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- 자료유형
- 학술저널
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- 2020.1
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Background: Neutrophil gelatinase-associated lipocalin (NGAL), a bacteriostatic agent, is known to inhibit erythropoiesis leading to anemia. We aimed to investigate the associations of NGAL, anemia, and renal scarring in children with febrile urinary tract infections (UTIs). Methods: We retrospectively reviewed the medical records of 261 children with febrile UTIs. The relationship between the presence of anemia and plasma NGAL levels was investigated. NGAL performance in comparison with serum C-reactive protein (CRP) at admission and after 72 hours of treatment was also evaluated for the prediction of renal scarring as well as acute pyelonephritis (APN) and vesicoureteral reflux (VUR). Results: Plasma NGAL levels were elevated in patients with anemia compared with those without anemia. Multiple linear regression analysis showed an inverse relationship between NGAL levels and erythrocyte counts (standard β = −0.397, P < 0.001). Increased NGAL, but not CRP, was independently associated with the presence of anemia (odds ratio [OR], 2.37; 95% confidence interval [CI], 1.07–5.27; P < 0.05). Receiver operating curve analyses showed good diagnostic profiles of pre- and post-treatment NGAL for identifying APN, VUR, and renal scarring (all P < 0.05). For detecting renal scars, the area under the curve of post-treatment NGAL (0.730; 95% CI, 0.591–0.843) was higher than that of post-treatment CRP (0.520; 95% CI, 0.395–0.643; P < 0.05). The presence of anemia and elevated NGAL at admission (> 150 ng/mL) were independent risk factors for renal scarring in children with febrile UTIs. With anemia, NGAL levels increased consecutively in children with febrile UTI without renal involvement, with APN without scar, and with APN with renal scarring. Conclusion: Increased plasma NGAL levels may be associated with the presence of anemia and renal scarring in children with febrile UTIs.
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참고문헌 (41)
참고문헌 신청
Kjeldsen L / 1993 / Isolation and primary structure of NGAL, a novel protein associated with human neutrophil gelatinase / J Biol Chem 268(14):10425~10432
Abella V / 2015 / The potential of lipocalin-2/NGAL as biomarker for inflammatory and metabolic diseases / Biomarkers 20(8):565~571
Clerico A / 2012 / Neutrophil gelatinase-associated lipocalin(NGAL)as biomarker of acute kidney injury : a review of the laboratory characteristics and clinical evidences / Clin Chem Lab Med 50(9):1505~1517
Bolignano D / 2009 / Neutrophil gelatinaseassociated lipocalin(NGAL)and progression of chronic kidney disease / Clin J Am Soc Nephrol 4(2):337~344
Flo TH / 2004 / Lipocalin 2 mediates an innate immune response to bacterial infection by sequestrating iron / Nature 432(7019):917~921
Abella V / 2015 / The potential of lipocalin-2/NGAL as biomarker for inflammatory and metabolic diseases / Biomarkers 20(8):565~571
Clerico A / 2012 / Neutrophil gelatinase-associated lipocalin(NGAL)as biomarker of acute kidney injury : a review of the laboratory characteristics and clinical evidences / Clin Chem Lab Med 50(9):1505~1517
Bolignano D / 2009 / Neutrophil gelatinaseassociated lipocalin(NGAL)and progression of chronic kidney disease / Clin J Am Soc Nephrol 4(2):337~344
Flo TH / 2004 / Lipocalin 2 mediates an innate immune response to bacterial infection by sequestrating iron / Nature 432(7019):917~921
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