Are there any new reliable markers to detect renal injury in obese children?

Özlem Bostan Gayret,Mehmet Taşdemir,Meltem Erol,Hikmet Tekin Nacaroğlu,Oğuzhan Zengi,Özgül Yiğit

doi:10.1080/0886022x.2018.1489284

Özlem Bostan Gayret, Mehmet Taşdemir + Show 4 more

Open Access

https://doi.org/10.1080/0886022x.2018.1489284

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Abstract

Aim: The aim of this study was to examine the serum and urine levels of kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), osteopontin (OPN), matrix metalloproteinase-9 (MMP-9), and serum Cystatin-C to determine the renal effect of obesity in obese children.Methods: Seventy-two obese and 35 non-obese healthy children were included in this study. Blood pressure (BP) was evaluated with office measurement. Creatinine, cystatin C, lipids, fasting glucose, and insulin levels were measured, and homeostasis model assessment -insulin resistance (HOMA-IR) was calculated. The urine albumin/creatinine ratio was calculated. The serum and urine KIM-1, NGAL, OPN, and MMP-9 levels were measured.Results: Serum cystatin-C, triglyceride, and homeostasis model assessment-insulin resistance (HOMA-IR) index were found to be significantly higher in the obese group (p = .0001), and high-density lipoprotein (HDL) cholesterol was found to be significantly lower (p = .019) in the obese group. No significant differences were found in serum KIM-1, NGAL, OPN or MMP-9 levels between groups (p > .05). No significant differences were found in urine KIM-1 and MMP-9 levels (p > .05), Urine NGAL, and OPN levels were found significantly higher in obese groups (p < .05).Conclusions: According to our results, although serum KIM-1, NGAL, OPN, MMP-9, and urine MMP-9, urine KIM-1 do not appear to be ideal markers to evaluate renal injury in the early period of obesity, the serum levels of cystatin C and urine NGAL, urine OPN can be used as a good marker for assessing the renal effect of obesity which can lead end stage renal disease in pediatric population.

Highlights

IntroductionNew epidemiological data show that obesity is related to increased risk of renal injury in children [1]
This single center, observational, cross-sectional, controlled study included 107 children, 72 of these suffered from obesity. between 3 and 16 years of age who were admitted to our pediatric outpatient clinic between April and August 2015
Metabolic or endocrine disease and children receiving dietary supplementation were excluded from the study

Summary

Introduction

New epidemiological data show that obesity is related to increased risk of renal injury in children [1]. Recent trials showed that pediatric renal patients have significantly higher BMI z-scores than the normal population [2]. These results indicate that obesity is an independent risk factor for CKD in children. Obesity-related renal disease is asymptomatic and difficult to diagnose, so useful biomarkers are necessary to prevent serious renal conditions in obese children. Known kidney biomarkers, including serum creatinine (sCr) level, blood urea nitrogen (BUN) level, urine albumin/protein ratio, and volume excretion, do not change quickly during the presentation of acute conditions. Candidate biomarkers for kidney injury have been published previously and include cystatin C, kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and osteopontin (OPN) [3]. The serum cystatin C level may correlate more closely with the GFR than the serum creatinine concentration [6]

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