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The Role of Urinary NGAL in the Management of Primary Vesicoureteral Reflux in Children

Cristina Gavrilovici1, Cristian Petru Dusa1, Codruta Iliescu Halitchi1

  • 1Department of Pediatrics, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.

International Journal of Molecular Sciences
|May 13, 2023
PubMed

Insights

Urine neutrophil gelatinase-associated lipocalin (NGAL) shows promise as a non-invasive biomarker for predicting reflux nephropathy (RN) and chronic kidney disease (CKD) in children with primary vesicoureteral reflux (VUR). Further research is needed to clarify its correlation with VUR severity.

Area of Science:

  • Pediatric Nephrology
  • Biomarker Discovery
  • Urology

Background:

  • Vesicoureteral reflux (VUR) is a common congenital anomaly linked to urinary tract infections (UTIs) and potential kidney damage.
  • Reflux nephropathy (RN) affects up to 50% of children with VUR, necessitating accurate, non-invasive diagnostic tools.
  • Neutrophil gelatinase-associated lipocalin (NGAL) is a known biomarker for acute kidney injury, with limited investigation in pediatric VUR.

Purpose of the Study:

  • To review the predictive value of urine NGAL (uNGAL) for RN in children with primary VUR.
  • To assess uNGAL's ability to predict the progression of chronic kidney disease (CKD) in this population.
  • To evaluate uNGAL as a non-invasive biomarker for renal damage in pediatric VUR.

Main Methods:

  • Systematic review and analysis of original studies investigating uNGAL in children with primary VUR.
  • Evaluation of uNGAL levels in relation to the presence and severity of RN.
  • Assessment of uNGAL's correlation with the development and progression of CKD.

Main Results:

  • Available studies suggest uNGAL is an accurate and reliable biomarker for RN and its progression to CKD.
  • Some studies indicate a correlation between VUR severity and uNGAL levels, while others found no significant association.
  • The relationship between VUR severity and uNGAL is complex, influenced by factors like UTIs and patient characteristics.

Conclusions:

  • uNGAL holds potential as a valuable non-invasive biomarker for monitoring renal damage in pediatric VUR.
  • Further research is warranted to elucidate the complex relationship between uNGAL, VUR severity, and CKD progression.
  • uNGAL may aid in risk stratification and management of children with primary VUR.

Keywords:
NGALbiomarkerschildrenvesicoureteral reflux

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