Youssef Doaa Mohammed, El-Shal Amal Abdelazeem
Department of Pediatrics, Zagazig University, Zagazig, Egypt.
Iran J Kidney Dis. 2012 Sep;6(5):355-60.
Neutrophil gelatinase-associated lipocalin (NGAL) is proposed as a marker of chronic kidney disease (CKD). This study was designed to find whether there is a correlation between urine NGAL and progression of kidney damage in children with focal segmental glomerulosclerosis (FSGS).
Data were collected at the initial diagnosis of FSGS and after 12 months of treatment based on the Mendoza protocol. Twelve children with FSGS and 15 healthy children were included. Urine NGAL was assessed at the initiation of the study in the two groups and after 1 year of receiving the treatment in the FSGS group.
Urine NGAL was elevated in the FSGS group (350.0 ± 67.2 ng/mL) as compared to that in the control group (9.3 ± 3.8 ng/mL; P < .001), and there was a significant decline after 1 year (180.0 ± 45.9 ng/mL) in the FSGS group (P < .001). There were significant inverse correlations between urine NGAL and estimated creatinine clearance in the FSGS patients both at diagnosis (r = -0.589, P = .03), and after 1 year (r = -0.76, P = .009). There was a significant correlation between urine NGAL and urinary protein excretion in FSGS patients at diagnosis (r = 0.628, P = .005).
Urine NGAL in children with FSGS can be used as a marker of progression of kidney damage as expressed in its positive correlation with both declining in glomerular filtration rate and the level of proteinuria even in those with remission.
中性粒细胞明胶酶相关脂质运载蛋白（NGAL）被认为是慢性肾脏病（CKD）的一个标志物。本研究旨在探究局灶节段性肾小球硬化症（FSGS）患儿尿NGAL与肾损伤进展之间是否存在相关性。
基于门多萨方案，在FSGS初诊时及治疗12个月后收集数据。纳入12例FSGS患儿和15例健康儿童。在研究开始时对两组进行尿NGAL评估，并在FSGS组接受治疗1年后再次评估。
与对照组（9.3±3.8 ng/mL；P<.001）相比，FSGS组尿NGAL升高（350.0±67.2 ng/mL），且FSGS组在1年后显著下降（180.0±45.9 ng/mL；P<.001）。在FSGS患者中，诊断时（r=-0.589，P=.03）及1年后（r=-0.76，P=.009）尿NGAL与估计肌酐清除率之间均存在显著负相关。FSGS患者诊断时尿NGAL与尿蛋白排泄之间存在显著正相关（r=0.628，P=.005）。
FSGS患儿的尿NGAL可作为肾损伤进展的标志物，因为它与肾小球滤过率下降及蛋白尿水平均呈正相关，即使在病情缓解的患儿中也是如此。
