Is Urinary Kidney Injury Molecule-1 a Noninvasive Marker for Renal Scarring in Children With Vesicoureteral Reflux?

Toker, Aysun; Ziypak, Tevfik; Orsal, Ebru; Laloğlu, Esra; Bedir, Fevzi; Aksoy, Yılmaz

doi:10.1016/j.urology.2012.09.004

Cited by 17 publications

(10 citation statements)

References 28 publications

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“…IL-6 seems to be associated with the presence of high grade VUR while IL-8 is linked to scar formation (23). Recent studies (24) point to a relationship between kidney injury molecule-1 (KIM-1), a trans-membrane protein and a marker of tubular damage, and severity of scar formation while urinary excretion of Beta 2-microglobin has been tested as a urinary marker of tubular damage and scar formation in VUR patients (25, 26). In addition, MCP-1 and macrophage colony stimulating factor (M-CSF) facilitate the homing of inflammatory cells to areas of tubular damage (27).…”

Section: Discussionmentioning

confidence: 99%

Urinary excretion of EGF and MCP-1 in children with vesico-ureteral reflux

Pastore

Bartoli

2017

Int. braz j urol.

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Purpose The aim of this study was to investigate the urinary concentration of epidermal growth factor (EGF) and monocyte chemotactic protein-1 (MCP-1) as reflux nephropathy (RN) biomarkers before and after endoscopic treatment of moderate to severe vesico-ureteral reflux (VUR).Materials and methods A prospective study was carried out on 72 children with moderate to severe VUR. All patients underwent endoscopic treatment using Macroplastique® or Deflux®. Vesico-ureteral reflux resolution was tested by post-operative voiding cystourethrography after 3 months and 2 years. Follow-up urinary samples were collected at that time. Control samples were taken from healthy children with no clinical evidence of renal and bladder disease and no history of UTI.Results In VUR patients, pre-operative urinary EGF levels had a down-regulation when compared to controls. Following successful VUR repair, urinary EGF levels of VUR children progressively increased only at long term follow-up but without returning to normal levels. Urinary MCP-1 levels were highly expressed in pre-operative samples and decreased markedly during early post-operative measurements. Urinary MCP-1 levels did not further decreased in late post-operative follow-up. In fact, these levels remained significantly higher when compared to controls.Conclusions Urinary levels of EGF and MCP-1 may become useful markers for monitoring the response to surgical treatment in VUR patients. Although endoscopic VUR treatment is effective in reducing the inflammatory response, the persistence of significant abnormal levels of inflammatory cytokines (such as urinary MCP-1) at long term follow-up suggests that surgery alone may not completely treat the chronic renal inflammation evidenced in these children.

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Section: Discussionmentioning

confidence: 99%

Urinary excretion of EGF and MCP-1 in children with vesico-ureteral reflux

Pastore

Bartoli

2017

Int. braz j urol.

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“…Unfortunately, there was no information what was the stage of CKD in the studied population. 47 In contrast, Parmakisiz et al 44 and Novan et al 48 did not confirm the usefulness of KIM-1 urine concentration measurements in predicting the formation of post-inflammatory renal scars in children with VUR. However, as far as we know, no studies were assessing the level of KIM-1 in the group of patients only with glomerular hyperfiltration.…”

Section: Discussionmentioning

confidence: 93%

“…Lee et al 45 demonstrated that the levels of NGAL and KIM-1 in the serum of patients with urinary tract infections are the predictors of future development of renal scarring. Toker et al 47 reported increased KIM-1 serum concentration in the group of children with the post-inflammatory scars visible in the renal scintigraphy images of renal parenchyma and caused by the high-grade vesicoureteral reflux (VUR). Unfortunately, there was no information what was the stage of CKD in the studied population.…”

Section: Discussionmentioning

confidence: 99%

The Assessment of the Usefulness of Selected Markers in the Diagnosis of Chronic Kidney Disease in Children

et al. 2021

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Introduction: The kidney deterioration, which starts in childhood often leads to end-stage renal failure in the future. Therefore, searching for an early, sensitive, and specific biomarkers became a paramount for chronic kidney disease diagnosis. The aim of this study was the assessment of markers: KIM-1, FGF-23, NAG, NGAL, and uromodulin for diagnosis of preclinical phase of the disease in children. Patients and methods: 59 children (15 boys, 44 girls from 6 months to 17 years old) with kidney disorders, which had clinical indications for renoscintigraphy, were included in the study. All patients were divided depending on the result of renoscintigraphy (renal scarring vs normal kidney picture) and depending on the level of estimated glomerular filtration rate (glomerular hyperfiltration vs normal filtration rate). The concentration of uromoduline, KIM-1, FGF-23, NAG, and NGAL in serum and of NGAL and uromoduline in urine were measured in all studied groups. Results: The children with glomerular hyperfiltration had a statistically significantly higher serum values of FGF-23 and NGAL than the children with normal filtration rate ( P < .05). There were no statistically significant differences in serum concentrations of tested markers in children with renal scars in comparison to children with normal renal image. There was no statistically significant difference in the concentration of tested markers in urine. Conclusions: The study confirmed the possible usefulness of FGF-23 and NGAL in detecting the preclinical-stage of renal disease associated with glomerular hyperfiltration in children. The study do not allow to indicate markers, which could be useful in the early diagnosis of kidney damage visible in the scintigraphic examination.

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“…Similarly, Ataei et al [ 36 ] reported a significant correlation between renal parenchyma changes and increased SCr, but Amaral et al [ 37 ] did not report any. This discrepancy may be due to the unbalanced alterations in muscle mass and tubular secretion and their effects on the SCr levels [ 38 ]. Breinbjerg et al [ 39 ] also found that even non- E. coli infections can lead to an elevated SCr in children after their first ANP.…”

Section: Discussionmentioning

confidence: 99%

Demographic, clinical, and laboratory factors associated with renal parenchymal injury in Iranian children with acute pyelonephritis

et al. 2021

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Background The association between renal parenchyma changes on dimercaptosuccinic acid (DMSA) scans and demographic, clinical, and laboratory markers was assessed in pediatric patients with acute pyelonephritis. Methods A retrospective study of 67 Iranian babies and children aged 1-month to 12-year with APN was conducted between 2012 and 2018. The presence of renal parenchymal involvement (RPI) during APN was determined using technetium-99m DMSA during the first 2 weeks of hospitalization. The association of DMSA results with demographic data, clinical features (hospitalization stay, fever temperature and duration), and laboratory parameters such as pathogen type, and hematological factors (ESR, CRP, BUN, Cr, Hb, and WBC) was evaluated. Results 92.5% of children with an average age of 43.76 ± 5.2 months were girls. Twenty-four children (35.8%) did not have renal parenchymal injury (RPI), while 26 (38.8%) and 17 (25.4%) patients showed RPI in one and both kidneys, respectively. There was no significant association between RPI and mean ESR, CRP, BUN, and WBC. However, there were significant associations between RPI and higher mean levels of Cr, Hb, and BMI. Conclusions Low BMI and Hb levels and increased Cr levels might be indicative of the presence of RPI in children with APN.

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Is Urinary Kidney Injury Molecule-1 a Noninvasive Marker for Renal Scarring in Children With Vesicoureteral Reflux?

Cited by 17 publications

References 28 publications

Urinary excretion of EGF and MCP-1 in children with vesico-ureteral reflux

Urinary excretion of EGF and MCP-1 in children with vesico-ureteral reflux

The Assessment of the Usefulness of Selected Markers in the Diagnosis of Chronic Kidney Disease in Children

Demographic, clinical, and laboratory factors associated with renal parenchymal injury in Iranian children with acute pyelonephritis

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