Evaluation of Serum and Urinary Neutrophil Gelatinase - Associated Lipocalin in Pediatric Patients with Chronic Nephrotic Syndrome

Background: Chronic kidney disease (CKI)) has recently assumed epidemic proportions, becoming a troubling emerging cause of morbidity, especially if it progresses to end stage renal disease (І:SRD). Objectives: This study aimed at evaluating whether neutrophil gelatіnase-associated lipocalin (NGAI.), a novel specific biomarker of acute kidney injury, could predict the progression of СКI in children with chronic nephrotic syndrome.
Subjects and Methods: Scrum NGAI. (sNGAI.) and urinary (uNGAI.) levels were evaluated in a study of 30 children affected by chronic nephrotic syndrome (NS). Their mean age was 8.7 t. 2.9 years. They were subdivided into two subgroups according to response to steroids therapy: 18 children with steroid dependent nephrotic syndrome (SINS) and 12 children with steroid sensitive nephrotic syndrome (SSNS). All patients were compared with control group of 15 age and sex matched healthy children.
Results: Both serum and urinary NGAI, showed significantly higher concentration in NS group vs. the control group (p - 0.001 and 0.024 respectively). sNGAI. was sigiiit'icantly higher in both SINS and SSNS groups versus the control group and SINS group versus SSNS group (p 0.001. 0.001 and 0.027 respectively). uNGAL was significantly higher in SINS group versus the control group while between SSNS group and control group. SINS group and SSNS group uNGAI. showed higher concentration but it didnt reach statistical signilicance (p . 0;.009, 0.055 and 0.637 respectively). There were also higher concentrations versus the
control group of both sNGAI, and uNGAI, in proteinuric (p 0.001 and 0.011). and non- proteinuric (p -- 0.001 and 0.023) groups while there was no significant difference as regards sNGAI. and uNGAI. (p = 0.143 and 0.407 respectively) between proteinuric versus non-proteinuric groups. We round that sNGAL showed a significant positive correlation with serum creatinine in SINS group (p - 0.017). The estimated glomerular filtration rate (eGFR) showed an inverse correlation with sNGAI. in NS patients and with sNGAI. and UNCIAL in SANS group but yet, it didn't reach statistical significance (p 0.41 7, 0.062 and 0.996 respectively).
Conclusion: NGAI. closely reflects the degree of renal impairment and represents a strong and independent risk marker for progression of СKl.