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Dr. Adrian Man
Association of serum and urinary neutrophil gelatinase-associated lipocalin (NGAL) levels with disease severity in patients with early-stage autosomal dominant polycystic kidney disease Gener Ismail, Raluca Bobeica, Simona Ioanitescu, Roxana Jurubita
Abstract: Introduction: Autosomal dominant polycystic kidney disease (ADPKD) is the most frequent inherited renal disease. Monitoring disease progression will become more and more important with the introduction of new therapeutic agents. The use of kidney and cyst volumetry as markers of disease progression in patients with early stage ADPKD seems rational and evidence-based, but assessing these parameters is time consuming and expensive. Previous studies suggest that neutrophil gelatinase-associated lipocalin (NGAL) is a high-quality renal biomarker of acute tubular injury, while its applicability in ADPKD is not certain.Methods: Serum and urinary NGAL levels were assessed in 30 patients with early-stage ADPKD (GFR ≥90 ml/ minute/ 1.73 m2 of body-surface area) and 30 healthy controls. Patients were further divided into two groups according to the cystic development assessed using magnetic resonance imaging: the group of patients with total kidney volume > 1500 cm3 (G1) and the group of patients with total kidney volume < 1500 cm3 (G2). Results: Serum and urinary NGAL levels were significantly higher in patients than in controls (sNGAL 159.5 ± 54.2 ng/ml vs. 53.1 ± 6.3 ng/ml, p < 0.05; uNGAL 113.5 ± 41.3 vs. 18.9 ± 5.9 ng/ml, p < 0.05) and these parameters were strongly correlated with the total renal volume (sNGAL/Total Renal Volume: r = 0.81, p < 0.0001; uNGAL/Total Renal Volume: r = 0.87, p < 0.0001).The median total renal volume was 2107.4 ± 442.7cm3 in the G1 group and 1121.9±253.9 cm3 in the G2 group. Subjects from the G1 group presented higher sNGAL and uNGAL levels compared to those from the other group (sNGAL: 181.5±55.6 vs. 137.5±44.3 ng/ml, p < 0.05; uNGAL: 137±33.1 vs. 89.9±35.3 ng/ml, p < 0.05). Conclusion: An accurate, non-invasive method for the regular assessment of disease progression in patients with early stage ADPKD would be very helpful in the management of these challenging patients. Our study suggests that serum and urinary NGAL levels might be useful as novel biomarkers in patients with ADPKD. Keywords: NGAL,ADPKD,cyst growth,cystogenesis |
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Ismail G, Bobeica R, Ioanitescu S, Jurubita R. Association of serum and urinary neutrophil gelatinase-associated lipocalin (NGAL) levels with disease severity in patients with early-stage autosomal dominant polycystic kidney disease. Rev Romana Med Lab. 2012;20(2):109-16
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