title: KIM-1 and NGAL: new markers of obstructive nephropathy.
abstract: Congenital obstructive nephropathy is the primary cause of chronic renal failure in children. Rapid diagnosis and initiation of the treatment are vital to preserve function and/or to slow down renal injury. The aim of our study was to determine whether urinary (u) kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) may be useful non-invasive biomarkers in children with congenital hydronephrosis (HN) caused by ureteropelvic junction obstruction. The study cohort consisted of 20 children with severe HN who required surgery (median age 2.16 years) and two control groups (control group 1: 20 patients with mild, non-obstructive HN; control group 2: 25 healthy children). All of the children had normal renal function. Immunoenzymatic ELISA commercial kits were used to measure uKIM-1 and uNGAL concentrations. The preoperative median uKIM-1/creatinine (cr.) and uNGAL levels were significantly greater in the children with severe HN than in both control groups. Three months after surgery, uNGAL had decreased significantly (p<0.05) in the children with severe HN, but was still higher than that in control group 2 children (p<0.05). Receiver operator characteristic analyses revealed a good diagnostic profile for uKIM-1 and uNGAL in terms of identifying a differential renal function of <40% in HN patients (area under the curve (AUC) 0.8 and 0.814, respectively) and <45% in all examined children (AUC 0.779 and 0.868, respectively). Based on these results, we suggest that increasing uNGAL and uKIM-1 levels are associated with worsening obstruction. Further studies are required to confirm a potential application of uKIM-1 and uNGAL as useful biomarkers for the diagnosis and progression of chronic kidney disease.
authors.affiliation: Department of Pediatrics and Nephrology, Medical University of Białystok, Waszyngtona 17, 15-274, Białystok, Poland. annwasil@interia.pl
authors.forename: Anna
authors.initials: A
authors.lastname: Wasilewska
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Taranta-Janusz
authors.forename: Wojciech
authors.initials: W
authors.lastname: Dębek
authors.forename: Walentyna
authors.initials: W
authors.lastname: Zoch-Zwierz
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Kuroczycka-Saniutycz
mesh_terms: D000209:Acute-Phase Proteins / Q000652:urine*; D000293:Adolescent; D019540:Area Under Curve; D015415:Biomarkers / Q000652:urine; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D006869:Hydronephrosis / Q000151:congenital / Q000175:diagnosis* / Q000652:urine*; D007223:Infant; D007231:Infant, Newborn; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D008562:Membrane Glycoproteins / Q000652:urine*; D011518:Proto-Oncogene Proteins / Q000652:urine*; D012372:ROC Curve; D011991:Receptors, Virus; D012680:Sensitivity and Specificity
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D008562:Membrane Glycoproteins; D011518:Proto-Oncogene Proteins; D011991:Receptors, Virus