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Plasma Neutrophil Gelatinase-Associated Lipocalin as a Marker of Tubular Damage in Diabetic Nephropathy

Title
Plasma Neutrophil Gelatinase-Associated Lipocalin as a Marker of Tubular Damage in Diabetic Nephropathy
Authors
Kim, So YoungJeong, Tae-DongLee, WoochangChun, SailSunwoo, SungKim, Soon BaeMin, Won-Ki
Ewha Authors
정태동
SCOPUS Author ID
정태동scopus
Issue Date
2018
Journal Title
ANNALS OF LABORATORY MEDICINE
ISSN
2234-3806JCR Link2234-3814JCR Link
Citation
vol. 38, no. 6, pp. 524 - 529
Keywords
Neutrophil gelatinase-associated lipocalinDiabetic nephropathyHemodialysisTubular damage
Publisher
KOREAN SOC LABORATORY MEDICINE
Indexed
SCIE; SCOPUS; KCI WOS
Abstract
Background: An increase in neutrophil gelatinase-associated lipocalin (NGAL) indicates tubular injury. Diabetic nephropathy causes typical changes in the kidney, characterized by glomerulosclerosis and eventual tubular damage. We validated the usefulness of plasma NGAL (pNGAL) as a biomarker of tubular damage in patients with diabetic nephropathy. Methods: We included 376 patients with diabetes mellitus (260 patients with chronic renal insufficiency who had not received hemodialysis and 116 hemodialyzed due to diabetic nephropathy) and 24 healthy controls. Patients with chronic renal insufficiency were divided into three groups according to urinary albumin excretion (UAE) levels. pNGAL levels were measured using the Triage NGAL test (Alere, San Diego, CA, USA) and were compared between groups. We also examined whether pNGAL level was related to the degree of albuminuria and cystatin C-based glomerular filtration rate (GFR). Results: Mean pNGAL levels of the healthy controls, chronic renal insufficiency patients with diabetes mellitus, and hemodialyzed patients were 61.9 +/- 5.3 ng/mL, 93.4 +/- 71.8 ng/ mL, and 1,536.9 +/- 554.9 ng/mL, respectively. pNGAL level increased significantly in patients with severe albuminuria (P<0.001) and had a moderate correlation with the degree of albuminuria (r=0.467; P<0.001) and GFR (r=0.519; P<0.001). Multivariate regression analysis showed that the pNGAL level was associated with tubular damage independent of patient age, sex, and GFR. Conclusions: pNGAL level independently reflects the degree of tubular damage in patients with diabetic nephropathy. Measurement of pNGAL, combined with UAE, would enable simultaneous, highly reliable assessments of tubular damage for such patients.
DOI
10.3343/alm.2018.38.6.524
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의료원 > 의료원 > Journal papers
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