Abstract
The aim of this study was to evaluate the galectin-3 (Gal-3) level in children with a congenital solitary functioning kidney (cSFK) and determine its association with common renal function parameters. The study consisted of 68 children (49 males) with cSFK. We demonstrated that children with cSFK had a lower level of galectin-3 than that of healthy subjects (p < 0.001). No significant differences in serum cystatin C (Cys C) levels between the cSFK children and the reference group were found. The subjects with cSFK and reduced estimated glomerular filtration rate (eGFR) had significantly higher levels of Gal-3 and Cys C compared to those with normal eGFR (p < 0.05). Children with eGFR <60 mL/min/1.73 m2 showed significant statistical differences between the values of area under ROC curve (AUC) for Gal-3 (AUC 0.91) and Cys C (AUC 0.96) compared to that for creatinine level (AUC 0.76). Similar analyses carried out among cSFK children with eGFR <90 mL/min/1.73 m2 revealed an AUC value of 0.69 for Gal-3, 0.74 for Cys C, and 0.64 for creatinine; however, no significant superiority was shown for any of them. The receiver operating characteristic (ROC) analyses for identifying the SFK children among all participants based on the serum levels of Gal-3 and Cys C did not show any diagnostic profile (AUCs for Gal-3 and Cys C were 0.22 and 0.59, respectively). A positive correlation between the Gal-3 and Cys C concentrations was found (r = 0.39, p = 0.001). We demonstrated for the first time that Gal-3 might play an important role in the subtle kidney damage in children with cSFK. However, further prospective studies are required to confirm the potential applicability of Gal-3 as an early biomarker for kidney injury and possible progression to CKD.
Highlights
A solitary functioning kidney (SFK) is a common abnormality in the spectrum of congenital anomalies of the kidney and urinary tract (CAKUT)
Higher levels of serum urea and uric acid were found in the congenital SFK (cSFK) children
Galectin-3 differed significantly between the groups, and its lower concentrations were observed in cSFK patients compared to healthy controls (302.8 vs. 475.9 pg/mL, p < 0.001) (Figure 1)
Summary
A solitary functioning kidney (SFK) is a common abnormality in the spectrum of congenital anomalies of the kidney and urinary tract (CAKUT). It may cause chronic kidney disease (CKD) in approximately 50% of cases [1,2]. Children diagnosed with congenital SFK (cSFK) are at higher risk of kidney diseases and hypertension later in life. In recent years, the influence of other factors in renal function decline in individuals with SFK has been emphasized [5,6]. Since the mechanisms that result in renal function decline in children born with SFK are only partly understood, there is a need for new biomarkers to distinguish those at higher risk
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