Skip to main content
SpringerLink
Log in

Urine Neutrophil Gelatinase Associated Lipocalin to Creatinine Ratio: A Novel Index for Steroid Response in Idiopathic Nephrotic Syndrome

  • Original Article
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objective

To find the value of urine neutrophil gelatinase associated lipocalin (NGAL) in differentiating steroid response in children with idiopathic nephrotic syndrome (INS).

Methods

A total of 52 children with INS (n = 27, steroid resistant; n = 25, steroid responsive) aged 1–16 y, along with 18 healthy control children were enrolled in this study. Urine NGAL as well as urine protein, and serum creatinine were analyzed during active phase of INS.

Results

Serum creatinine (P 0.032), and urine NGAL/Cr (P 0.001) were significantly higher in steroid resistant than steroid sensitive patients. The optimal cutoff value for urine NGAL/Cr with the highest sensitivity and specificity was 0.46 ng/mg and cut off value of 0.01 and 1.15 ng/mg had maximum sensitivity and specificity, respectively.

Conclusions

Urine NGAL/Cr could be considered as a marker of steroid resistance in children with idiopathic nephrotic syndrome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Nickavar A, Lahouti Harahdashti A. Is steroid response changing in children with idiopathic nephrotic syndrome. Iran J Kidney Dis. 2014;8:389–93.

    PubMed  Google Scholar 

  2. Wasilewska A, Zoch-Zwierz W, Taranta-Janusz K, Michaluk-Skutnik J. Neutrophil gelatinase-associated lipocalin: a new marker of cyclosporine nephrotoxicity? Pediatr Nephrol. 2010;25:889–97.

    Article  PubMed  Google Scholar 

  3. Noto A, Cibecchini F, Fanos V, Mussap M. NGAL and metabolomics: the single biomarker to reveal the metabolome alterations in kidney injury. Biomed Res Int. 2013;2013:612032.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  4. Wasilewska A, Taranta-Janusz K, Dębek W, Zoch-Zwierz W, Kuroczycka-Saniutycz E. KIM-1 and NGAL: new markers of obstructive nephropathy. Pediatr Nephrol. 2011;26:579–86.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Hirsch R, Dent C, Pfriem H, Allen J, Beekman RH 3rd, Ma Q, et al. NGAL is an early predictive biomarker of contrast-induced nephropathy in children. Pediatr Nephrol. 2007;22:2089–95.

    Article  PubMed  Google Scholar 

  6. Wheeler DS, Devarajan P, Ma Q, et al. Serum neutrophil gelatinase-associated lipocalin (NGAL) as a marker of acute kidney injury in critically ill children with septic shock. Crit Care Med. 2008;36:1297–303.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  7. Bolignano D, Lacquaniti A, Coppolino G, et al. Neutrophil gelatinase-associated lipocalin (NGAL) and progression of chronic kidney disease. Clin J Am Soc Nephrol. 2009;4:337–44.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  8. Bolignano D, Coppolino G, Aloisi C, Romeo A, Nicocia G, Buemi M. Effect of a single intravenous immunoglobulin infusion on neutrophil gelatinase-associated lipocalin levels in proteinuric patients with normal renal function. J Investig Med. 2008;56:997–1003.

    PubMed  CAS  Google Scholar 

  9. Nickolas TL, Forster CS, Sise ME, et al. NGAL (Lcn2) monomer is associated with tubulointerstitial damage in chronic kidney disease. Kidney Int. 2012;82:718–22.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  10. Kim JS, Bellew CA, Silverstein DM, Aviles DH, Boineau FG, Vehaskari VM. High incidence of initial and late steroid resistance in childhood nephrotic syndrome. Kidney Int. 2005;68:1275–81.

    Article  PubMed  CAS  Google Scholar 

  11. Bennett MR, Piyaphanee N, Czech K, Mitsnefes M, Devarajan P. NGAL distinguishes steroid sensitivity in idiopathic nephrotic syndrome. Pediatr Nephrol. 2012;27:807–12.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Xia H, He QN, Li XY, Shuai LJ, Chen HX, Yi ZW. Expression of urinary neutrophil gelatinase-associated lipocalin and its clinical significance in children with idiopathic nephrotic syndrome. Zhongguo Dang Dai Er Ke Za Zhi. 2013;15:541–5.

    PubMed  CAS  Google Scholar 

  13. Nishida M, Kawakatsu H, Okumura Y, Hamaoka K. Serum and urinary neutrophil gelatinase-associated lipocalin levels in children with chronic renal diseases. Pediatr Int. 2010;52:563–8.

    Article  PubMed  CAS  Google Scholar 

  14. Korzeniecka-Kozerska A, Wasilewska A, Tenderenda E, Sulik A, Cybulski K. Urinary MMP-9/NGAL ratio as a potential marker of FSGS in nephrotic children. Dis Markers. 2013;34:357–62.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  15. Wen Q, Huang LT, Luo N, Wang YT, Li XY, Mao HP. Proteomic profiling identifies haptoglobin as a potential serum biomarker for steroid-resistant nephrotic syndrome. Am J Nephrol. 2012;36:105–13.

    Article  PubMed  CAS  Google Scholar 

  16. Bazzi C, Rizza V, Casellato D, et al. Urinary IgG and α2-macroglobulin are powerful predictors of outcome and responsiveness to steroids and cyclophosphamide in idiopathic focal segmental glomerulosclerosis with nephrotic syndrome. Biomed Res Int. 2013;2013:941831.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Youssef DM, El-Shal AA. Urine neutrophil gelatinase-associated lipocalin and kidney injury in children with focal segmental glomerulosclerosis. Iran J Kidney Dis. 2012;6:355–60.

    PubMed  Google Scholar 

Download references

Conflict of Interest

None.

Source of Funding

This study was supported by “Children’s and Neonatal Health Center of Gorgan Medical University.

Author information

Authors and Affiliations

  1. Department of Pediatric Nephrology, Iran University Medical Sciences, Tehran, Iran

    Azar Nickavar

  2. Department of Pediatrics, Gorgan University Medical Sciences, Gorgan, Iran

    Baranak Safaeian

  3. Department of Pediatrics, Zahedan University Medical Sciences, Zahedan, Iran

    Simin Sadeghi-Bojd

  4. Department of Medicine, Iran University Medical Sciences, Tehran, Iran

    Arash Lahouti Harah dashti

Authors
  1. Azar Nickavar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Baranak Safaeian
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Simin Sadeghi-Bojd
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Arash Lahouti Harah dashti
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Baranak Safaeian.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nickavar, A., Safaeian, B., Sadeghi-Bojd, S. et al. Urine Neutrophil Gelatinase Associated Lipocalin to Creatinine Ratio: A Novel Index for Steroid Response in Idiopathic Nephrotic Syndrome. Indian J Pediatr 83, 18–21 (2016). https://doi.org/10.1007/s12098-015-1809-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-015-1809-0

Keywords

Search

Navigation