The Expression And Significance Of Neutrophil Genatinase-association Lipocalin In Children With Idiopathic Nephrotic Syndrome

Objective:To study the expression and significance of neutrophil genatinase-association lipocalin (NGAL) in children with idiopathic nephrotic syndrome.Methods:Thirty-four cases of newly diagnosed INS children were fully treated through regular GC treatment. Then all cases were divided into two groups after4weeks according to response to GC treatment:GC-resistant cases as steroid-resistant nephrotic syndrome (SRNS) group, GC-sensitive cases as steroid-sensitive nephrotic syndrome (SSNS) group. Morning midstream urine specimens were obtained before use of glucocorticoids (GC) and1,2,3,4weeks after GC treatment. ELISA was used to detect the uine NGAL concentration. At the same time, thirty-two INS cases with mesangial proliferative glomerulonephritis were selected, including16SRNS and16SSNS of cases. Immunohistochemical methods was used to detect expression of NGAL in renal tissue obtained by renal biopsy, and compared the differentially expression between two group.Results:①At time of0,1and2weeks after GC treatment, there was no statistical difference of urine NGAL/Cr ratio between SSNS and SRNS group (P>0.05). While at time of3and4weeks after GC treatment, urine NGAL/Cr in SSNS group decreased significantly, compared with that of in SRNS group (P<0.05).②t time of0,1,2and3weeks after GC treatment, there was no statistical difference of urine β2-MG/Cr between SSNS and SRNS group (P>0.05). At time of4weeks after GC treatment, urine β2-MG/Cr in SSNS group decreased significantly, compared with SRNS group (P<0.05), and its fall time is later than urine NGAL/Cr.③Urine NGAL/Cr and urine protein/Cr were positively correlated in all of the INS cases (r=0.510, P<0.01).④Expression of NGAL in renal tissue, which tested by immunohistochemistry assay, was significant higher in SRNS group than that of in SSNS group (P<0.01)Conclusions:①rine NGAL level maintains high expression in cases with SRNS. In contrast, urine NAGL levels in cases with SSNS gradually decline after GC treatment and its fall time is earlier than that of urine β2-MG. These results suggested that dynamic monitoring of urine NGAL concentration is useful for early diagnosis of GC cases with sensitive or resistant to GC treatment.②Expression of NAGL in kidney tissue in SRNS cases is significant higer than that of in SSNS cases.