Güneş Ali, Ece Aydın, Aktar Fesih, Tan İlhan, Söker Murat, Karabel Duran, Balık Hasan, Uluca Ünal, Şen Velat, Yolbaş İlyas
Department of Pediatrics, Medical School, Dicle University, Diyarbakır, Turkey.
Department of Pediatric Nephrology, Medical School, Dicle University, Diyarbakır, Turkey.
Med Sci Monit. 2015 Dec 24;21:4023-9. doi: 10.12659/msm.896794.
The aim of this study was to investigate the urine levels of human kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-β-D-glucosaminidase (NAG), and liver-type fatty acid-binding protein (L-FABP) in children with iron-deficiency anemia (IDA).
Thirty-five children with IDA and 32 matched healthy controls were recruited. We assessed complete blood count, serum iron, iron-binding capacity, ferritin, serum levels of urea, creatinine (Cr), sodium (Na), potassium (K), calcium (Ca), and glucose levels. Estimated glomerular filtration rate (eGFR) was calculated. Urinary NAG, NGAL, KIM-1, and L-FABP were measured and divided by urine creatinine for comparisons.
There were no significant differences in serum urea, Cr, or eGFR between the IDA group and the control group (p>0.05, for all). IDA patients had significantly higher urine NGAL/Cr, L-FABP/Cr, KIM-1/Cr, and NAG/Cr compared with the control group (p<0.05). There were significant negative correlations between hemoglobin, hematocrit, red blood cell count, and urine NGAL/Cr, NAG/Cr, L-FABP/Cr, KIM-1/Cr levels (p<0.05).
Higher urinary kidney injury molecule levels in IDA patients suggest a possible subclinical renal injury in pediatric IDA patients whose renal functions and serum electrolytes were normal.
本研究旨在调查缺铁性贫血(IDA)患儿尿中人肾损伤分子-1(KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)和肝型脂肪酸结合蛋白(L-FABP)的水平。
招募了35例IDA患儿和32例匹配的健康对照。我们评估了全血细胞计数、血清铁、铁结合能力、铁蛋白、血清尿素、肌酐(Cr)、钠(Na)、钾(K)、钙(Ca)和葡萄糖水平。计算估计肾小球滤过率(eGFR)。测量尿NAG、NGAL、KIM-1和L-FABP,并除以尿肌酐进行比较。
IDA组和对照组之间血清尿素、Cr或eGFR无显著差异(所有p>0.05)。与对照组相比,IDA患者的尿NGAL/Cr、L-FABP/Cr、KIM-1/Cr和NAG/Cr显著更高(p<0.05)。血红蛋白、血细胞比容、红细胞计数与尿NGAL/Cr、NAG/Cr、L-FABP/Cr、KIM-1/Cr水平之间存在显著负相关(p<0.05)。
IDA患者尿中肾损伤分子水平较高,提示肾功能和血清电解质正常的小儿IDA患者可能存在亚临床肾损伤。