Association of urinary vitamin-D binding protein and neutrophil gelatinase-associated lipocalin with steroid responsiveness in idiopathic nephrotic syndrome of childhood

Idiopathic nephrotic syndrome (NS) is one of the most common diseases of childhood. The prognosis depends on the underlying histopathology and response to steroid treatment. A non-invasive biomarker panel that could predict steroid responsiveness in NS would help in avoiding unnecessary exposure to...

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Veröffentlicht in:Indian journal of clinical biochemistry 2022-05, Vol.33 (S1), p.S90
Hauptverfasser: Choudhary, Amit, Raj, P.S. Mohan, Sonal, S, Krishnamurthy, S, Rajappa, M
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Sprache:eng
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Zusammenfassung:Idiopathic nephrotic syndrome (NS) is one of the most common diseases of childhood. The prognosis depends on the underlying histopathology and response to steroid treatment. A non-invasive biomarker panel that could predict steroid responsiveness in NS would help in avoiding unnecessary exposure to high-dose corticosteroids in children with SRNS. Hence we undertook to assess the urine vitamin-D binding protein (VDBP) and neutrophil gelatinase-associated lipocalin (NGAL) levels as predictors of steroid resistance in children with idiopathic NS. This cross-sectional study included three groups: children with SRNS (n = 28), SSNS (n = 28) and healthy controls (n = 28). Urine levels of VDBP and NGAL were measured using commercially available ELISA kits and normalized to urine creatinine (Cr). Urine microalbumin (MALB) was measured using nephelometer and MALB/Cr was computed. uVDBP and uNGAL levels were significantly higher in children with SRNS, when compared with children with SSNS and controls. eGFR showed a significant negative correlation with MALB/Cr, uVDBP and uNGAL. However, uVDBP and uNGAL showed a much higher discriminatory ability for differentiating SRNS than MALB/Cr. uVDBP and uNGAL at cutoff value of 303.81 and 13.1 ng/mL respectively yielded the optimal sensitivity (82 and 86%) and specificity (78 and 89%) to distinguish SRNS from SSNS. Urine levels of VDBP and NGAL are good predictors of steroid resistance in children with idiopathic NS.
ISSN:0970-1915