title: Neutrophil gelatinase-associated lipocalin and Cathepsin L as early predictors of kidney dysfunction in children with type 1 diabetes.
abstract: BACKGROUND
  The aim of this study was to evaluate serum levels and urinary excretion of neutrophil-gelatinase associated lipocalin (respectively sNGAL and uNGAL) and urinary excretion of Cathepsin L (uCathL) in children with type 1 diabetes mellitus (DM1) who presented normoalbuminuria and the estimated glomerular filtration rate (eGFR) above 90 mL/min/1.73 m2.
  
  
  METHODS
  The study group consisted of 63 children with a diabetes duration of 5.16 ± 3.39 years. The degree of albuminuria was based on urine albumin-to-creatinine ratio (ACR), while eGFR was based on serum cystatin C. Glomerular hyperfiltration (GH) was defined as an eGFR value above 135 mL/min/1.73 m2.
  
  
  RESULTS
  Children with DM1 showed significantly higher concentrations of uNGAL, and lower sNGAL and uCathL. Significant changes of uNGAL and uCathL levels were even found in children without GH and with optimal glycaemic control (HbA1c < 7.5%). Positive correlations between uNGAL, ACR and eGFR were shown, as well as between uCathL and eGFR.
  
  
  CONCLUSIONS
  Significant changes in the concentration of markers of early kidney injury: sNGAL, uNGAL, and uCathL, can occur in children with DM1 and normoalbuminuria. The changes of uNGAL and uCathL can be even found in children without GH and with optimal glycaemic control. The earliest signs of diabetic kidney dysfunction seem to result from tubular damage.
authors.affiliation: Department of Paediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poland. jsoltysiak1@gmail.com.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Sołtysiak
authors.forename: Bogda
authors.initials: B
authors.lastname: Skowrońska
authors.forename: Piotr
authors.initials: P
authors.lastname: Fichna
authors.forename: Witold
authors.initials: W
authors.lastname: Stankiewicz
authors.forename: Maria
authors.initials: M
authors.lastname: Lewandowska-Stachowiak
authors.forename: Danuta
authors.initials: D
authors.lastname: Ostalska-Nowicka
authors.forename: Jacek
authors.initials: J
authors.lastname: Zachwieja
mesh_terms: D000419:Albuminuria / Q000652:urine; D015415:Biomarkers / Q000652:urine; D056668:Cathepsin L / Q000652:urine*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000378:metabolism* / Q000503:physiopathology* / Q000652:urine; D003928:Diabetic Nephropathies / Q000209:etiology / Q000378:metabolism*; D005260:Female; D006801:Humans; D000071068:Lipocalin-2 / Q000652:urine; D008297:Male; D011379:Prognosis; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D000071068:Lipocalin-2; D056668:Cathepsin L