BACKGROUND/AIMS: Persistent proteinuria is a sign of renal damage caused by several factors, but it is itself a cause of tubular injury leading to chronic renal failure. Neutrophil gelatinase-associated lipocalin (NGAL) is a stress protein released by tubular cells which urinary excretion (uNGAL) increases in response to various stimuli. METHODS: In the present study we analyzed uNGAL levels in 23 macroproteinuric patients with membranous glomerulonephritis. RESULTS: In these subjects, uNGAL concentrations were significantly higher than in controls, directly correlated with proteinuria and inversely related to residual renal function. Patients were further categorized into two groups, according to a cut-off baseline uNGAL value of 350 ng/ml and evaluated during a 1-year follow-up period. After 12 months, subjects with higher uNGAL levels showed a significant worsening in baseline renal function and a 3.36 risk ratio of developing a severe decrease in GFR (>or=50% of baseline values) compared with others. CONCLUSIONS: These findings suggest that NGAL may play a key role in tubular adaptations to persistent macroproteinuria. Furthermore, a new, interesting application of NGAL measurement could be proposed in clinical nephrology as a predictor of worsening renal function in patients affected by chronic kidney disease. Copyright 2008 S. Karger AG, Basel.
BACKGROUND/AIMS: Persistent proteinuria is a sign of renal damage caused by several factors, but it is itself a cause of tubular injury leading to chronic renal failure. Neutrophil gelatinase-associated lipocalin (NGAL) is a stress protein released by tubular cells which urinary excretion (uNGAL) increases in response to various stimuli. METHODS: In the present study we analyzed uNGAL levels in 23 macroproteinuric patients with membranous glomerulonephritis. RESULTS: In these subjects, uNGAL concentrations were significantly higher than in controls, directly correlated with proteinuria and inversely related to residual renal function. Patients were further categorized into two groups, according to a cut-off baseline uNGAL value of 350 ng/ml and evaluated during a 1-year follow-up period. After 12 months, subjects with higher uNGAL levels showed a significant worsening in baseline renal function and a 3.36 risk ratio of developing a severe decrease in GFR (>or=50% of baseline values) compared with others. CONCLUSIONS: These findings suggest that NGAL may play a key role in tubular adaptations to persistent macroproteinuria. Furthermore, a new, interesting application of NGAL measurement could be proposed in clinical nephrology as a predictor of worsening renal function in patients affected by chronic kidney disease. Copyright 2008 S. Karger AG, Basel.
Authors: Robin S Chirackal; Muthuvel Jayachandran; Xiangling Wang; Samuel Edeh; Zejfa Haskic; Majuran Perinpam; Timothy M Halling; Ramila Mehta; Marcelino E Rivera; John C Lieske Journal: Am J Physiol Renal Physiol Date: 2019-08-28
Authors: Natalia Nowak; Jan Skupien; Adam M Smiles; Masayuki Yamanouchi; Monika A Niewczas; Andrzej T Galecki; Kevin L Duffin; Matthew D Breyer; Nick Pullen; Joseph V Bonventre; Andrzej S Krolewski Journal: Kidney Int Date: 2018-02-02 Impact factor: 10.612