Urinary neutrophil gelatinase-associated lipocalin might be an associated marker for anticipating scar formation in children with vesicoureteral reflux

Abstract

Introduction: Vesicoureteral reflux (VUR) is considered as the most common urogenital abnormality occurring in children. There is no reliable and routine clinical test that is non-invasive and rapid for recognizing the renal scars from VUR. Objectives: Urine neutrophil gelatinase-associated lipocalin (uNGAL) can be the best indicator for early diagnosis of scar formation in children with VUR. Patients and Methods: Children with primary VUR admitted to Hamadan’s Besat hospital from March to December 2020 were included in this cross-sectional study. A dimercaptosuccinic acid (DMSA) scan was employed to assess all subjects in order to diagnose scar formation at least 180 days after the last episode of urinary tract infection (UTI). Additionally, uNGAL and its ratio to urine creatinine (uCr) levels were measured. Results: During the study, all 63 cases (male/female, 13.50) with VUR were included for further evaluation. The mean age of the patients was 59.1 ± 34.7 months (range 2 to 132 months). Twelve subjects suffered from unilateral VUR, while bilateral VUR inflicted 51. According to the disease severity, nine patients had mild, 35 had moderate, and 19 had a severe form of VUR. No significant difference was observed between patients with (n = 31) and without (n = 32) renal scars regarding mean levels of the uNGAL and uNGAL/uCR ratios (P>0.05). Conclusion: We found no significant difference between the groups with and without the renal scar in terms of biomarker levels.

Role of Urinary Biomarkers (Transforming Growth Factor β1, Neutrophil Gelatinase-Associated Lipocalin, and Cystatin C) as a Prognostic Factor of Renal Outcome in the Posterior Urethral Valve

“…NGAL is known to originate in the collecting ducts. [ 32 ] This study compared the uNGAL excretion in PUV with that of the earlier studies on UPJO, ureterovesical junction obstruction (UVJO), LUTO, and ureteric calculi due to the common pathway of nephropathy due to obstructive HDN. [ 10 11 12 13 , 33 ] In the present study, the median uNGAL was found to be significantly raised in the case group during the preoperative period (17.78 ng/ml [1.54–34.75 ng/ml]) when compared to the control (1.31 ng/ml [0.21–8.55 ng/ml]) ( P = 0.02).…”

The Role of Urinary NGAL in the Management of Primary Vesicoureteral Reflux in Children

“…Vesicoureteral reflux (VUR) is the most frequent congenital renal malformation and is defined as a backward flow of urine from the bladder into the ureter [1]. It is considered the most important congenital risk factor for the development of urinary tract infections (UTIs) in the pediatric population [2,3]. Primary VUR is considered to be the most common type of congenital anomaly of the kidney and urinary tract (CAKUT) [2,4].…”

“…It is considered the most important congenital risk factor for the development of urinary tract infections (UTIs) in the pediatric population [2,3]. Primary VUR is considered to be the most common type of congenital anomaly of the kidney and urinary tract (CAKUT) [2,4]. It accounts for up to 44% of cases of CKD in children and is the main cause of end-stage renal disease in children younger than 5 years [5].…”

“…Half of children with VUR may develop RN. VUR is asymptomatic and is usually diagnosed during a urinary tract infection [1,2]. VUR is diagnosed in 40% of children presenting febrile UTIs and in 15-20% of children with a history of antenatal hydronephrosis [6].…”

“…Neutrophil gelatinase-associated lipocalin (NGAL) is included in the lipocalin family [13]. NGAL is secreted by the thick limb of the Henle loop and collecting renal ducts [2] and normally accumulates at low levels in different organs (such as the stomach, colon, trachea, kidneys, and lungs) in the healthy population. It increases to high levels in the kidney serum and urine after an ischemic or nephrotoxic injury [1,14].…”