Is galectin-3 a novel marker of reflux nephropathy in children?

Vesicoureteral reflux may lead to renal parenchymal scarring (RPS) by causing recurrent pyelonephritis. Galectin-3 (Gal-3) is considered to be a new marker for fibrosis, which plays a role in the pathogenesis of RPS. Serum Gal-3 levels in patients with RPS were examined in our study, and it was attempted to elucidate the role of serum Gal-3 levels in the diagnosis and pathophysiology of RPS.

The study included 154 patients with RPS between 4 and 18 years of age. Serum creatinine levels and estimated glomerular filtration rates of all patients were normal. Patients were divided into three groups according to findings on dimercaptosuccinic acid scintigraphy. Group-1 consisted of 19 patients with one scar. Group-2 consisted of nine patients with multiple scars without loss of renal function. Group-3 consisted of 126 patients with renal hypodysplasia and/or multiple scars and with separate (split) renal function below 40%. Moreover, 41 age-matched healthy children without chronic disease constituted the control group (Group-4). Serum Gal-3 levels were measured in blood samples of all children.

The mean serum Gal-3 level was higher in patients with RPS than healthy controls (10.9 ± 7.1 ng/ml and 6.9 ± 4.6 ng/ml) (P: 0.01), and it was also assessed separately for each scar group. There was a significant difference between Gal-3 levels and scar groups. The mean serum Gal-3 levels were increased as the degree of RPS increased.

Serum Gal-3 levels are higher in patients with RPS and are thought to be useful in diagnosing RPS and in elucidating its pathophysiology.