Będzichowska Agata, Jobs Katarzyna, Kloc Małgorzata, Bujnowska Anna, Kalicki Bolesław
Department of Pediatrics, Pediatric Nephrology and Allergology, Military Institute of Medicine, Warsaw, Poland.
The Houston Methodist Research Institute, Houston, TX, USA.
Biomark Insights. 2021 Apr 20;16:11772719211011173. doi: 10.1177/11772719211011173. eCollection 2021.
The kidney deterioration, which starts in childhood often leads to end-stage renal failure in the future. Therefore, searching for an early, sensitive, and specific biomarkers became a paramount for chronic kidney disease diagnosis. The aim of this study was the assessment of markers: KIM-1, FGF-23, NAG, NGAL, and uromodulin for diagnosis of preclinical phase of the disease in children.
59 children (15 boys, 44 girls from 6 months to 17 years old) with kidney disorders, which had clinical indications for renoscintigraphy, were included in the study. All patients were divided depending on the result of renoscintigraphy (renal scarring vs normal kidney picture) and depending on the level of estimated glomerular filtration rate (glomerular hyperfiltration vs normal filtration rate). The concentration of uromoduline, KIM-1, FGF-23, NAG, and NGAL in serum and of NGAL and uromoduline in urine were measured in all studied groups.
The children with glomerular hyperfiltration had a statistically significantly higher serum values of FGF-23 and NGAL than the children with normal filtration rate ( < .05). There were no statistically significant differences in serum concentrations of tested markers in children with renal scars in comparison to children with normal renal image. There was no statistically significant difference in the concentration of tested markers in urine.
The study confirmed the possible usefulness of FGF-23 and NGAL in detecting the preclinical-stage of renal disease associated with glomerular hyperfiltration in children. The study do not allow to indicate markers, which could be useful in the early diagnosis of kidney damage visible in the scintigraphic examination.
始于儿童期的肾脏恶化往往会在未来导致终末期肾衰竭。因此，寻找早期、敏感且特异的生物标志物对于慢性肾脏病的诊断至关重要。本研究的目的是评估标志物：KIM-1、FGF-23、N-乙酰-β-D-氨基葡萄糖苷酶（NAG）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和尿调节蛋白，用于诊断儿童疾病的临床前期。
59名患有肾脏疾病且有肾闪烁显像临床指征的儿童（15名男孩，44名女孩，年龄从6个月至17岁）被纳入研究。所有患者根据肾闪烁显像结果（肾瘢痕形成与正常肾脏影像）以及根据估计肾小球滤过率水平（肾小球高滤过与正常滤过率）进行分组。在所有研究组中测量血清中尿调节蛋白、KIM-1、FGF-23、NAG和NGAL的浓度以及尿液中NGAL和尿调节蛋白的浓度。
肾小球高滤过的儿童血清中FGF-23和NGAL的值在统计学上显著高于滤过率正常的儿童（P＜0.05）。与肾脏影像正常的儿童相比，有肾瘢痕的儿童血清中检测标志物的浓度无统计学显著差异。尿液中检测标志物的浓度无统计学显著差异。
该研究证实了FGF-23和NGAL在检测儿童肾小球高滤过相关肾脏疾病临床前期的可能有用性。该研究未发现可用于早期诊断肾闪烁显像中可见肾脏损伤的标志物。
