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Urinary Biomarkers of Renal Injury KIM-1 and NGAL: Reference Intervals for Healthy Pediatric Population in Sri Lanka

P Mangala C S De Silva1, T D K S C Gunasekara1, S D Gunarathna1

  • 1Department of Zoology, Faculty of Science, University of Ruhuna, Matara 81000, Sri Lanka.

Children (Basel, Switzerland)
|August 27, 2021
PubMed

Insights

This study establishes crucial reference intervals for kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) in Sri Lankan children. These findings aid in early detection of renal damage, particularly in areas affected by chronic kidney disease of unexplained etiology (CKDu).

Area of Science:

  • Nephrology
  • Biomarker Discovery
  • Pediatric Research

Background:

  • Emerging renal biomarkers like KIM-1 and NGAL show promise for diagnosing kidney injury.
  • Limited global data exists on reference intervals for these biomarkers in pediatric populations.
  • Sri Lanka faces a high burden of chronic kidney disease of unexplained etiology (CKDu), particularly in children.

Purpose of the Study:

  • To determine reference intervals for urinary KIM-1 and NGAL in a pediatric population in Sri Lanka.
  • To provide essential data for early renal damage screening in at-risk communities.
  • To address the lack of pediatric reference data for emerging renal biomarkers.

Main Methods:

  • Urine samples were collected from 909 children (10-18 years) without prior renal disease in Sri Lanka's dry zone.
  • Urinary KIM-1 and NGAL concentrations were measured using ELISA and normalized to urinary creatinine.
  • Reference intervals were derived using quantile regression, stratified by age and gender.

Main Results:

  • Median reference intervals for urinary KIM-1 ranged from 0.081-0.426 ng/mg Cr (males) and 0.078-0.508 ng/mg Cr (females).
  • Median reference intervals for urinary NGAL ranged from 2.966-4.850 ng/mg Cr (males) and 2.085-3.496 ng/mg Cr (females).
  • Biomarker levels showed weak correlations with age, gender, ACR, and BMI.

Conclusions:

  • This study provides the first pediatric reference intervals for KIM-1 and NGAL in Sri Lanka.
  • These reference intervals are vital for facilitating early detection of renal damage.
  • The findings are particularly relevant for screening in rural communities affected by CKDu.

Keywords:
CKDuKIM-1NGALSri Lankachildrenkidney biomarkers

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