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Urinary liver-type fatty acid-binding protein in pediatric nephrotic syndrome and tubular dysfunction
Masashi Nishida1, Hidekazu Kawakatsu2, Kenji Hamaoka3
1Department of Pediatrics, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan.
Background:
Urinary liver-type fatty acid-binding protein (uL-FABP) has recently been identified as a biomarker for kidney injury. uL-FABP excretion in pediatric relapsing nephrotic syndrome and tubular dysfunction, however, has not been reported previously.
Methods:
We measured uL-FABP level in children with steroid-sensitive nephrotic syndrome (SSNS), in those with tubular dysfunction, and in control subjects.
Results:
uL-FABP was markedly increased in relapsing SSNS (median, 30.3 μg/gCr; range, 12.6-171.0 μg/gCr; n = 13), and also in the tubular dysfunction group (median, 164.8 μg/gCr; range, 41.6-834.5 μg/gCr; n = 7), compared with the control subjects (median, 3.0 μg/gCr; range, 1.1-13.9 μg/gCr; n = 21). uL-FABP level was significantly correlated with urinary protein excretion in the SSNS group, and in the total group. Additionally, in the SSNS group, elevated uL-FABP in the relapsing stage returned to a level similar to that in the control group on remission of NS. In the tubular dysfunction group, uL-FABP was significantly correlated with urinary β2-microglobulin.
Conclusion:
Urinary protein amount, and the ability of the proximal tubules to reabsorb low-molecular-weight proteins, should also be considered when evaluating the clinical significance of uL-FABP as a biomarker for kidney injury in children.
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