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. 2024 Dec 9;16(4):1099-1114.
doi: 10.3390/pediatric16040094.

Evaluating Neutrophil Gelatinase-Associated Lipocalin in Pediatric CKD: Correlations with Renal Function and Mineral Metabolism

Ruxandra Maria Steflea  1   2   3 , Emil Robert Stoicescu  4   5 , Oana Aburel  2   4 , Florin George Horhat  6 , Silviu Valentin Vlad  7 , Felix Bratosin  8 , Andreea-Mihaela Banta  3 , Gabriela Doros  1   2
Affiliations

Evaluating Neutrophil Gelatinase-Associated Lipocalin in Pediatric CKD: Correlations with Renal Function and Mineral Metabolism

Ruxandra Maria Steflea et al. Pediatr Rep. .

Abstract

Background: Pediatric chronic kidney disease (CKD) requires reliable biomarkers for early detection and monitoring. Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as a potential marker due to its responsiveness to renal impairment and involvement in mineral metabolism.

Objectives: To evaluate serum NGAL levels in pediatric CKD patients and explore correlations with estimated glomerular filtration rate (eGFR), ferritin, calcium-phosphorus (Ca*P) product, and total serum protein.

Methods: A cross-sectional study included 54 pediatric CKD patients and 29 healthy controls. Laboratory assessments encompassed serum NGAL, creatinine, ferritin, calcium, phosphorus, and total serum protein. eGFR was calculated using the Schwartz formula. Pearson correlation and linear regression analyses determined associations between NGAL and other parameters.

Results: NGAL levels were significantly higher in CKD patients compared to controls (median 453 ng/mL vs. 78 ng/mL, p < 0.001). A strong negative correlation existed between NGAL and eGFR (r = -0.81, p < 0.001). NGAL showed moderate positive correlations with ferritin (r = 0.56, p = 0.009) and CaP product (r = 0.57, p = 0.006) and a moderate negative correlation with total serum protein (r = -0.36, p = 0.225). Regression analysis confirmed NGAL as a significant predictor of eGFR, ferritin, and CaP product.

Conclusions: Elevated serum NGAL levels are associated with decreased renal function and alterations in mineral metabolism in pediatric CKD patients. NGAL may serve as a valuable biomarker for assessing disease progression and guiding clinical management in this population.

Keywords: children; pediatric disease; pediatric nephrology; pediatrics.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Chronic kidney disease staging according to eGFR and albuminuria.
Figure 2
Figure 2
Correlation analysis between eGFR and NGAL.
Figure 3
Figure 3
Correlation analysis between Ca-Phosphorus and NGAL.
Figure 4
Figure 4
Correlation analysis between total serum protein and NGAL.
Figure 5
Figure 5
Correlation analysis between ferritin and NGAL.
See this image and copyright information in PMC

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