavian, Mostafa

doi:10.1007/s11255-019-02355-3

Cited by 10 publications

(25 citation statements)

References 9 publications

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“…11,12 We found higher urinary biomarkers concentrations in patients with malformations or urinary tract dilation, as well as in cases of VUR. The prevalence of VUR among children with UTI ranges between 30%-50% 15,16 and was lower in our population study (16.7%).…”

Section: Discussioncontrasting

confidence: 64%

“…A nonnegligible percentage of these patients will present long‐term chronic kidney damage (8%–18%), so early diagnosis and management could improve their prognosis. The increased urinary excretion of cytokines and other biomarkers occurs secondary to tubular damage and interstitial fibrosis in patients with VUR 16 ; therefore, the study of biomarkers, such as IL6 and IL8, has been proposed as an alternative to more invasive classical methods (i.e. VCUG) 15,16 .…”

Section: Discussionmentioning

confidence: 99%

“…10 The analysis of serum and urine cytokines, mainly interleukin (IL) 6 and IL8, and other biomarkers like neutrophil gelatinase-associated lipocalin-2 (NGAL/Lipocalin-2), is emerging in the literature, showing higher levels of these proteins in children and adults with UTI and kidney damage. [11][12][13][14][15][16][17][18][19][20] Considering this hypothesis, the role of anti-inflammatory treatment has been assessed as a potential control of cytokine cascade. Sharifian et al 21 demonstrated in 54 children with a first episode of APN that coadjuvant treatment with dexamethasone enhanced the decrease in urinary IL6 and IL8 compared with children who received only the usual antimicrobial treatment.…”

Section: Introductionmentioning

confidence: 99%

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Role of dexamethasone in controlling the proinflammatory cytokine cascade in the first episode of paediatric acute pyelonephritis

Rius‐Gordillo,

Ferré,

González

et al. 2023

Acta Paediatrica

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AimFebrile urinary tract infection is a common bacterial infection in childhood. The kidney damage after acute pyelonephritis (APN) could be related to the stimulation of the proinflammatory response. We aimed to investigate the role of inflammatory cytokines and the effect of dexamethasone after a first episode of APN.MethodsSubanalysis of the DEXCAR RCT in which children with confirmed APN (1 month–14 years) were randomly assigned to receive a 3 days course of either intravenous dexamethasone or placebo. Urinary cytokine levels at diagnosis and after 72 h of treatment were measured.ResultsNinety‐two patients were recruited. Younger patients, males and those with abnormalities in the ultrasound study or vesicoureteral reflux showed higher values of urinary cytokines. Patients with severe APN had higher Tumour Necrosis Factor (TNF)α levels (81.0 ± 75.8 vs. 33.6 ± 48.5 pg/mg creatinine, p = 0.015). Both intervention groups showed similar basal clinical characteristics, including urinary cytokine levels. Treatment reduced urinary cytokine levels irrespective of dexamethasone administration. Neither the intervention group nor the urinary cytokine levels modulated the development of kidney scars.ConclusionBasal urinary cytokines were associated with age, abnormal ultrasound and vesicoureteral reflux. Patients with severe APN had higher TNFa urinary levels. Administration of dexamethasone in children with APN does not improve the control of the proinflammatory cytokine cascade.

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Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Role of dexamethasone in controlling the proinflammatory cytokine cascade in the first episode of paediatric acute pyelonephritis

Rius‐Gordillo,

Ferré,

González

et al. 2023

Acta Paediatrica

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“…Several publications have appeared in recent years documenting the relationship between uNGAL and VUR but these results are not conclusive. Parmaksız [ 23 ] and Nickavar [ 24 ] indicate that uNGAL may be considered as a noninvasive diagnostic biomarker of primary VUR, especially of its long-term consequences such as renal scarring. However, our results are in good agreement with other studies which showed that presence of VUR did not change the uNGAL concentrations [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

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

Bagińska

Korzeniecka‐Kozerska

2021

JCM

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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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“…Elevated levels of urinary NGAL (uNGAL) excretion have been demonstrated in children with renal tubular damage depending upon the severity which is due to the overproduction of NGAL and decreased NGAL reabsorption. uNGAL has been demonstrated to be a sensitive biomarker of damage to the proximal kidney and chronic tubulointerstitial injury,[ 8 ] and recently, uNGAL has been evaluated in multiple studies as a potential marker for VUR and renal scarring. [ 3 4 9 10 ]…”

Section: Introductionmentioning

confidence: 99%

Utility of Urinary Biomarkers Neutrophil Gelatinase-Associated Lipocalin and Kidney Injury Molecule-1 as a Marker for Diagnosing the Presence of Renal Scar in Children with Vesicoureteral Reflux (VUR)

Naik

Jindal

Kumaravel

et al. 2022

Journal of Indian Association of Pediatric Surgeons

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Aim: To explore the possibility of using urinary biomarkers neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) to assess the presence of renal scars in children with Vesicoureteric Reflux (VUR). Materials and Methods: This cross-sectional study was conducted in 94 children aged 0–16 years diagnosed with VUR in the Department of Pediatric Surgery, JIPMER. Urinary biomarkers were measured using the enzyme-linked immunosorbent assay kits, normalized with urinary creatinine (Cr) and compared with severity of VUR (low grade [I and II] and high grade [III, IV, and V]), presence or absence of renal scar in VUR patients and severity of renal scar. Independent Student's t -test, Mann–Whitney U-test, and analysis of variance Kruskal–Wallis test were used for comparison, and receiver operating characteristic (ROC) curve analysis for predicting the accuracy of biomarkers in detecting the presence of renal scars. Results: The median urinary NGAL (uNGAL) value was higher in children with renal scar (1.49 ng/mL) than those without renal scar (0.58 ng/mL) and was statistically significant (<0.001). Whereas median uNGAL/Cr was higher in children with renal scar (0.07) than those without renal scar (0.03) but was not statistically significant ( P = 0.06). Urinary KIM-1 and urinary KIM-1/urinary Cr (uKIM-1/Cr) was not found to be a significant predictor of renal scar. The difference of uNGAL/Cr was comparable between the grades of renal scar but was not statistically significant. On ROC curve analysis, uNGAL had area under the ROC curve (AUC) of 0.769 with 71% of both specificity and sensitivity, whereas uNGAL/Cr was found to be a poor predictor of renal scar with AUC of 0.611, 60% sensitivity, and 61.2% specificity. Conclusion: uNGAL can serve as a noninvasive marker for diagnosing the presence of renal scar in children with VUR and a multicentric more extensive cohort study may be needed to strengthen or negate its role.

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Validity of urine neutrophile gelatinase-associated lipocalin in children with primary vesicoureteral reflux

Cited by 10 publications

References 9 publications

Role of dexamethasone in controlling the proinflammatory cytokine cascade in the first episode of paediatric acute pyelonephritis

Role of dexamethasone in controlling the proinflammatory cytokine cascade in the first episode of paediatric acute pyelonephritis

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

Utility of Urinary Biomarkers Neutrophil Gelatinase-Associated Lipocalin and Kidney Injury Molecule-1 as a Marker for Diagnosing the Presence of Renal Scar in Children with Vesicoureteral Reflux (VUR)

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