title: Hypertensive nephropathy in children - do we diagnose early enough?
abstract: OBJECTIVE
  The aim was to evaluate the level of neutrophil gelatinase-associated lipocalin (NGAL), interleukin 18 (IL-18) and retinol binding protein (RBP) in children with primary hypertension and no features of hypertensive nephropathy.
  
  
  METHODS
  The study group consisted of 19 children (15 males) aged 14.8 ± 2.18 years with primary hypertension. Estimated glomerular filtration rate (eGFR) and albumin/creatinine ratio (ACR) were within the normal range. Mean blood pressure (BP) was 141/79 mmHg (mean systolic BP percentile was 98, mean diastolic BP percentile was 80). Ambulatory BP measurement (ABPM), blood and urine biochemical measurements and features of end organ damage were assessed. The control group consisted of 20 healthy children.
  
  
  RESULTS
  Hypertensive children showed significantly increased serum and urine NGAL concentration vs controls. Urine RBP was significantly higher in the study group vs controls. A positive correlation was found between urine NGAL and the index of mean systolic BP measured in ABPM, between urine IL-18 and the index of office diastolic BP, between serum NGAL and ACR, and between urine NGAL concentration and serum HDL.
  
  
  CONCLUSIONS
  In children with primary hypertension, increased serum and urine NGAL may reflect kidney injury earlier than typical markers of hypertensive nephropathy.
authors.affiliation: Department of Pediatric Nephrology and Cardiology, Poznan University of Medical Sciences, Poznan, Poland. ablumczynski@poczta.fm
authors.forename: Andrzej
authors.initials: A
authors.lastname: Blumczynski
authors.forename: Jolanta
authors.initials: J
authors.lastname: Sołtysiak
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Lipkowska
authors.forename: Magdalena
authors.initials: M
authors.lastname: Silska
authors.forename: Anna
authors.initials: A
authors.lastname: Poprawska
authors.forename: Anna
authors.initials: A
authors.lastname: Musielak
authors.forename: Marcin
authors.initials: M
authors.lastname: Zaniew
authors.forename: Jacek
authors.initials: J
authors.lastname: Zachwieja
mesh_terms: D000209:Acute-Phase Proteins / Q000378:metabolism*; D000293:Adolescent; D015415:Biomarkers / Q000378:metabolism; D002648:Child; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000378:metabolism*; D020382:Interleukin-18 / Q000378:metabolism*; D007674:Kidney Diseases / Q000175:diagnosis* / Q000209:etiology; D000071068:Lipocalin-2; D054834:Lipocalins / Q000378:metabolism*; D008297:Male; D010865:Pilot Projects; D011379:Prognosis; D011518:Proto-Oncogene Proteins / Q000378:metabolism*; D012177:Retinol-Binding Proteins / Q000378:metabolism*
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D020382:Interleukin-18; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D012177:Retinol-Binding Proteins