Assessment of Urinary Level of Neutrophil Gelatinaseassociated Lipocalin (NAGL) in Children with Renal Scar Due to Vesicoureteral Reflux.

IF 0.8 4区医学 Q4 UROLOGY & NEPHROLOGY

Iranian journal of kidney diseases Pub Date : 2023-01-01

Alireza Eskandarifar, Rama Naghshizadian, Adnan Tari

{"title":"Assessment of Urinary Level of Neutrophil Gelatinaseassociated Lipocalin (NAGL) in Children with Renal Scar Due to Vesicoureteral Reflux.","authors":"Alireza Eskandarifar, Rama Naghshizadian, Adnan Tari","doi":"","DOIUrl":null,"url":null,"abstract":"Introduction: Renal scarring is a serious complications of urinary tract infection and vesicoureteral reflux (VUR). The dimercaptosuccinic acid (DMSA) scan is the gold standard method for diagnosing renal scars but is an expensive procedure that risks ionizing materials and is not available to everyone. Neutrophil gelatinase-associated lipocalin (NGAL) increases following inflammation, infection, and acute kidney injury in the urine. The aim of this study was to evaluate the urinary level of NGAL and determine its diagnostic value in renal scarring.Methods: Patients aged 3 to 60 months with pyelonephritis were included in this study. Voiding cystourethrography (VCUG) was performed in the presence of hydronephrosis on ultrasonography. Children with VUR underwent DMSA scans six months after successful treatment of pyelonephritis., Patients were divided into two groups based on the result of DMSA scan: those with and those without renal scars. Levels of urinary NGAL were measured in both groups.Results: Ninety-two children with VUR (grades 2 to 5) were studied, of whom 40 had renal scars and 52 did not. The urinary level of NGAL at the cutoff point of 284 ng/dL had 70% sensitivity and 100% specificity for the detection of renal scars and was higher in patients with renal scars. (P < .05).Conclusion: The urinary level of NGAL is considerably higher in children with renal scarring. It is not a good test for screening and early diagnosis due to its low sensitivity, although it can identify renal scars caused by VUR with high specificity. DOI: 10.52547/ijkd.6951.","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"1 1","pages":"14-19"},"PeriodicalIF":0.8000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Iranian journal of kidney diseases","FirstCategoryId":"3","ListUrlMain":"","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Renal scarring is a serious complications of urinary tract infection and vesicoureteral reflux (VUR). The dimercaptosuccinic acid (DMSA) scan is the gold standard method for diagnosing renal scars but is an expensive procedure that risks ionizing materials and is not available to everyone. Neutrophil gelatinase-associated lipocalin (NGAL) increases following inflammation, infection, and acute kidney injury in the urine. The aim of this study was to evaluate the urinary level of NGAL and determine its diagnostic value in renal scarring.

Methods: Patients aged 3 to 60 months with pyelonephritis were included in this study. Voiding cystourethrography (VCUG) was performed in the presence of hydronephrosis on ultrasonography. Children with VUR underwent DMSA scans six months after successful treatment of pyelonephritis., Patients were divided into two groups based on the result of DMSA scan: those with and those without renal scars. Levels of urinary NGAL were measured in both groups.

Results: Ninety-two children with VUR (grades 2 to 5) were studied, of whom 40 had renal scars and 52 did not. The urinary level of NGAL at the cutoff point of 284 ng/dL had 70% sensitivity and 100% specificity for the detection of renal scars and was higher in patients with renal scars. (P < .05).

Conclusion: The urinary level of NGAL is considerably higher in children with renal scarring. It is not a good test for screening and early diagnosis due to its low sensitivity, although it can identify renal scars caused by VUR with high specificity. DOI: 10.52547/ijkd.6951.

本刊更多论文

膀胱输尿管反流所致肾瘢痕患儿尿中性粒细胞明胶酶相关脂钙素(NAGL)水平的评估

导读:肾瘢痕形成是尿路感染和膀胱输尿管反流(VUR)的严重并发症。二巯基琥珀酸(DMSA)扫描是诊断肾疤痕的金标准方法，但这是一个昂贵的程序，有电离物质的风险，并不是每个人都可以使用。中性粒细胞明胶酶相关脂钙蛋白(NGAL)在炎症、感染和急性肾损伤后尿液中增加。本研究的目的是评估尿中NGAL的水平，并确定其在肾脏瘢痕形成中的诊断价值。方法:3 ~ 60月龄肾盂肾炎患者为研究对象。在有肾积水的情况下，行排尿膀胱尿道造影(VCUG)。肾盂肾炎患儿在成功治疗6个月后接受DMSA扫描。根据DMSA扫描结果将患者分为两组:有肾疤痕组和无肾疤痕组。两组均测量尿NGAL水平。结果:研究了92例VUR患儿(2 ~ 5级)，其中40例有肾瘢痕，52例无。尿中NGAL在284 ng/dL的临界值对检测肾疤痕的敏感性为70%，特异性为100%，且在肾疤痕患者中更高。(p < 0.05)。结论:肾瘢痕儿童尿中NGAL水平明显增高。虽然它能以较高的特异性识别VUR所致的肾疤痕，但由于其敏感性较低，并不是一种很好的筛查和早期诊断方法。DOI: 10.52547 / ijkd.6951。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Iranian journal of kidney diseases UROLOGY & NEPHROLOGY-

CiteScore

2.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The Iranian Journal of Kidney Diseases (IJKD), a peer-reviewed journal in English, is the official publication of the Iranian Society of Nephrology. The aim of the IJKD is the worldwide reflection of the knowledge produced by the scientists and clinicians in nephrology. Published quarterly, the IJKD provides a new platform for advancement of the field. The journal’s objective is to serve as a focal point for debates and exchange of knowledge and experience among researchers in a global context. Original papers, case reports, and invited reviews on all aspects of the kidney diseases, hypertension, dialysis, and transplantation will be covered by the IJKD. Research on the basic science, clinical practice, and socio-economics of renal health are all welcomed by the editors of the journal.