The Korean journal of internal medicine

  • 제30권3호
  • /
  • Pages.354-361
  • /
  • 2015
  • /
  • 1226-3303(pISSN)
  • /
  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지
DOI QR코드

DOI QR Code

High serum and urine neutrophil gelatinase-associated lipocalin levels are independent predictors of renal progression in patients with immunoglobulin A nephropathy

  • Rhee, Harin (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Shin, Nari (Biomedical Research Institute, Pusan National University Hospital) ;
  • Shin, Min Ji (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Yang, Byung Yun (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Kim, Il Young (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Song, Sang Heon (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Lee, Dong Won (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Lee, Soo Bong (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Kwak, Ihm Soo (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Seong, Eun Young (Department of Internal Medicine, Pusan National University School of Medicine)
  • 투고 : 2014.08.11
  • 심사 : 2014.09.05
  • 발행 : 2015.05.01
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: Tubulointerstitial injury plays an important role in the progression of immunoglobulin A nephropathy (IgAN), and neutrophil gelatinase-associated lipocalin (NGAL) is among the most sensitive tubular biomarkers. We investigated whether serum or urine NGAL predicts prognosis in patients with IgAN. Methods: The present study enrolled patients with biopsy-proven IgAN from January 2005 to December 2010, whose serum and urine samples at the time of kidney biopsy were preserved by freezing. We retrospectively reviewed patient clinical data and followed patients until October 2012. Serum and urine NGAL levels were measured using an enzyme-linked immunosorbent assay kit. Renal progression was defined as an estimated glomerular filtration rate decline by > 50% or progression to end-stage renal disease. Results: There were 121 patients enrolled in this study. During the median follow-up period of 41.49 months, renal progression was found in nine patients (7.4%). Serum or urine NGAL alone could not predict renal progression; however, when serum and urine NGAL levels were combined, belonging to the high NGAL group independently predicted renal progression (hazard ratio [HR], 5.56; 95% confidence interval [CI], 1.42 to 21.73; p = 0.014), along with tubular damage graded according to the Oxford classification as $T_2$ (HR, 8.79; 95% CI, 2.01 to 38.51; p = 0.004). In addition, a Kaplan-Meier curve of renal survival showed significantly higher renal progression in patients in the high NGAL group (log rank, p = 0.004). Conclusions: In patients with IgAN, high serum and urine NGAL levels at the time of kidney biopsy predict renal progression.

키워드

과제정보

연구 과제 주관 기관 : Pusan National University Hospital

참고문헌

  1. Moranne O, Watier L, Rossert J, Stengel B; GN-Progress Study Group. Primary glomerulonephritis: an update on renal survival and determinants of progression. QJM 2008;101:215-224. https://doi.org/10.1093/qjmed/hcm142
  2. Chapter 10: immunoglobulin A nephropathy. Kidney Int Suppl (2011) 2012;2:209-217. https://doi.org/10.1038/kisup.2012.23
  3. Donadio JV, Bergstralh EJ, Grande JP, Rademcher DM. Proteinuria patterns and their association with subsequent end-stage renal disease in IgA nephropathy. Nephrol Dial Transplant 2002;17:1197-1203. https://doi.org/10.1093/ndt/17.7.1197
  4. Goto M, Wakai K, Kawamura T, Ando M, Endoh M, Tomino Y. A scoring system to predict renal outcome in IgA nephropathy: a nationwide 10-year prospective cohort study. Nephrol Dial Transplant 2009;24:3068-3074. https://doi.org/10.1093/ndt/gfp273
  5. Working Group of the International IgA Nephropathy Network and the Renal Pathology Society, Roberts IS, Cook HT, et al. The Oxford classification of IgA nephropathy: pathology definitions, correlations, and reproducibility. Kidney Int 2009;76:546-556. https://doi.org/10.1038/ki.2009.168
  6. Shi B, Ni Z, Cao L, et al. Serum IL-18 is closely associated with renal tubulointerstitial injury and predicts renal prognosis in IgA nephropathy. Mediators Inflamm 2012;2012:728417.
  7. Peters HP, Waanders F, Meijer E, et al. High urinary excretion of kidney injury molecule-1 is an independent predictor of end-stage renal disease in patients with IgA nephropathy. Nephrol Dial Transplant 2011;26:3581-3588. https://doi.org/10.1093/ndt/gfr135
  8. Ding H, He Y, Li K, et al. Urinary neutrophil gelatinase-associated lipocalin (NGAL) is an early biomarker for renal tubulointerstitial injury in IgA nephropathy. Clin Immunol 2007;123:227-234. https://doi.org/10.1016/j.clim.2007.01.010
  9. Mishra J, Mori K, Ma Q, et al. Amelioration of ischemic acute renal injury by neutrophil gelatinase-associated lipocalin. J Am Soc Nephrol 2004;15:3073-3082. https://doi.org/10.1097/01.ASN.0000145013.44578.45
  10. Devarajan P. Review: neutrophil gelatinase-associated lipocalin: a troponin-like biomarker for human acute kidney injury. Nephrology 2010;15:419-428. https://doi.org/10.1111/j.1440-1797.2010.01317.x
  11. Schmidt-Ott KM, Mori K, Li JY, et al. Dual action of neutrophil gelatinase-associated lipocalin. J Am Soc Nephrol 2007;18:407-413. https://doi.org/10.1681/ASN.2006080882
  12. Matsushita K, Tonelli M, Lloyd A, et al. Clinical risk implications of the CKD Epidemiology Collaboration (CKDEPI) equation compared with the Modification of Diet in Renal Disease (MDRD) Study equation for estimated GFR. Am J Kidney Dis 2012;60:241-249. https://doi.org/10.1053/j.ajkd.2012.03.016
  13. Supavekin S, Zhang W, Kucherlapati R, Kaskel FJ, Moore LC, Devarajan P. Differential gene expression following early renal ischemia/reperfusion. Kidney Int 2003;63:1714-1724. https://doi.org/10.1046/j.1523-1755.2003.00928.x
  14. Yuen PS, Jo SK, Holly MK, Hu X, Star RA. Ischemic and nephrotoxic acute renal failure are distinguished by their broad transcriptomic responses. Physiol Genomics 2006;25:375-386. https://doi.org/10.1152/physiolgenomics.00223.2005
  15. Mishra J, Dent C, Tarabishi R, et al. Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for acute renal injury after cardiac surgery. Lancet 2005;365:1231-1238. https://doi.org/10.1016/S0140-6736(05)74811-X
  16. Wagener G, Jan M, Kim M, et al. Association between increases in urinary neutrophil gelatinase-associated lipocalin and acute renal dysfunction after adult cardiac surgery. Anesthesiology 2006;105:485-491. https://doi.org/10.1097/00000542-200609000-00011
  17. Ling W, Zhaohui N, Ben H, et al. Urinary IL-18 and NGAL as early predictive biomarkers in contrast-induced nephropathy after coronary angiography. Nephron Clin Pract 2008;108:c176-c181. https://doi.org/10.1159/000117814
  18. Bachorzewska-Gajewska H, Malyszko J, Sitniewska E, Malyszko JS, Dobrzycki S. Neutrophil-gelatinase-associated lipocalin and renal function after percutaneous coronary interventions. Am J Nephrol 2006;26:287-292. https://doi.org/10.1159/000093961
  19. Hall IE, Yarlagadda SG, Coca SG, et al. IL-18 and urinary NGAL predict dialysis and graft recovery after kidney transplantation. J Am Soc Nephrol 2010;21:189-197. https://doi.org/10.1681/ASN.2009030264
  20. Parikh CR, Jani A, Mishra J, et al. Urine NGAL and IL-18 are predictive biomarkers for delayed graft function following kidney transplantation. Am J Transplant 2006;6:1639-1645. https://doi.org/10.1111/j.1600-6143.2006.01352.x
  21. Bolignano D, Lacquaniti A, Coppolino G, et al. Neutrophil gelatinase-associated lipocalin (NGAL) and progression of chronic kidney disease. Clin J Am Soc Nephrol 2009;4:337-344. https://doi.org/10.2215/CJN.03530708
  22. Mori K, Nakao K. Neutrophil gelatinase-associated lipocalin as the real-time indicator of active kidney damage. Kidney Int 2007;71:967-970. https://doi.org/10.1038/sj.ki.5002165
  23. Aghel A, Shrestha K, Mullens W, Borowski A, Tang WH. Serum neutrophil gelatinase-associated lipocalin (NGAL) in predicting worsening renal function in acute decompensated heart failure. J Card Fail 2010;16:49-54. https://doi.org/10.1016/j.cardfail.2009.07.003
  24. Bolignano D, Lacquaniti A, Coppolino G, Campo S, Arena A, Buemi M. Neutrophil gelatinase-associated lipocalin reflects the severity of renal impairment in subjects affected by chronic kidney disease. Kidney Blood Press Res 2008;31:255-258. https://doi.org/10.1159/000143726
  25. Poniatowski B, Malyszko J, Bachorzewska-Gajewska H, Malyszko JS, Dobrzycki S. Serum neutrophil gelatinase-associated lipocalin as a marker of renal function in patients with chronic heart failure and coronary artery disease. Kidney Blood Press Res 2009;32:77-80. https://doi.org/10.1159/000208989
  26. Geddes CC, Rauta V, Gronhagen-Riska C, et al. A tricontinental view of IgA nephropathy. Nephrol Dial Transplant 2003;18:1541-1548. https://doi.org/10.1093/ndt/gfg207
  27. Fellin G, Gentile MG, Duca G, D'Amico G. Renal function in IgA nephropathy with established renal failure. Nephrol Dial Transplant 1988;3:17-23.

피인용 문헌

  1. Neutrophil gelatinase-associated lipocalin as a predictor of adverse renal outcomes in immunoglobulin A nephropathy vol.30, pp.3, 2015, https://doi.org/10.3904/kjim.2015.30.3.305
  2. Novel biomarkers for early diagnosis of acute kidney injury after cardiac surgery in adults vol.13, pp.1, 2015, https://doi.org/10.5114/kitp.2016.58962
  3. Plasma endocan level and prognosis of immunoglobulin A nephropathy vol.35, pp.3, 2015, https://doi.org/10.1016/j.krcp.2016.07.001
  4. NGAL - Urinary Biomarker With Pathologic Significance in Nephrology Practice vol.16, pp.2, 2015, https://doi.org/10.2478/inmed-2019-0056
  5. Monitoring Immune Responses in IgA Nephropathy: Biomarkers to Guide Management vol.11, pp.None, 2015, https://doi.org/10.3389/fimmu.2020.572754
  6. Diagnostic value of urinary biomarkers excretion in estimation of morphological lesions in patients with primary glomerulopathies vol.93, pp.6, 2015, https://doi.org/10.26442/00403660.2021.06.200850