尿中性粒细胞明胶酶相关脂钙蛋白作为埃及儿童特发性肾病综合征的预后生物标志物

Mohamed Elaziz El-Gamasy, M. Abdelhafez, M. Barr, M. Mehrez, M. Nassar, Mohsen M Eldeeb, M. Abdelmageed
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引用次数: 1

摘要

背景和目的:区分类固醇敏感性肾病综合征(SSNS)和类固醇抵抗性肾病综合征(SRNS)对于避免后者的初始全剂量类固醇治疗是很重要的。中性粒细胞明胶酶相关脂钙蛋白(NGAL)是急性肾损伤(AKI)的生物标志物,甚至是慢性肾脏疾病(CKD)的生物标志物。目的是测定儿童特发性肾病综合征(INS)的尿NGAL水平作为INS的预后因素,它可以预测INS病程早期的类固醇抵抗。对象与方法:本研究以坦大大学附属医院儿科肾脏病科收治的90例INS患儿为研究对象。30名同年龄、同性别的健康儿童作为对照组。将受试者再分为3组:1组(SSNS)、2组(SRNS)和3组(对照组)。患者和对照组接受临床评估和实验室调查,包括24小时收集尿量和尿蛋白、全血细胞计数、血清胆固醇、血清白蛋白、血清尿素、血清肌酐和酶联免疫吸附法测定尿NGAL。结果:与SSNS或对照组相比,SRNS中uNGAL水平明显升高。各组间uNGAL水平差异无统计学意义。uNGAL预测SRNS的ROC曲线在曲线下面积0.9处临界值>315,敏感性86.7%,特异性93.3%。尿NGAL水平与患者年龄、病程、血清肌酐水平呈正相关。结论:尿NGAL可预测INS患儿的SRNS。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Urinary neutrophil gelatinase-associated lipocalin as prognostic biomarker for idiopathic nephrotic syndrome in Egyptian children
Background and Objectives: It is important to distinguish steroid sensitive nephrotic syndrome (SSNS) from steroid resistant nephrotic syndrome (SRNS) to avoid initial full dose steroid therapy in the latter. Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker of acute kidney injury (AKI) even on top of chronic kidney disease (CKD). The aim is to determine urinary NGAL level in children with idiopathic nephrotic syndrome (INS) as a prognostic factor for INS, it can predict steroid resistance early in the course of INS. Subjects and Methods: The present study was carried out on ninety children with INS who were admitted in Pediatric Nephrology Unit of Tanta University Hospital. Thirty healthy children of the same age and sex served as control group. The subjects were subdivided into three groups: Group 1 (SSNS), Group 2 (SRNS), and Group 3 (controls). Patients and controls were subjected to clinical evaluation, laboratory investigations which included 24 h urinary collection for urinary volume and protein, complete blood count, serum cholesterol, serum albumin, blood urea, serum creatinine, and urinary NGAL measurement by enzyme-linked immunosorbent assay. Results: There was a significant increase in uNGAL levels in SRNS when compared with SSNS or controls. There was no significant difference in uNGAL levels between Group 1 and Group 3. ROC curve of uNGAL to predict SRNS had cutoff value >315 at the area under the curve 0.9, sensitivity 86.7%, and specificity 93.3%. There was a significant positive correlation between urinary NGAL level and age of patients and disease duration and serum creatinine level. Conclusions: Urinary NGAL can predict SRNS in INS in children.
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