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Preoperative and postoperative urinary NGAL levels in children with bladder exstrophy

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Abstract

Background

Urinary NGAL (neutrophil gelatinase-associated lipocalin) levels have been shown to predict renal damage in various medical conditions. The present study was conducted to study the role of urinary NGAL levels in children with bladder exstrophy–epispadias complex post single-stage total reconstruction (SSTR) as markers of early renal function reduction.

Methods

Urine samples were collected from children with bladder exstrophy before SSTR (Group A, n = 11), 5 years post SSTR (Group B, n = 40) and controls (Group C, n = 41) and stored at − 20 °C. NGAL levels were estimated using double antibody sandwich ELISA.

Results

Mean NGAL levels in Groups A, B and C were 1.39, 34.24 and 2.58 ng/ml, respectively. Mean NGAL levels among Group B subjects with glomerular filtration rate (GFR) ≥ 80 ml/min/1.73 m2 body surface area (BSA) was 29.8 ng/ml, while it was 31.74 ng/ml in those with GFR < 80 ml/min. Urine samples were also evaluated 6 months post SSTR. Mean NGAL at 6 months was 6.76 ng/ml, while at 12 months it was 30.3 ng/ml, remaining > 30 ng/ml at 18 and 24 months. Dimercaptosuccinic acid (DMSA) scans did not show any scarring, and GFR on diethylenetriamine pentaacetate (DTPA) scans remained stable.

Conclusions

Increasing levels of urinary NGAL following bladder-exstrophy and epispadias complex repair suggest that NGAL detects the earliest signs of renal damage even before any deterioration is observed in DMSA and/or DTPA-GFR scans. Further studies with an adequate sample size and periodic measurement of NGAL need to be performed before any definitive conclusion can be drawn.

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Data availability

Data that support this study are available from the corresponding author upon reasonable request.

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Acknowledgments

The contribution of all patients who participated in the study is acknowledged. The funds received from the Indian Council of Medical Research were used to purchase the Urinary Neutrophil gelatinase-associated lipocalin ELISA kits for enzyme estimation.

Funding

This study was funded by the Indian Council of Medical Research (Grant number: I-632) as part of a research project.

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Authors and Affiliations

  1. Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India

    Alisha Gupta, Minu Bajpai, Sachit Anand & Abid Ali

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  1. Alisha Gupta
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  2. Minu Bajpai
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  3. Sachit Anand
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Corresponding author

Correspondence to Minu Bajpai.

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Conflict of interest

Author (Minu Bajpai) has received research grants from Indian Council of Medical Research (Grant number: I-632).

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All procedures performed in the study were in accordance with the ethical standards of the institutional ethics committee.

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Informed consent was obtained from the parents or guardians of all individual participants included in the study.

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Gupta, A., Bajpai, M., Anand, S. et al. Preoperative and postoperative urinary NGAL levels in children with bladder exstrophy. J Nephrol 36, 1409–1414 (2023). https://doi.org/10.1007/s40620-022-01548-x

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  • DOI: https://doi.org/10.1007/s40620-022-01548-x

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