Role of new biomarkers for predicting renal scarring in vesicoureteral reflux: NGAL, KIM-1, and L-FABP.
BACKGROUND
Reflux nephropathy is the most serious complication of vesicoureteral reflux (VUR). The aim of this study was to assess the role of urinary levels of neutrophil-gelatinase-associated lipocalin (NGAL),kidney injury molecule-1 (KIM-1), and liver-type fatty-acid-binding protein (L-FABP) in the early diagnosis of reflux nephropathy in patients with VUR.


METHODS
This study assessed 123 patients with primary VUR and 30 healthy children as a control group. The children were divided into five groups: Group A, patients with VUR and renal parenchymal scarring (RPS); Group B, patients with VUR and without RPS; Group C, patients with RPS and resolved VUR; Group D, patients with resolved VUR and without RPS; Group E, healthy reference group.


RESULTS
Median urinary NGAL (uNGAL)/Creatinine (Cr) was significantly higher in patients with than those without RPS and the control group (p = 0.0001). Median uKIM-1/Cr was similar in all groups (p = 0.417). Median uL-FABP/Cr was significantly higher in patients with RPS than in the reference group (p < 0.05).


CONCLUSIONS
Urinary NGAL levels may be used as a noninvasive diagnostic marker for predicting renal scarring in reflux nephropathy.
Department of Pediatric Nephrology, Baskent University, School of Medicine, Adana, Turkey. gonulped1@hotmail.com.
Gönül
http://orcid.org/0000-0003-2373-1837
G
Parmaksız
Department of Pediatric Nephrology, Baskent University, School of Medicine, Adana, Turkey.
Aytül
A
Noyan
Department of Pediatric Nephrology, Baskent University, School of Medicine, Adana, Turkey.
Hasan
H
Dursun
Department of Pediatric Surgery, Baskent University, School of Medicine, Adana, Turkey.
Emine
E
İnce
Department of Biochemistry, Baskent University, School of Medicine, Adana, Turkey.
Rüksan
R
Anarat
Department of Pediatric Nephrology, Baskent University, School of Medicine, Adana, Turkey.
Nurcan
N
Cengiz
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; D002921:Cicatrix / Q000209:etiology* / Q000473:pathology; D003404:Creatinine / Q000652:urine; D050556:Fatty Acid-Binding Proteins / Q000652:urine*; D005260:Female; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology* / Q000473:pathology; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D008562:Membrane Glycoproteins / Q000652:urine*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000652:urine*; D012372:ROC Curve; D011991:Receptors, Virus; D012307:Risk Factors; D016482:Urinalysis; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000175:diagnosis / Q000652:urine*
D000209:Acute-Phase Proteins; D015415:Biomarkers; C493319:FABP1 protein, human; D050556:Fatty Acid-Binding Proteins; 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; D003404:Creatinine
Kidney injury molecule-1; Liver-type fatty-acid-binding protein; Neutrophil-gelatinase-associated lipocalin; Renal parenchymal scarring; Vesicoureteral reflux