Urinary biomarkers of latent inflammation and fibrosis in children with vesicoureteral reflux

Морозова, О.Л.; Morozov, D.A.; Pervouchine, Dmitri D.; Einav, Yulia; Lakomova, D Y; Захарова, Н Б; Severgina, L O; Maltseva, Larisa D.; Budnik, Ivan

doi:10.1007/s11255-019-02357-1

Cited by 11 publications

(6 citation statements)

References 26 publications

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“…Other studies suggest that MCP1, TGFβ1, and VEGF may be useful in the diagnosis and monitoring of renal parenchymal fibrosis in patients with VUR. One more noninvasive marker in the diagnosis and prediction of renal scarring in children with VUR seems to be urinary NGAL [ 50 , 97 , 98 ].…”

Section: Discussionmentioning

confidence: 99%

Vesicoureteral Reflux and Innate Immune System: Physiology, Physiopathology, and Clinical Aspects

Colceriu

Aldea

Răchișan

et al. 2023

JCM

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Vesicoureteral reflux represents one of the most concerning topics in pediatric nephrology due to its frequency, clinical expression with the potential to evolve into chronic kidney disease, and last but not least, its socio-economic implications. The presence of vesicoureteral reflux, the occurrence of urinary tract infections, and the development of reflux nephropathy, hypertension, chronic kidney disease, and finally, end-stage renal disease represent a progressive spectrum of a single physiopathological condition. For the proper management of these patients with the best clinical outcomes, and in an attempt to prevent the spread of uropathogens’ resistance to antibacterial therapy, we must better understand the physiopathology of urinary tract infections in patients with vesicoureteral reflux, and at the same time, we should acknowledge the implication and response of the innate immune system in this progressive pathological condition. The present paper focuses on theoretical aspects regarding the physiopathology of vesicoureteral reflux and the interconditionality between urinary tract infections and the innate immune system. In addition, we detailed aspects regarding cytokines, interleukins, antimicrobial peptides, and proteins involved in the innate immune response as well as their implications in the physiopathology of reflux nephropathy. New directions of study should focus on using these innate immune system effectors as diagnostic and therapeutic tools in renal pathology.

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Section: Discussionmentioning

confidence: 99%

Vesicoureteral Reflux and Innate Immune System: Physiology, Physiopathology, and Clinical Aspects

Colceriu

Aldea

Răchișan

et al. 2023

JCM

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“…However, in addition to the role of urinary biomarkers (uNGAL and uKIM-1) in renal scar studied above, studies are there that have suggested role of urinary liver-type fatty acid binding protein,[ 3 ] urinary transforming growth factor β1, vascular endothelial growth factor, monocyte chemoattractant protein-1[ 19 ] and interleukin-8[ 20 ] as a reliable tool for early and noninvasive detection of renal injury, inflammation and fibrosis in VUR.…”

Section: Discussionmentioning

confidence: 99%

Utility of urinary biomarkers neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 as a marker for diagnosing the presence of renal scar in children with vesicoureteral reflux (VUR): A cross-sectional study

Naik

Jindal

Kumaravel

et al. 2022

J Indian Assoc Pediatr Surg

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Aim: To explore the possibility of using urinary biomarkers neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) to assess the presence of renal scars in children with Vesicoureteric Reflux (VUR). Materials and Methods: This cross-sectional study was conducted in 94 children aged 0–16 years diagnosed with VUR in the Department of Pediatric Surgery, JIPMER. Urinary biomarkers were measured using the enzyme-linked immunosorbent assay kits, normalized with urinary creatinine (Cr) and compared with severity of VUR (low grade [I and II] and high grade [III, IV, and V]), presence or absence of renal scar in VUR patients and severity of renal scar. Independent Student's t -test, Mann–Whitney U-test, and analysis of variance Kruskal–Wallis test were used for comparison, and receiver operating characteristic (ROC) curve analysis for predicting the accuracy of biomarkers in detecting the presence of renal scars. Results: The median urinary NGAL (uNGAL) value was higher in children with renal scar (1.49 ng/mL) than those without renal scar (0.58 ng/mL) and was statistically significant (<0.001). Whereas median uNGAL/Cr was higher in children with renal scar (0.07) than those without renal scar (0.03) but was not statistically significant ( P = 0.06). Urinary KIM-1 and urinary KIM-1/urinary Cr (uKIM-1/Cr) was not found to be a significant predictor of renal scar. The difference of uNGAL/Cr was comparable between the grades of renal scar but was not statistically significant. On ROC curve analysis, uNGAL had area under the ROC curve (AUC) of 0.769 with 71% of both specificity and sensitivity, whereas uNGAL/Cr was found to be a poor predictor of renal scar with AUC of 0.611, 60% sensitivity, and 61.2% specificity. Conclusion: uNGAL can serve as a noninvasive marker for diagnosing the presence of renal scar in children with VUR and a multicentric more extensive cohort study may be needed to strengthen or negate its role.

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“…VUR increases the risk of renal scarring by establishing a ground for UTI and pyelonephritis. If the necessary precautions are not taken and the condition is not treated in a timely manner, VUR causes reflux nephropathy and CRF develops in 25%-60% of these patients (15). The reflux of the infected urine back to the kidney does not always cause parenchymal damage and renal scar in VUR (16).…”

Section: Discussionmentioning

confidence: 99%

“…It has been shown that the inflammatory process is more influential than the direct damage caused by bacterial infection in renal scar development after pyelonephritis (17,18). It has been suggested that even if the infection is treated and VUR is corrected, the inflammatory process that has already started continues and therefore scar may develop (1,15). Partial benefits of the use of corticosteroids com-bined with antibiotic therapy have been observed in animal studies based on the hypothesis that the development of renal scarring can be reduced by preventing the inflammatory process (19).…”

Section: Discussionmentioning

confidence: 99%

Is there a relationship between renal scarring and neutrophil-to-lymphocyte ratio in patients with vesicoureteral reflux?

Demir

Yağmur

Pelit

et al. 2021

Arch Ital Urol Androl

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Objectives: Vesicoureteral reflux (VUR) exacerbates the risk of renal scarring by establishing a ground for pyelonephritis. It is known that the inflammatory process is more influential than the direct damage caused by bacterial infection in the development of renal scars after pyelonephritis. Therefore, the present study aims to investigate the relationship between renal scarring and systemic inflammatory markers in patients with VUR.Material and methods: Hundred and ninety-two patients (116 females, 76 males) diagnosed with VUR were divided into two groups based on the presence or absence of renal scarring and into three groups according to the grade of VUR (low, moderate and high). Neutrophil count, lymphocyte count, mean platelet volume (MPV) and neutrophil-to-lymphocyte ratio (NLR) were compared among the groups.Results: Of the 192 patients, 102 had renal scarring. The age and gender distribution did not differ significantly between the groups with and without renal scarring (p > 0.05). However, the grade of reflux and lymphocyte count were significantly higher in the group with renal scarring (p < 0.05), and the NLR was significantly lower in the group with renal scarring (p < 0.05). The lymphocyte count was significantly higher (p < 0.05) and NLR was significantly lower in the high-grade VUR group (p < 0.05). However, MPV values did not differ significantly (p > 0.05) between the groups. Conclusions: NLR can be used to predict renal scarring in patients with VUR, especially in the period of 3-6 months after the first attack of infection, and may even serve as a candidate marker for treatment selection. However, larger series and prospective studies are needed.

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Urinary biomarkers of latent inflammation and fibrosis in children with vesicoureteral reflux

Cited by 11 publications

References 26 publications

Vesicoureteral Reflux and Innate Immune System: Physiology, Physiopathology, and Clinical Aspects

Vesicoureteral Reflux and Innate Immune System: Physiology, Physiopathology, and Clinical Aspects

Utility of urinary biomarkers neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 as a marker for diagnosing the presence of renal scar in children with vesicoureteral reflux (VUR): A cross-sectional study

Is there a relationship between renal scarring and neutrophil-to-lymphocyte ratio in patients with vesicoureteral reflux?

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