Role of new biomarkers for predicting renal scarring in vesicoureteral reflux: NGAL, KIM-1, and L-FABP

Pediatr Nephrol. 2016 Jan;31(1):97-103. doi: 10.1007/s00467-015-3194-3. Epub 2015 Sep 1.

Abstract

Background: Reflux nephropathy is the most serious complication of vesicoureteral reflux (VUR). The aim of this study was to assess the role of urinary levels of neutrophil-gelatinase-associated lipocalin (NGAL),kidney injury molecule-1 (KIM-1), and liver-type fatty-acid-binding protein (L-FABP) in the early diagnosis of reflux nephropathy in patients with VUR.

Methods: This study assessed 123 patients with primary VUR and 30 healthy children as a control group. The children were divided into five groups: Group A, patients with VUR and renal parenchymal scarring (RPS); Group B, patients with VUR and without RPS; Group C, patients with RPS and resolved VUR; Group D, patients with resolved VUR and without RPS; Group E, healthy reference group.

Results: Median urinary NGAL (uNGAL)/Creatinine (Cr) was significantly higher in patients with than those without RPS and the control group (p = 0.0001). Median uKIM-1/Cr was similar in all groups (p = 0.417). Median uL-FABP/Cr was significantly higher in patients with RPS than in the reference group (p < 0.05).

Conclusions: Urinary NGAL levels may be used as a noninvasive diagnostic marker for predicting renal scarring in reflux nephropathy.

Keywords: Kidney injury molecule-1; Liver-type fatty-acid-binding protein; Neutrophil-gelatinase-associated lipocalin; Renal parenchymal scarring; Vesicoureteral reflux.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute-Phase Proteins / urine*
  • Adolescent
  • Area Under Curve
  • Biomarkers / urine
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Cicatrix / etiology*
  • Cicatrix / pathology
  • Creatinine / urine
  • Fatty Acid-Binding Proteins / urine*
  • Female
  • Hepatitis A Virus Cellular Receptor 1
  • Humans
  • Kidney Diseases / etiology*
  • Kidney Diseases / pathology
  • Lipocalin-2
  • Lipocalins / urine*
  • Male
  • Membrane Glycoproteins / urine*
  • Predictive Value of Tests
  • Prospective Studies
  • Proto-Oncogene Proteins / urine*
  • ROC Curve
  • Receptors, Virus
  • Risk Factors
  • Urinalysis
  • Vesico-Ureteral Reflux / complications
  • Vesico-Ureteral Reflux / diagnosis
  • Vesico-Ureteral Reflux / urine*

Substances

  • Acute-Phase Proteins
  • Biomarkers
  • FABP1 protein, human
  • Fatty Acid-Binding Proteins
  • HAVCR1 protein, human
  • Hepatitis A Virus Cellular Receptor 1
  • LCN2 protein, human
  • Lipocalin-2
  • Lipocalins
  • Membrane Glycoproteins
  • Proto-Oncogene Proteins
  • Receptors, Virus
  • Creatinine