title: Serum neutrophil gelatinase-associated lipocalin as a marker of renal function in children with chronic kidney disease.
abstract: Very few biomarkers exist for monitoring chronic kidney disease (CKD). We have recently shown that serum neutrophil gelatinase-associated lipocalin (NGAL) represents a novel biomarker for early identification of acute kidney injury. In this study, we hypothesized that serum NGAL may also represent a biomarker for the quantitation of CKD. Forty-five children with CKD stages 2-4 were prospectively recruited for measurement of serum NGAL, serum cystatin C, glomerular filtration rate (GFR) by Ioversol clearance, and estimated GFR (eGFR) by Schwartz formula. Serum NGAL significantly correlated with cystatin C (r=0.74, P<0.000). Both NGAL and cystatin C significantly correlated with measured GFR (r=0.62, P<0.000; and r=0.71, P<0.000, respectively) as well as with eGFR (r=0.66, P<0.000 and r=0.59, P<0.000, respectively). At GFR levels of >or=30 ml/min per 1.73 m(2), serum NGAL, cystatin C, and eGFR were all significantly correlated with measured GFR. However, in subjects with lower GFRs (<30 ml/min per 1.73 m(2)), serum NGAL levels correlated best with measured GFR (r=0.62), followed by cystatin C (r=0.41). We conclude that (a) both serum NGAL and cystatin C may prove useful in the quantitation of CKD, and (b) by correlation analysis, NGAL outperforms cystatin C and eGFR at lower levels of measured GFR.
authors.affiliation: Divisions of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, MLC 7022, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA.
authors.forename: Mark M
authors.initials: MM
authors.lastname: Mitsnefes
authors.forename: Thelma S
authors.initials: TS
authors.lastname: Kathman
authors.forename: Jaya
authors.initials: J
authors.lastname: Mishra
authors.forename: Janis
authors.initials: J
authors.lastname: Kartal
authors.forename: Philip R
authors.initials: PR
authors.lastname: Khoury
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Nickolas
authors.forename: Jonathan
authors.initials: J
authors.lastname: Barasch
authors.forename: Prasad
authors.initials: P
authors.lastname: Devarajan
mesh_terms: D000209:Acute-Phase Proteins; D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002648:Child; D002908:Chronic Disease; D003287:Contrast Media; D003430:Cross-Sectional Studies; D055316:Cystatin C; D015891:Cystatins / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology*; D000071068:Lipocalin-2; D054834:Lipocalins; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000097:blood*; D014283:Triiodobenzoic Acids
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C525030:CST3 protein, human; D003287:Contrast Media; D055316:Cystatin C; D015891:Cystatins; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D014283:Triiodobenzoic Acids; C054871:ioversol