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Indian Journal of Pediatrics

Published in:

01-01-2016 | Original Article

Urine Neutrophil Gelatinase Associated Lipocalin to Creatinine Ratio: A Novel Index for Steroid Response in Idiopathic Nephrotic Syndrome

Authors: Azar Nickavar, Baranak Safaeian, Simin Sadeghi-Bojd, Arash Lahouti Harah dashti

Published in: Indian Journal of Pediatrics | Issue 1/2016

Abstract

Objective

To find the value of urine neutrophil gelatinase associated lipocalin (NGAL) in differentiating steroid response in children with idiopathic nephrotic syndrome (INS).

Methods

A total of 52 children with INS (n = 27, steroid resistant; n = 25, steroid responsive) aged 1–16 y, along with 18 healthy control children were enrolled in this study. Urine NGAL as well as urine protein, and serum creatinine were analyzed during active phase of INS.

Results

Serum creatinine (P 0.032), and urine NGAL/Cr (P 0.001) were significantly higher in steroid resistant than steroid sensitive patients. The optimal cutoff value for urine NGAL/Cr with the highest sensitivity and specificity was 0.46 ng/mg and cut off value of 0.01 and 1.15 ng/mg had maximum sensitivity and specificity, respectively.

Conclusions

Urine NGAL/Cr could be considered as a marker of steroid resistance in children with idiopathic nephrotic syndrome.

Nickavar A, Lahouti Harahdashti A. Is steroid response changing in children with idiopathic nephrotic syndrome. Iran J Kidney Dis. 2014;8:389–93.PubMed

Wasilewska A, Zoch-Zwierz W, Taranta-Janusz K, Michaluk-Skutnik J. Neutrophil gelatinase-associated lipocalin: a new marker of cyclosporine nephrotoxicity? Pediatr Nephrol. 2010;25:889–97.PubMedCrossRef

Noto A, Cibecchini F, Fanos V, Mussap M. NGAL and metabolomics: the single biomarker to reveal the metabolome alterations in kidney injury. Biomed Res Int. 2013;2013:612032.PubMedPubMedCentralCrossRef

Wasilewska A, Taranta-Janusz K, Dębek W, Zoch-Zwierz W, Kuroczycka-Saniutycz E. KIM-1 and NGAL: new markers of obstructive nephropathy. Pediatr Nephrol. 2011;26:579–86.PubMedPubMedCentralCrossRef

Hirsch R, Dent C, Pfriem H, Allen J, Beekman RH 3rd, Ma Q, et al. NGAL is an early predictive biomarker of contrast-induced nephropathy in children. Pediatr Nephrol. 2007;22:2089–95.PubMedCrossRef

Wheeler DS, Devarajan P, Ma Q, et al. Serum neutrophil gelatinase-associated lipocalin (NGAL) as a marker of acute kidney injury in critically ill children with septic shock. Crit Care Med. 2008;36:1297–303.PubMedPubMedCentralCrossRef

Bolignano D, Lacquaniti A, Coppolino G, et al. Neutrophil gelatinase-associated lipocalin (NGAL) and progression of chronic kidney disease. Clin J Am Soc Nephrol. 2009;4:337–44.PubMedPubMedCentralCrossRef

Bolignano D, Coppolino G, Aloisi C, Romeo A, Nicocia G, Buemi M. Effect of a single intravenous immunoglobulin infusion on neutrophil gelatinase-associated lipocalin levels in proteinuric patients with normal renal function. J Investig Med. 2008;56:997–1003.PubMed

Nickolas TL, Forster CS, Sise ME, et al. NGAL (Lcn2) monomer is associated with tubulointerstitial damage in chronic kidney disease. Kidney Int. 2012;82:718–22.PubMedPubMedCentralCrossRef

10.

Kim JS, Bellew CA, Silverstein DM, Aviles DH, Boineau FG, Vehaskari VM. High incidence of initial and late steroid resistance in childhood nephrotic syndrome. Kidney Int. 2005;68:1275–81.PubMedCrossRef

11.

Bennett MR, Piyaphanee N, Czech K, Mitsnefes M, Devarajan P. NGAL distinguishes steroid sensitivity in idiopathic nephrotic syndrome. Pediatr Nephrol. 2012;27:807–12.PubMedPubMedCentralCrossRef

12.

Xia H, He QN, Li XY, Shuai LJ, Chen HX, Yi ZW. Expression of urinary neutrophil gelatinase-associated lipocalin and its clinical significance in children with idiopathic nephrotic syndrome. Zhongguo Dang Dai Er Ke Za Zhi. 2013;15:541–5.PubMed

13.

Nishida M, Kawakatsu H, Okumura Y, Hamaoka K. Serum and urinary neutrophil gelatinase-associated lipocalin levels in children with chronic renal diseases. Pediatr Int. 2010;52:563–8.PubMedCrossRef

14.

Korzeniecka-Kozerska A, Wasilewska A, Tenderenda E, Sulik A, Cybulski K. Urinary MMP-9/NGAL ratio as a potential marker of FSGS in nephrotic children. Dis Markers. 2013;34:357–62.PubMedPubMedCentralCrossRef

15.

Wen Q, Huang LT, Luo N, Wang YT, Li XY, Mao HP. Proteomic profiling identifies haptoglobin as a potential serum biomarker for steroid-resistant nephrotic syndrome. Am J Nephrol. 2012;36:105–13.PubMedCrossRef

16.

Bazzi C, Rizza V, Casellato D, et al. Urinary IgG and α2-macroglobulin are powerful predictors of outcome and responsiveness to steroids and cyclophosphamide in idiopathic focal segmental glomerulosclerosis with nephrotic syndrome. Biomed Res Int. 2013;2013:941831.PubMedPubMedCentralCrossRef

17.

Youssef DM, El-Shal AA. Urine neutrophil gelatinase-associated lipocalin and kidney injury in children with focal segmental glomerulosclerosis. Iran J Kidney Dis. 2012;6:355–60.PubMed

Title: Urine Neutrophil Gelatinase Associated Lipocalin to Creatinine Ratio: A Novel Index for Steroid Response in Idiopathic Nephrotic Syndrome
Authors: Azar Nickavar
Baranak Safaeian
Simin Sadeghi-Bojd
Arash Lahouti Harah dashti
Publication date: 01-01-2016
Publisher: Springer India
Published in: Indian Journal of Pediatrics / Issue 1/2016
Print ISSN: 0019-5456
Electronic ISSN: 0973-7693
DOI: https://doi.org/10.1007/s12098-015-1809-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Urine Neutrophil Gelatinase Associated Lipocalin to Creatinine Ratio: A Novel Index for Steroid Response in Idiopathic Nephrotic Syndrome

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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