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评估儿童慢性肾脏病中的中性粒细胞明胶酶相关脂质运载蛋白:与肾功能和矿物质代谢的相关性

Evaluating Neutrophil Gelatinase-Associated Lipocalin in Pediatric CKD: Correlations with Renal Function and Mineral Metabolism.

作者信息

Steflea Ruxandra Maria, Stoicescu Emil Robert, Aburel Oana, Horhat Florin George, Vlad Silviu Valentin, Bratosin Felix, Banta Andreea-Mihaela, Doros Gabriela

机构信息

Department of Pediatrics, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.

"Louis Turcanu" Emergency Hospital for Children, 300011 Timisoara, Romania.

出版信息

Pediatr Rep. 2024 Dec 9;16(4):1099-1114. doi: 10.3390/pediatric16040094.

Abstract

BACKGROUND

Pediatric chronic kidney disease (CKD) requires reliable biomarkers for early detection and monitoring. Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as a potential marker due to its responsiveness to renal impairment and involvement in mineral metabolism.

OBJECTIVES

To evaluate serum NGAL levels in pediatric CKD patients and explore correlations with estimated glomerular filtration rate (eGFR), ferritin, calcium-phosphorus (Ca*P) product, and total serum protein.

METHODS

A cross-sectional study included 54 pediatric CKD patients and 29 healthy controls. Laboratory assessments encompassed serum NGAL, creatinine, ferritin, calcium, phosphorus, and total serum protein. eGFR was calculated using the Schwartz formula. Pearson correlation and linear regression analyses determined associations between NGAL and other parameters.

RESULTS

NGAL levels were significantly higher in CKD patients compared to controls (median 453 ng/mL vs. 78 ng/mL, < 0.001). A strong negative correlation existed between NGAL and eGFR (r = -0.81, < 0.001). NGAL showed moderate positive correlations with ferritin (r = 0.56, = 0.009) and CaP product (r = 0.57, = 0.006) and a moderate negative correlation with total serum protein (r = -0.36, = 0.225). Regression analysis confirmed NGAL as a significant predictor of eGFR, ferritin, and CaP product.

CONCLUSIONS

Elevated serum NGAL levels are associated with decreased renal function and alterations in mineral metabolism in pediatric CKD patients. NGAL may serve as a valuable biomarker for assessing disease progression and guiding clinical management in this population.

摘要

背景

儿童慢性肾脏病(CKD)需要可靠的生物标志物用于早期检测和监测。中性粒细胞明胶酶相关脂质运载蛋白(NGAL)因其对肾功能损害的反应性以及参与矿物质代谢,已成为一种潜在标志物。

目的

评估儿童CKD患者的血清NGAL水平,并探讨其与估计肾小球滤过率(eGFR)、铁蛋白、钙磷(Ca*P)乘积和总血清蛋白的相关性。

方法

一项横断面研究纳入了54例儿童CKD患者和29例健康对照。实验室评估包括血清NGAL、肌酐、铁蛋白、钙、磷和总血清蛋白。使用Schwartz公式计算eGFR。Pearson相关性分析和线性回归分析确定NGAL与其他参数之间的关联。

结果

与对照组相比,CKD患者的NGAL水平显著更高(中位数453 ng/mL对78 ng/mL,<0.001)。NGAL与eGFR之间存在强负相关(r = -0.81,<0.001)。NGAL与铁蛋白(r = 0.56,= 0.009)和CaP乘积(r = 0.57,= 0.006)呈中度正相关,与总血清蛋白呈中度负相关(r = -0.36,= 0.225)。回归分析证实NGAL是eGFR、铁蛋白和CaP乘积的重要预测指标。

结论

儿童CKD患者血清NGAL水平升高与肾功能下降和矿物质代谢改变有关。NGAL可能是评估该人群疾病进展和指导临床管理的有价值生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11a5/11676301/7b6d0f33feda/pediatrrep-16-00094-g001.jpg

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