title: The Usefulness of Determining Neutrophil Gelatinase-Associated Lipocalin Concentration Excreted in the Urine in the Evaluation of Cyclosporine A Nephrotoxicity in Children with Nephrotic Syndrome.
abstract: Introduction.The use of cyclosporine (CsA) in the treatment of nephrotic syndrome (NS) contributed to a significant reduction in the amount of corticosteroids used in therapy and its cumulative side effects. One of the major drawbacks of CsA therapy is its nephrotoxicity. Prolonged CsA treatment protocols require sensitive, easily available, and simple to measure biomarkers of nephrotoxicity. NGAL is an antibacterial peptide, excreted by cells of renal tubules in response to their toxic or inflammatory damage.Aim of the Study.The aim of this study was to assess the suitability of the NGAL concentration in the urine as a potential biomarker of the CsA nephrotoxicity.Material and Methods.The study was performed on a group of 31 children with NS treated with CsA. The control group consisted of 23 children diagnosed with monosyptomatic enuresis. The relationship between NGAL excreted in urine and the time of CsA treatment, concentration of CsA in blood serum, and other biochemical parameters was assessed.Results.The study showed a statistically significant positive correlation between urine NGAL concentration and serum triglycerides concentration and no correlation between C0 CsA concentration and other observed parameters of NS. The duration of treatment had a statistically significant influence on the NGAL to creatinine ratio.Conclusions.NGAL cannot be used alone as a simple CsA nephrotoxicity marker during NS therapy. Statistically significant correlation between NGAL urine concentration and the time of CsA therapy indicates potential benefits of using this biomarker in the monitoring of nephrotoxicity in case of prolonged CsA therapy.
authors.affiliation: Department of Pediatric Nephrology, Center for Pediatrics and Oncology, Chorzów, Poland.
authors.forename: Ewa
authors.identifier: 0000-0001-6444-4506
authors.initials: E
authors.lastname: Gacka
authors.affiliation: Department of Urology, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.
authors.forename: Marcin
authors.identifier: 0000-0001-9566-7948
authors.initials: M
authors.lastname: Życzkowski
authors.affiliation: Department of Urology, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.
authors.forename: Rafał
authors.identifier: 0000-0002-2698-5413
authors.initials: R
authors.lastname: Bogacki
authors.affiliation: Department of Urology, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.
authors.forename: Andrzej
authors.identifier: 0000-0003-1742-8372
authors.initials: A
authors.lastname: Paradysz
authors.affiliation: Department of Pediatric Nephrology, Center for Pediatrics and Oncology, Chorzów, Poland.
authors.forename: Lidia
authors.identifier: 0000-0002-2497-4737
authors.initials: L
authors.lastname: Hyla-Klekot
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000652:urine*; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000009:adverse effects* / Q000097:blood; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007674:Kidney Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000652:urine*; D000071068:Lipocalin-2 / Q000652:urine*; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D011379:Prognosis
chemical_list: D015415:Biomarkers; D007166:Immunosuppressive Agents; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D016572:Cyclosporine