Serum and urinary neutrophil gelatinase-associated lipocalin levels in children with chronic renal diseases
Serum and urinary neutrophil gelatinase-associated lipocalin levels in children with chronic renal diseases
复制标题
DOI：
10.1111/j.1442-200x.2010.03067.x
复制
发表时间：
2010-08-01
影响因子：
1.4
通讯作者：
Hamaoka, Kenji
中科院分区：
文献类型：
--
作者：
Nishida, Masashi;Kawakatsu, Hidekazu;Hamaoka, Kenji
背景：最近的研究表明，血清和尿液中性粒细胞明胶酶相关脂质运载蛋白（NGAL）是一种新的、敏感的、特异的急性肾损伤早期检测的生物标志物。然而，检测血清和尿NGAL对慢性肾脏疾病的临床意义尚不清楚。方法：本研究中，我们检测了几种常见的小儿肾脏疾病如肾功能不全患者的血清和尿NGAL水平（估计肾小球滤过率< 90 mL/min/1.73 m2）、增生性肾小球肾炎、激素抵抗型和激素敏感型肾病综合征以及肾小管功能障碍。除激素敏感性肾病综合征缓解期患者外，所有这些疾病组的尿NGAL水平与对照组相比均显著升高，尽管仅在肾功能不全组中观察到血清NGAL水平的显著增加。血清和尿NGAL水平均显示出与总受试者分析中估计的肾小球滤过率呈显著负相关，并且在尿NGAL的肾功能不全组分析中也显示出显著负相关。在蛋白尿患者中，蛋白尿的程度与尿NGAL水平显著相关。结论：尿NGAL水平是儿童慢性肾脏疾病较血清NGAL水平更好的生物标志物，但在评价NGAL值时应考虑多种病理机制。
Background:Recent studies showed that serum and urinary neutrophil gelatinase-associated lipocalin (NGAL) represents a novel, sensitive, specific biomarker for early detection of acute kidney injury. However, the clinical significance of measuring serum and urinary NGAL on chronic renal diseases remains unclear.Methods:In this study, we measured serum and urinary NGAL levels in patients with several common pediatric renal diseases such as renal dysfunction (estimated glomerular filtration rate < 90 mL/min/1.73 m2), proliferative glomerulonephritis, steroid-resistant and steroid-sensitive nephrotic syndrome, and tubular dysfunction.Results:Urinary NGAL level was significantly increased compared with the control in all of these disease groups except in patients with a remission stage of steroid-sensitive nephrotic syndrome, although a significant increase in serum NGAL level was observed in the renal dysfunction group only. Both serum and urinary NGAL levels showed significant inverse correlations with an estimated glomerular filtration rate in the analysis with total subjects, and also in the analysis with the renal dysfunction group in urinary NGAL. In proteinuric patients, the extent of proteinuria significantly correlated with urinary NGAL level. In patients with tubular dysfunction, the increase of urinary NGAL level was remarkable compared with the other disease groups.Conclusion:These results indicated that urinary NGAL level is a better biomarker for chronic renal diseases in children than serum NGAL level, although multiple pathological mechanisms should be considered in evaluating these NGAL values.