Serum intercellular adhesion molecule (ICAM-1), a marker of renal scarring in infants with vesico-ureteric reflux.

OBJECTIVE

To determine if serum intercellular adhesion molecule (ICAM-1) levels correlate with renal scarring in children with vesico-ureteric reflux (VUR).

PATIENTS AND METHODS

Serum ICAM-1 levels were measured in 81 children (29 boys and 52 girls, age range 2 months-13 years) with VUR using an enzyme-linked immunosorbent assay (ELISA) and compared with levels in a control group of 24 children (16 boys and eight girls, age range 2 days-13 years) with no urological abnormalities.

RESULTS

The mean serum ICAM-1 level in the control group was 202 +/- 79 ng/mL (mean +/- 1 SD) compared with 347 +/- 96 ng/mL in children with VUR (P < 0.001). Fifteen of 26 children under 2 years of age demonstrated renal scarring while 18 of 44 children older than 2 years exhibited renal scarring. The mean serum ICAM-1 level in patients who were < 2 years of age and had renal scarring was 408 +/- ng/mL, significantly higher than in those who had no renal scarring (296 +/- 68 ng/mL, P < 0.01). In contrast, there was no difference in serum ICAM-1 levels in patients > 2 years of age with or with no renal scarring (353 +/- 87 and 325 +/- 91 ng/mL, respectively).

CONCLUSION

Serum ICAM-1 levels are significantly higher in children with VUR and may represent a valuable marker of tubular damage in younger children with VUR.