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Uso de NGAL urinario en el síndrome nefrótico resistente a esteroides frente al síndrome nefrótico sensible a
Aymen Abdalla1, Abdelrahman Ali2, I O Abufatima2
1Faculty of Medicine, University of Khartoum, Alqasr Avenue, P.O. Box 102, Khartoum, Sudan.
BMC nephrology
|August 23, 2025
Resumen
Los niveles urinarios de lipocalina asociada a la gelatinasa de los neutrófilos (NGAL) son significativamente más altos en pacientes con síndrome nefrótico. Los niveles más altos de NGAL en el síndrome nefrótico resistente a esteroides (SRNS) en comparación con el síndrome nefrótico sensible a esteroides (SSNS) sugieren NGAL
Área de la Ciencia:
- Nefrología
- Los biomarcadores
- Enfermedades glomerulares
Sus antecedentes:
- El síndrome nefrótico es un trastorno renal común con respuesta corticosteroide variable.
- La diferenciación temprana entre las formas sensibles a esteroides (SSNS) y las resistentes a esteroides (SRNS) es crucial debido al peor pronóstico de SRNS.
- La lipocalina asociada a la gelatinasa de neutrófilos (NGAL) es un biomarcador que indica una lesión tubular y un posible daño renal.
Objetivo del estudio:
- Revisar sistemáticamente y metaanalizar los estudios sobre los niveles de NGAL urinario en SSNS y SRNS.
- Evaluar el potencial del NGAL urinario como biomarcador no invasivo para diferenciar entre SSNS y SRNS.
Principales métodos:
- Revisión sistemática y metanálisis que se adhieren a las directrices de PRISMA.
- Búsqueda exhaustiva de la literatura en las principales bases de datos científicas.
- Modelo de efectos aleatorios para el análisis estadístico de las diferencias medias estandarizadas (SMD).
Principales resultados:
- Se incluyeron 16 estudios en el metanálisis.
- Los niveles de NGAL urinarios fueron significativamente elevados tanto en pacientes con SSNS como en pacientes con SRNS en comparación con los controles sanos.
- Los niveles de NGAL en orina fueron notablemente más altos en pacientes con SRNS que en pacientes con SSNS (SMD = 1.889).
- Los análisis de ROC indicaron una capacidad moderada a fuerte del NGAL urinario para discriminar entre SRNS y SSNS.
Conclusiones:
- El NGAL urinario muestra un potencial significativo como biomarcador no invasivo.
- NGAL ayuda a distinguir entre SRNS y SSNS, apoyando su utilidad clínica.
- Este biomarcador puede ayudar en el diagnóstico precoz, la estratificación del riesgo y el manejo del paciente.
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