Abstract
The lack of early biomarkers of renal damage in children with neurogenic bladder (NB) prompts us to investigate the role of promising proteins: neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1). This prospective analysis was conducted on 58 children with NB and 25 healthy children. We assessed urinary levels of NGAL and KIM-1 in both groups. Age, sex, anthropometric measurements, activity assessment, renal function, and urodynamics parameters were analyzed. The differences between the median uNGAL and uKIM-1 in the NB group compared to control were recorded. However, only uNGAL levels were statistically significantly higher. Statistically significant correlation was found between gender, recurrent urinary tract infections, bladder trabeculation, its compliance, activity assessment, and uNGAL. To conclude, elevated levels of uNGAL may be considered a biomarker of tubular injury in children with NB due to MMC in contrast to uKIM-1.
Highlights
Neurogenic bladder (NB) due to myelomeningocele (MMC), with an estimated prevalence of 1/700 live births, is a condition strongly associated with multiple disturbances which, untreated, can result in progressive renal damage
Several biomarkers related to inflammation and tubular injury have been identified as potent predictors of renal outcome, including neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1)
It is increasingly recognized that the inflammatory process and tubular injury have an important role in the pathogenesis and progression of chronic processes, and the severity of tubulointerstitial lesions has a significant impact on renal outcome in, e.g., diabetic nephropathy [7] or chronic kidney disease (CKD) [8,9,10,11,12]
Summary
Neurogenic bladder (NB) due to myelomeningocele (MMC), with an estimated prevalence of 1/700 live births, is a condition strongly associated with multiple disturbances which, untreated, can result in progressive renal damage. Several biomarkers related to inflammation and tubular injury have been identified as potent predictors of renal outcome, including neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1). Urinary NGAL (uNGAL) and urinary KIM-1 (uKIM-1) are rapidly released in response to tubular damage. They are very sensitive biomarkers of acute kidney injury (AKI) [4,5,6]. To the best of our knowledge, our study represents the first investigation of uNGAL and uKIM-1 in NB as potential markers in detecting tubular damage
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