Biomarkers of acute kidney injury in patients with nephrotic syndrome
العنوان: | Biomarkers of acute kidney injury in patients with nephrotic syndrome |
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المؤلفون: | Maria Brandão Tavares, Caroline Vilas Boas de Melo, Paula Neves Fernandes, Maria da Conceição Chagas de Almeida, Marcia Fernanda dos Santos Melo Carneiro, Rilma Ferreira de Souza Santos, Marilia Bahiense-Oliveira, Reinaldo Martinelli, Washington LC dos-Santos |
المصدر: | Brazilian Journal of Nephrology, Volume: 43, Issue: 1, Pages: 20-27, Published: 11 SEP 2020 Jornal Brasileiro de Nefrologia Brazilian Journal of Nephrology, Issue: ahead, Published: 11 SEP 2020 Brazilian Journal of Nephrology, Vol 43, Iss 1, Pp 20-27 (2020) Brazilian Journal of Nephrology v.43 n.1 2021 Sociedade Brasileira de Nefrologia (SBN) instacron:SBN |
بيانات النشر: | FapUNIFESP (SciELO), 2021. |
سنة النشر: | 2021 |
مصطلحات موضوعية: | Adult, medicine.medical_specialty, Nephrotic Syndrome, Urinary system, 030232 urology & nephrology, Lupus nephritis, Urology, Kidney Function Tests, Kidney Injury Molecule 1, 03 medical and health sciences, Glomerulonephritis, Lesão Renal Aguda, 0302 clinical medicine, Lipocalin-2, Glomerulopathy, Humans, Medicine, Lipocalina-2, Minimal change disease, Acute tubular necrosis, 030304 developmental biology, 0303 health sciences, business.industry, Acute kidney injury, Necrose Tubular Aguda, Molécula de lesão renal 1, General Medicine, Kidney Tubular Necrosis, Acute, Acute Kidney Injury, medicine.disease, Diseases of the genitourinary system. Urology, Glomerulonefrite, Cross-Sectional Studies, Original Article, RC870-923, business, Nephrotic syndrome, Biomarkers |
الوصف: | Introduction: Emergence of acute kidney injury (AKI) in patients with nephrotic syndrome (NS) requires prompt diagnosis and differentiation between acute tubular necrosis (ATN) and proliferative glomerulonephritis. We studied the potential use of commercial urinary biomarkers' tests in the diagnosis of AKI in patients with NS. Methods: A cross sectional estimate of urinary concentrations of KIM-1 and NGAL was performed in 40 patients with NS: 9 with proliferative glomerulopathy, being 4 with AKI and 31 without proliferative glomerulopathy, being 15 with AKI. AKI was defined using the KDIGO criteria. Results: The mean age was 35 ± 16 years. The main diagnoses were focal and segmental glomerulosclerosis (10, 25%), membranous glomerulopathy (10, 25%), minimal change disease (7, 18%), lupus nephritis (6, 15%), and proliferative glomerulonephritis (3, 8%). Patients with ATN had higher levels of urinary KIM-1 (P = 0.0157) and NGAL (P = 0.023) than patients without ATN. The urinary concentrations of KIM-1 (P= 0.009) and NGAL (P= 0.002) were higher in patients with AKI than in patients without AKI. Urinary NGAL and KIM-1 levels were significantly higher in patients with ATN without proliferative glomerulonephritis than in patients with proliferative glomerulonephritis (P = 0.003 and P=0.024, respectively). Conclusions: Neutrophil gelatinase associated lipocalin (NGAL) and kidney injury molecule 1 (KIM-1) estimates correlated with histological signs of ATN and were able to discriminate patients with AKI even in conditions of NS. Furthermore, urinary levels of NGAL and KIM-1 may be useful in the differential diagnosis of acute tubular necrosis and exudative glomerulonephritis in patients with nephrotic syndrome. RESUMO Introdução: O surgimento de lesão renal aguda (LRA) em pacientes com síndrome nefrótica (SN) requer diagnóstico imediato e diferenciação entre necrose tubular aguda (NTA) e glomerulonefrite proliferativa. Avaliamos o uso potencial de testes de biomarcadores urinários comerciais no diagnóstico de LRA em pacientes com SN. Métodos: Uma estimativa transversal das concentrações urinárias de KIM-1 e NGAL foi realizada em 40 pacientes com SN: 9 com glomerulopatia proliferativa, sendo 4 com LRA e 31 sem glomerulopatia proliferativa, sendo 15 com LRA. A LRA foi definida usando os critérios da KDIGO. Resultados: A média de idade foi de 35 ± 16 anos. Os principais diagnósticos foram glomeruloesclerose segmentar e focal (10, 25%), glomerulopatia membranosa (10, 25%), doença por lesão mínima (7, 18%), nefrite lúpica (6, 15%) e glomerulonefrite proliferativa (3, 8 %). Os pacientes com NTA apresentaram níveis mais elevados de KIM-1 urinário (P = 0,0157) e NGAL (P = 0,023) do que pacientes sem NTA. As concentrações urinárias de KIM-1 (P = 0,009) e NGAL (P = 0,002) foram maiores em pacientes com LRA do que em pacientes sem LRA. Os níveis urinários de NGAL e KIM-1 foram significativamente maiores em pacientes com NTA sem glomerulonefrite proliferativa do que em pacientes com glomerulonefrite proliferativa (P = 0,003 e P = 0,024, respectivamente). Conclusões: As estimativas de lipocalina associada a gelatinase de neutrófilos (NGAL) e molécula de lesão renal 1 (KIM-1) se correlacionaram com sinais histológicos de NTA, e foram capazes de discriminar pacientes com LRA mesmo em condições de SN. Além disso, os níveis urinários de NGAL e KIM-1 podem ser úteis no diagnóstico diferencial de necrose tubular aguda e glomerulonefrite exsudativa em pacientes com síndrome nefrótica. |
وصف الملف: | text/html |
تدمد: | 2175-8239 0101-2800 |
الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b8b3ef9fae26fe1cd7f5afa5b839e5efTest https://doi.org/10.1590/2175-8239-jbn-2020-0021Test |
حقوق: | OPEN |
رقم الانضمام: | edsair.doi.dedup.....b8b3ef9fae26fe1cd7f5afa5b839e5ef |
قاعدة البيانات: | OpenAIRE |
تدمد: | 21758239 01012800 |
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